Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Comparative analysis of ICSI outcomes with testicular or secondary ejaculated sperm in men with oligoasthenoteratozoospermia
No full textObjectiveTo investigate the comparative outcomes of intracytoplasmic sperm injection (ICSI) using sperm from testicular biopsies versus secondary ejaculated sperm in men with oligoasthenoteratozoospermia (OAT), aiming to identify optimal strategies for improving fertility success rates.MethodsThis prospective study involved 36 infertile men with OAT undergoing ICSI treatment. On the day of oocyte retrieval, a semen sample through short-interval secondary ejaculation was obtained from each patient and also they underwent testicular sperm retrieval using fine needle aspiration (FNA). Sibling MII oocytes were randomly allocated to two groups: those injected with sperm from secondary ejaculation and those injected with testicular sperm from FNA. Embryo quality, fertilization rates, and blastocyst formation rates were compared as primary outcomes of the study.ResultsA total of 42 participants were enrolled, with 36 completing the analysis. The second ejaculation showed significantly enhanced progressive sperm motility and lower sperm DNA fragmentation compared to the first. ICSI outcomes revealed no significant differences in fertilization rate (76.48 vs. 75.17, P = 0.46), blastocyst formation rate (57.50 vs. 57.86, P = 0.65), and cleavage rate (85.18 vs. 86.81, P = 0.31) between secondary ejaculation and FNA groups. High-quality embryos were slightly more in the secondary ejaculation group (2.61 +/- 1.61 vs. 2.47 +/- 1.56, P = 0.06).ConclusionsWhile testicular sperm retrieval via FNA has been a standard approach in ICSI for men with OAT, secondary ejaculation presents a valuable alternative that can achieve comparable embryological outcomes. This approach could be a less stressful and equally effective option for OAT patients who prefer less invasive procedures, potentially enhancing reproductive success in men with OAT. Further studies with larger sample sizes that investigate clinical pregnancy and live birth rates are needed to confirm these findings and address our limitations
A Review on Radiologic Hot Cross Bun Sign and Related Clinical Conditions
No full textThe hot cross bun (HCB) sign is a cruciform-shaped hyperintensity on axial T2 weighted-image magnetic resonance imaging (MRI), mostly reported with multiple system atrophy (MSA). However, several other diagnoses were reported with this radiologic manifestation as well. This review investigates the wide spectrum of disorders in which the HCB sign has been reported as a positive radiologic manifestation. This narrative review was conducted using the PubMed database. Studies reporting the HCB sign in their manuscript are included in this manuscript. 83 studies with available full text met the inclusion criteria for this review. The total number of reported patients with HCB sign is addressed in the manuscript. In addition to MSA, the HCB sign has been reported in various other disorders, including spinocerebellar ataxia, malignancies, infections, autoimmune disorders, and some vascular and ischemic changes. Any disorder involving the pontocerebellar fibers can manifest the HCB sign following the gliosis changes or infarction-mediated damage to the region, whether due to gliosis changes. The range of diseases linked to the HCB sign is broader than previously recognized, as numerous disorders affect the transverse pontocerebellar fibers and cause radiologic HCB manifestation. MSA remains the most common condition; however, clinicians should consider alternate differential diagnoses in patients displaying the HCB sign in whom clinical presentation is not typical of MSA
Scleritis in Iran
No full textPurposeTo present the demographic and clinical presentations of anterior scleritis among Iranian patients.MethodsThis retrospective case-series at a tertiary center in Iran, identified and analyzed anterior scleritis cases admitted from 2008 to 2018. Extracted data included demographics, clinical features, background systemic diseases, utilized therapies, and follow-up data on visual outcomes, ocular complications, and recurrence rate. Patients with incomplete records were excluded from the analysis.ResultsSixty-five patients (83 eyes) with anterior scleritis were included, with a female predilection (77) and a mean age (+/- SD; range) of 44.8 (+/- 14.6; 11-81). Diffuse and necrotizing scleritis were the most and least common subtypes, respectively. Bilateral involvement (28 at baseline, 44.6 