Repository of Research and Investigative Information
Not a member yet
797 research outputs found
Sort by
Comparison of Methylprednisolone Injection Versus Diclofenac Injection in Treatment of Trigger Finger
Get PDFBACKGROUND AND OBJECTIVE: Trigger finger is a condition in the finger that is locked in flexion or has a heterogeneous movement and is one of the most common causes of pain in the hand; the first line of treatment is the use of corticosteroids. Due to the fact that corticosteroid injection has side effects in diabetic patients, therefore, this study was performed to compare the results of injecting non-steroidal anti-inflammatory drugs (NSAIDs) as an alternative treatment instead of corticosteroid injection in trigger finger therapy.
METHODS: This double-blind clinical trial study was performed on 84 patients with trigger finger referred to Shahid Beheshti Hospital in Babol which were divided in two equal groups of 42 individuals of injections of diclofenac and methylprednisolone. The severity of the disease was compared according to the Quinnell classification (with a score of 0-4) and the rate of improvement in the two groups in the first, third, sixth weeks and third, sixth and twelfth months.
FINDINGS: The mean age in the diclofenac injection group was 52±9 years and in the prednisolone group was 53±7 years. There was no statistically significant difference between the two groups in terms of age, sex, presence of
underlying disease, symptoms and duration of disease. The need for re-injection due to no improvement in
symptoms was 34 patients (81%) in the diclofenac group and 20 patients (46%) in the methylprednisolone group (p=0.001). In the methylprednisolone group, the mean Quinnell rank was 1.4±0.8. The rate of recovery was higher in the methylprednisolone injection group than in the diclofenac group. From the beginning of the study to week 6th and from the beginning of the study to the 12th month, the improvement rate in the methylprednisolone injection group was significantly better than the diclofenac group (p=0.0001).
CONCLUSION: The results of the study showed that both treatments are effective in improving the symptoms of trigger finger disease. But corticosteroid injections are associated with better and faster results in long-term and short-term studies
Evaluating the Establishment of the National Program on Regarding of Medical Residents to the Principles of Professional Ethics at the Universities of Medical Sciences Located in the Macro Educational Region Number One
Get PDFBACKGROUND AND OBJECTIVE: Professional assistants are among the learners whose ability in terms of professional ethics and commitment influences their future performance after graduation so that, as an excellent physician, they can combine patient care with confidence and desirable medical skills. Considering that no comprehensive assessment of the national guideline on regarding of establishment of medical residents to the professional ethics has been published, so far this study aimed to evaluate the activities of medical universities to conduct this program.
METHODS: This cross-sectional study was conducted to assess the activities of the major medical universities in region one, where had medical residents, during 2015-2018. Information on the formation of committees related to the evaluation of feedback, teaching the basics of professional ethics and how to respond to residents by asking managers of different levels of the university in the Medical Ethics Council, the Vice Chancellor for Education, medical School, department heads and departments Educational and medical centers with assistants.
FINDINGS: Four universities of medical sciences (80% of the target population) with 4 faculties, 8 educational hospitals and 8 educational departments were evaluated. The implementation and activities of committees to investigate the professional ethics of assistants in the educational departments and hospitals of different universities has not been exactly in accordance with national guidelines. The hospital committee and the medical school committee have been established in accordance with the national guideline only at one university. None of the universities in the region had a fourth-level university committee.
CONCLUSION: This study shows the establishment of a national program of commitment of medical assistants to the principles of professional ethics in the majority of macro medical universities in region one and the attention of different levels of universities, including senior administrators, faculties, educational centers and clinical departments in different dimensions of this program especially training for assistants to commitment to professional principles in these universities
A brief review of the latest pharmacological treatments of COVID-19
Get PDFNew Coronavirus which is called 2019-nCoV (2019-Novel-Coronavirus) or SARS-Cov-2 (Severe Acute respiratory Syndrome-Coronavirus 2) causes deadly pneumonia that first appeared in December 2019 in Wuhan city in China. This virus spreads all over the world quickly and made several problems for the community and healthcare system. Several drugs have been tried to manage COVID-19; however, our knowledge of this virus is not complete. At any rate, effective treatment or vaccine for this disease has not been discovered yet. Furthermore, to achieve this goal, more studies are needed on the structure of the virus and its pathogenesis mechanism. In this article, we summarized several articles suggesting treatments of COVID-19
Comparison of intermittent and continuous monitoring on endotracheal cuff pressure changes in patients in intensive care units
Get PDFBACKGROUND AND OBJECTIVE: During patients’ admission to intensive care units (ICUs) and use of an endotracheal tube, the cuff pressure may increase or decrease, both of which are harmful for patients. The best method to measure and maintain the endotracheal tube cuff pressure and also the appropriate times for measurement are not known. This study was conducted to compare the effect of intermittent monitoring with that of continuous monitoring on changes in endotracheal tube cuff pressure in patients admitted to ICUs.
METHODS: This descriptive comparative study was conducted on 61 intubated patients undergoing mechanical ventilation, aged >18 years, and admitted to ICU. The cuff pressure was first controlled using a manometer, adjusted on 25cm water, monitored continuously for 6 hours using the transducer attached to the monitor, and finally, controlled again using the manometer and modified if necessary. After these procedures, the mean cuff pressure and its changes during the continuous monitoring were compared with those during the two times of intermittent monitoring, and the error rate and limits of agreement were estimated using Bland-Altman test.
FINDINGS: The results showed that the mean cuff pressure in the two times of intermittent monitoring was statistically significant (P<0.005). Moreover, the values over the monitoring time fluctuated, but these variations were not statistically significant (P=0.051). The results revealed that the error rate and limits of agreement in both monitoring methods were -1.43±3.99 and -9.41-6.32, respectively.
CONCLUSION: Considering the error rate and limits of agreement in both methods and their clinical importance, further studies are needed to distinguish the more suitable and preferable method. However, it can be suggested that regular measurement intermittently can keep the cuff pressure in the normal range to a great extent
Glucose-6-phosphate dehydrogenase enzyme deficiency in Iranian newborns: A systematic review and meta-analysis
Get PDFBackground: The aim of this study was to perform a systematic review and meta-analysis on available data about glucose-6-phosphate dehydrogenase enzyme deficiency (G6PDD) status in Iranian neonates screened for the disease. Methods: A literature search was conducted in electronic databases of Embase, PubMed, Web of Sciences, Scopus and Google Scholar for articles published from inception to 1 December 2018. Moreover, the literatures from Iranian databases, including Magiran and Scientific Information Database were searched. We included observational studies reporting prevalence of G6PDD, related complications and genetic factors among Iranian neonates. Data were analyzed using STATA software. Results: Of 656 articles were initially found, 16 were finally included. Overall pooled prevalence of G6PDD was 5.5 (95 confidence interval: 2-8.9). Analysis also indicated that boys were significantly 3 times more at risk of G6PDD compared with girls. Three articles were identified related to the jaundice and 4 papers related to kernicterus. A range of 43-67 of newborns with G6PDD presents with jaundice. Additionally, 5-9 of G6PDD cases with jaundice present with kernicterus. One article reported that out of 412 newborns, 12.9 were carriers for one of the three G6PD gene mutations, including Mediterranean, Chatham and Cosenza. Conclusions: Prevalence of G6PDD in Iran is comparable to most countries. Jaundice and kernicterus are major complications of G6PDD. Therefore, it is necessary to pay attention to all patients with G6PDD. Also, it is recommended that hospitals provide the result of G6PD testing as soon as possible and before discharging newborn children