eventually) and concurrent keratitis (10.7) or uveitis (16.9) were documented in some cases. Most cases were idiopathic (61.5). Scleritis was the initial manifestation of autoimmune diseases in six patients. In addition to oral and/or intravenous corticosteroid therapy, most of our patients (70.7) were treated with immunosuppressive regimens. No inter-subtype difference was noted in recurrence rate and time to treatment cessation. Necrotizing subtype was associated with worse visual outcomes and more frequent ocular complications.ConclusionDespite limitations in data collection and follow-up, our findings contribute valuable insights into the clinical characteristics and management of scleritis in a group of Iranian patients for the first time
Effect of Electrical Heat Carrier Temperature on Bacterial Leakage of Endodontically Treated Teeth Using a Bioceramic Sealer
No full textObjectivesThe aim of this study is to investigate the effect of electrical heat carrier temperature on bacterial leakage of root canals obturated with the continuous wave of condensation (CWC) technique and a bioceramic sealer.MethodsThis ex vivo experimental study was conducted on 92 extracted single-rooted teeth. The teeth were subjected to endodontic treatment and obturated with the Endoseal MTA bioceramic sealer by the CWC technique using two different temperature settings of the electrical heat carrier: 120 degrees C (group G120, n = 41) and 200 degrees C (group G200, n = 41). A positive and a negative control group were also considered (n = 5 each). Bacterial leakage was assessed over a 40-day period using a bacterial leakage model. The incidence of bacterial leakage was compared between the experimental groups using the log-rank test. The significance level was set at 0.05.ResultsThe median survival rate was 39.0 (25.0) days in the G120 group and 34.0 (25.0) days in the G200 group. Despite a slightly higher survival rate in the G120 group, the difference between the two experimental groups was not statistically significant (p = 0.612).ConclusionThe tested temperatures of the electrical heat carrier (120 degrees C and 200 degrees C) did not have a significant effect on bacterial leakage of root canals obturated by the CWC technique and the Endoseal MTA bioceramic sealer
Effectiveness of a bioenergy economy program versus mindfulness-based cognitive therapy on the severity and psychological symptoms of irritable bowel syndrome
No full textBACKGROUND:Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder causing a great burden on patients' lives due to its physical and psychological symptoms. Mindfulness-based cognitive therapy (MBCT) has previously alleviated IBS symptoms. Bioenergy economy (BEE) is a novel mind-body intervention that has shown moderating effects on many psychological and physical symptoms, particularly in chronic diseases. This research aimed to compare the effectiveness of MBCT and BEE on IBS symptom severity, somatic symptoms, depression, and anxiety. MATERIALS AND METHODS:This study was conducted using a quasi-experimental method with a pre-test, post-test, and follow-up design with a control group in Isfahan, Iran. Forty-five patients with IBS were divided into two experimental and one control group (15 subjects in each group). The patients were assessed using the ROME III Diagnostic Criteria for IBS, IBS Severity Index (IBS-SI), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory, and Patient Health Questionnaire (PHQ-15) before and after the intervention. Data were analyzed using analysis of covariance, and SPSS-22 software was used. RESULTS:The findings showed that MBCT and BEE both had significant effects on the IBS symptom severity, somatic symptoms, depression, and anxiety (P 0.05). This concludes that there was no difference between the effectiveness of MBCT and BEE programs (P > 0.05). CONCLUSION:Although both interventions had significant results in improving patients' symptoms, the BEE program had a stronger and wider range of effectiveness
Evaluation of anti-SARS-CoV-2 RBD antibody response after booster dose of SpikoGen® in individuals with two previous doses of Sinopharm and its association with HLA-DR and -DQ alleles