The assessment of function, histopathological changes, and oxidative stress in liver tissue due to ionizing and non-ionizing radiations
Get PDFBackground: Compared to past decades, humans are exposed to rapidly increasing levels of radiofrequency electromagnetic radiations (RF-EMF). Despite numerous studies, the biological effects of human exposure to different levels of RF-EMF are not fully understood yet. This study aimed to evaluate the bioeffects of exposure to "900/1800 MHz" and “2.4 GHz" RF-EMFs, and x-rays alone as well as their potential interactions, i.e. inducing simple additive, adaptive, or synergistic effects. Methods: 120 Wistar rats were randomly divided into ten groups of 12 each. The rats were exposed to RF-EMF, 10 cGy, and 8 Gy x-rays, a combination of these exposures, or only sham-exposed. The levels of liver enzymes were determined in serum samples by an autoanalyzer. Moreover, the histopathological changes, and the levels of malondialdehyde (MDA), nitric oxide, ferric reducing antioxidant power, total thiols, and protein carbonyl (PCO) were measured. Results: Among the markers of liver function, gamma-glutamyltransferase was not associated with irradiation but, aspartate transaminase, alanine transaminase, and alkaline phosphatase showed some levels of association. MDA and PCO levels after 8 Gy irradiation increased, but pre-exposure to RF-EMF could modulate their changes. At the cellular level, the frequency of lobular inflammation was associated with the type of intervention. Conclusion: The exposure to both ionizing and non-ionizing radiations could alter some liver function tests. A short term pre-exposure to RF-EMF before exposure to an 8 Gy challenging dose of x-rays caused the alterations in oxidative stress markers and liver function tests, which indicate that oxidative stress is possibly involved in the adaptive response
Epidemiologic comparison of the first and second waves of coronavirus disease epidemics in Babol, North of Iran
Get PDFBackground: A few studies compared the epidemiologic features of the first and second waves of coronavirus disease 2019 (COVID-19) outbreak. This research was carried out to compare the 1st and the 2nd waves of the epidemics in the northern Iran. Methods: In this observational research, demographic, clinical and laboratory characteristics of the patients with COVID-19, admitted to four government hospitals affiliated to Babol University of Medical Sciences during the 1st and the 2nd waves of COVID-19 epidemics have been compared. The period from May 21, 2020 to September 21, 2020 was considered as the second wave of the epidemics while from February 19, 2020 to May 20, 2020, as the first wave of the outbreak in this region. Results: Out of 6691 total hospitalized cases, 4374 (65.37), including 1532 (49.6) people in the first wave and 2842 (78.9) in the second wave had RT-PCR test for disease confirmation. Among those who were examined with RT-PCR test, 2322 patients (53.1) including 728 (31.4) persons in the first wave and 1594 (68.6) in the second wave were positive for SARS-CoV-2 RNA. 414 (56.9) of the confirmed cases in the first wave and 767 (48.1) in the second wave were males (p<0.001). Gastrointestinal symptoms were more incidental in the second wave of the disease. However, severe respiratory conditions were more common during the first wave (p<0.001). Crude mortality rate was lower in the second wave of the outbreak (p<0.001). Conclusion: Different epidemiologic characteristics were found in the second wave of COVID-19 outbreak in comparison with the first wave of the epidemics in northerrn Iran
Determining the Midwifery Staff in the Maternity Ward of Hospitals Using the Birthrate Plus Model
Get PDFBACKGROUND AND OBJECTIVE: In addition to reducing the costs in hospitals, manpower planning can ensure the quality of patient care. Therefore, this study, which is part of a comprehensive study, was conducted with the aim of applying the birth rate method to estimate the number of midwives required in the maternity ward.
METHODS: In this analytical study, 334 patients who referred to the delivery ward of two hospitals affiliated to the Social Security Organization in Khorasan Razavi province were selected by systematic random sampling. Retrospective data were collected from patients' medical records using the Birthrate Plus (BR+) model questionnaire consisting of 34 items related to maternal and neonatal clinical factors based on scores obtained in five groups (score 6 in group one, score 7-9 in group two, score 10-13 in group three, score 14-18 in group four, and score 19 and above in group five). Then, the data were analyzed.
FINDINGS: The results showed that the duration of stay in the maternity wards of the province and district hospitals was 12.07±5.18 and 7.17±4.22 hours, respectively (p<0.001). The mean duration of midwife's care in the two hospitals was significantly different (p<0.001). The results indicated more patients with complex conditions in the maternity ward of the province hospital. According to the "BR+" model, about 60% of patients in the province hospital were in groups 4 and 5, while it was 18% in another hospital. The number of midwives required in district and province hospitals was 27 and 72, respectively, based on full-time equivalent (FTE), which was obtained by converting it into an index equivalent to one midwife for 142 and 95 annual deliveries in the mentioned hospitals.
CONCLUSION: The results of the study showed that the use of the BR+ model, considering the length of stay and the severity of clients' symptoms, is a suitable model for determining the midwifery staff in the maternity ward
The Role of Gnrh Analogues in 36-Month Disease-Free Survival in Non-Menopausal Patients with Hormone Receptor-Positive Breast Cancer
Get PDFBACKGROUND AND OBJECTIVE: The effectiveness of ovarian function suppression therapies in patients with non-menopausal breast cancer has not yet been established. This study was performed to evaluate the role of gonadotropin-releasing hormone agonist (GnRH agonist) receptor in reducing local recurrence or metastasis in non-menopausal women with localized breast cancer.
METHODS: This clinical trial was performed on 104 non-menopausal women with localized and advanced localized breast cancer (in stages 2 and 3) with positive hormone receptor (HR+) in the two groups of control and intervention with GnRH analog. The control group received standard treatment at the time of the study, which included tamoxifen. The GnRHa group received 3.75 mg triptorelin subcutaneously per month in addition to the standard treatment. Patients were evaluated for local recurrence and metastasis within 36 months.
FINDINGS: The mean age of patients was 39.78±3.99 years. 9 patients in the control group (mean metastasis time of 17±6.65 months) and 6 patients in the GnRHa group (mean metastasis time of 14.33±8.12 months) had metastasis (p=0.498). The 36-month disease-free survival was 83.3% in the control group and 88% in the GnRHa group (p=0.518). 36-month disease-free survival in patients with HER2, 1+ or higher levels was greater in the GnRHa group compared to controls (p=0.049). In patients who received GnRH analogues, patients with HER2/neu 1+ and above had 20.7% less metastasis than patients with HER2 0 (p=0.029). However, this significant difference was not seen in the control group and other variables.
CONCLUSION: According to the results of this study, GnRH analogues do not have a significant effect on reducing the rate of metastasis in patients who received it compared to other patients in a short-term period
Frequency of middle mesial canal and radix entomolaris in mandibular first molars by cone beam computed tomography in a selected Iranian population
Get PDFIntroduction: Although there are many studies about the internal anatomy of mandibular molars, there is still controversy over the frequency of middle mesial canals and isthmuses in the mesial root of mandibular molars and distolingual third root (Radix entomolaris) that it can be seen in any population, but it is more frequent in Asians and makes endodontic treatment difficult. Because of limited studies on the middle mesial canal, isthmus in north of Iran; therefore, the aim of this study was to investigate the frequency of these variations in the north of country.
Materials & Methods: In this retrospective cross-sectional study, The cone beam computed tomography (CBCT) images of 200 mandibular first molar teeth without any root canal treatment and completely erupted and developed were evaluated. Samples with open apex, internal root resorption, calcification, crown and extensive restoration were excluded. The patients’ gender, age, tooth location (left and right), count of canals in the mesial root, presence or absence of isthmus in mesial root, middle mesial canal and isthmus level in the mesial root and distolingual root (Radix entomolaris) were studied in three groups based on age; 40.
Results: From 200 samples, 18 teeth (9%) had middle mesial canal, 38 teeth (19%) had isthmus in mesial root and 6 teeth (3%) had distolingual root (Radix entomolaris).
Conclusion: due to the high frequency of isthmuses, middle mesial canals and Radix entomolaris in the population, which cannot be ignored, missing and treating these spaces could be one of the main reasons for failure in root canal treatment. Therefore, it is advised to put more effort into detecting and completely clean and obturate these spaces in surgical and non-surgical endodontic treatments