No full textBackground: It has been demonstrated that COVID-19 vaccines confer significant protection, but temporal decay in the vaccine-induced antibodies has been reported; therefore, a third booster dose was considered. Human leukocyte antigen (HLA) class II molecules act as antigen presenting structures, play critical roles in the formation of an efficient antibody response. The current study aimed to evaluate the anti-receptor binding domain (RBD) antibody response after the booster dose of SpikoGen (R) vaccine in individuals with a history of Sinopharm primary vaccination series and its association with HLA-DQB1 and -DRB alleles. Methods: Whole blood samples were drawn from 95 eligible individuals before and three weeks after the booster dose of SpikoGen (R). Quantitative measurement of anti-RBD IgG and qualitative assessment of anti-RBD IgA was performed using the ELISA method and HLA-DQB1 and -DRB loci were genotyped by low-resolution SSP- PCR method. Results: A significant increase was observed in the anti-RBD IgG antibodies after the booster dose of SpikoGen (R) (baseline: 1.82 +/- 0.55 GMT, after: 2.28 +/- 0.36 GMT)(P < 0.0001). The median fold change of anti-RBD IgG antibodies for DRB1*14 positive individuals (3.96 (1.47-31.75)) was significantly higher than DRB1*14 negative people (1.18 (1.08-1.34))(P = 0.008). In addition, the median fold change of anti-RBD IgG antibodies for DQB1*04 positive individuals (1.39 (1.21-3.43)) was higher than those which were DQB1*04 negative (1.18 (1.08-1.34)), however it was marginally significant (P = 0.060). The seroconversion incidence for anti-RBD IgA antibodies was 68.42 . Conclusion: In conclusion, our study showed that the booster dose of SpikoGen (R) can elicit a robust anti-RBD antibody response which was positively associated with DRB1*14 allele
Unveiling the dynamics of team cognition in emergency response teams
No full textBackground Effective emergency response in various industries depends on the synergy between team coordination and cognitive abilities. Industries should prioritize investing in the development of team cognition to improve readiness and ensure swift, effective responses to emergencies and crises. This study aimed to identify and model factors influencing team cognition within Emergency Response Teams (ERTs).Methods This cross-sectional study undertook two principal phases: qualitative research using meta-synthesis and quantitative research using Best Worst Method (BWM), Interpretive Structural Modeling (ISM), and Fuzzy Cognitive Mapping (FCM). These methods were employed to assign weights to factors, establish their hierarchy, and determine cause-and-effect relationships among team cognition shaping factors (TCSFs).Results Through a comprehensive evaluation of the articles, 13 dimensions were identified as the primary TCSFs influencing team cognition. The reliability of the extracted factors was validated using the Kappa indicator, with a value of 0.63 signifying an acceptable level of agreement. Using BWM analysis, "Team maturity (The team members' harmonization)" and "Inefficient 4Cs (communication, coordination, cooperation, and collaboration)" were identified as the most influential factors shaping team cognition, with weights of 0.132 and 0.112, respectively. ISM analysis revealed "Improper team training programs" as a critical independent factor influencing other dimensions. FCM modeling further emphasized the significance of "Failure in decision-making" and "Leadership behavior and performance" as pivotal contributors to team cognition, with "Team maturity" and "Inefficient 4Cs" achieving the highest centrality scores of 13.44 and 13.28, respectively.Conclusion Stakeholders can enhance team performance and effectiveness in emergency situations by understanding the relative importance of various factors, their hierarchical relationships, and the causal links between them. This allows for informed decision-making and targeted interventions, such as training programs to improve team maturity and team communication
Multivariate Gaussian Bayes classifier with limited data for segmentation of clean and contaminated regions in the small bowel capsule endoscopy images
No full textA considerable amount of undesirable factors in the wireless capsule endoscopy (WCE) procedure hinder the proper visualization of the small bowel and take gastroenterologists more time to review. Objective quantitative assessment of different bowel preparation paradigms and saving the physician reviewing time motivated us to present an automatic low-cost statistical model for automatically segmenting of clean and contaminated regions in the WCE images. In the model construction phase, only 20 manually pixel-labeled images have been used from the normal and reduced mucosal view classes of the Kvasir capsule endoscopy dataset. In addition to calculating prior probability, two different probabilistic tri-variate Gaussian distribution models (GDMs) with unique mean vectors and covariance matrices have been fitted to the concatenated RGB color pixel intensity values of clean and contaminated regions separately. Applying the Bayes rule, the membership probability of every pixel of the input test image to each of the two classes is evaluated. The robustness has been evaluated using 5 trials; in each round, from the total number of 2000 randomly selected images, 20 and 1980 images have been used for model construction and evaluation modes, respectively. Our experimental results indicate that accuracy, precision, specificity, sensitivity, area under the receiver operating characteristic curve (AUROC), dice similarity coefficient (DSC), and intersection over union (IOU) are 0.89 +/- 0.07, 0.91 +/- 0.07, 0.73 +/- 0.20, 0.90 +/- 0.12, 0.92 +/- 0.06, 0.92 +/- 0.05 and 0.86 +/- 0.09, respectively. The presented scheme is easy to deploy for objectively assessing small bowel cleansing score, comparing different bowel preparation paradigms, and decreasing the inspection time. The results from the SEE-AI project dataset and CECleanliness database proved that the proposed scheme has good adaptability
Fruit and Vegetable Consumption and Risk of All-Cause and Cause-Specific Mortality in Individuals With Type 2 Diabetes: A Systematic Review and Dose-Response Meta-analysis of Prospective Cohort Studies
No full textContext Controversy exists regarding the association between fruit and vegetable consumption and all-cause and cause-specific mortality among individuals with type 2 diabetes (T2D).Objective This study aims to inform dietary recommendations and add to the body of evidence by providing a thorough investigation of the association between the consumption of fruits and vegetables and the mortality risk in patients with T2D. The literature on this association was evaluated by a comprehensive systematic review and meta-analysis.Data Sources PubMed, Scopus, and Web of Science were searched up to 29 June 2024.Data Extraction Prospective cohort studies involving participants with diabetes aged over 18 years reporting risk estimates for the association between total fruit and vegetable intake and all-cause or cause-specific mortality (including cardiovascular disease CVD, coronary heart disease, and stroke) were included.Data Analysis A random-effects approach was applied for combining risk estimates, and dose-response relationships were assessed using restricted cubic splines. Overall, 9 studies with 75 082 participants and 7590 deaths were included. Compared with the lowest intake, the highest fruit intake was associated with a decreased risk of all-cause (hazard ratio HR: 0.82; 95% CI: 0.75, 0.90; n = 6) and CVD (HR: 0.90; 95% CI: 0.84, 0.97; n = 4) mortality. The highest vegetable intake was also related to reduced all-cause (HR: 0.85; 95% CI: 0.73, 0.98; n = 6) and CVD (HR: 0.97; 95% CI: 0.94, 0.99; n = 2) mortality risk. An additional 200 g/day of fruit and vegetable consumption was associated with a 26% and 14% lower risk of all-cause mortality.Conclusion This meta-analysis indicates an inverse association between fruit and vegetable intake and mortality from all causes and CVD in T2D patients.Systematic Review Registration PROSPERO registration no. CRD42024571094
The Nurses' Attitudes Towards Patients With Non-Suicidal Self-Injury: Development and Preliminary Validation
No full textAim Non-suicidal self-injury (NSSI) is a public health problem throughout the world. Nurses are usually the first caregivers in the mental health team who deal with people with NSSI. Since the consequences of self-injury are associated with its care and treatment, nurses' attitudes towards these people are an important issue. This study aimed to develop and test a scale to measure nurses' attitudes towards patients with non-suicidal self-injury in the Farsi language. Design A methodological survey. Methods In this methodological study, to scale preparation, psychometric steps were performed on a questionnaire based on the results of a qualitative study and literature review. Exploratory Factor Analysis was conducted to identify the underlying structure of the scale. Results The results of the psychometric evaluation showed that the scale included the 22-item NANSSI in four dimensions, including negativism about the consequences of caring, adopting a counselling approach, violating caring norms, and perceptions about self-injury. By Cronbach's alpha equal to 0.75, its reliability is estimated. This scale showed a good validity and reliability, which is applicable to evaluate quality of care for patients with non-suicidal self-injury