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Dietary Antioxidant Index and the Risk of Recurrent Aphthous Stomatitis
No full textBACKGROUND: Recurrent aphthous stomatitis (RAS) is a common condition that affects the oral mucosa. Antioxidants are crucial in neutralizing free radicals in the body and may have a preventive role against RAS. This study aims to examine the association between dietary antioxidant index (DAI) and RAS occurrence. METHODS: This cross-sectional study was conducted on 144 individuals with RAS and 135 individuals without RAS. The dietary intake of the participants was assessed using the food frequency questionnaire. The DAI was applied to measure the antioxidant capacity of the diet. Logistic regression models were applied to assess the link between RAS and DAI after adjusting the confounding variables. RESULTS: There was a significant negative association between RAS and DAI of zinc (OR = 0.639, CI95: 0.456-0.896, P = .009) and total score of DAI (OR = 0.802, CI95: 0.682-0.944, P = .008) after adjustment for age. The results remained significant after further adjustment for body mass index and calorie intake. CONCLUSION: The present study indicated a possible negative association between the risk of RAS and the DAI score as a measure of the antioxidant potential of diet. Further studies are warranted
Predictors of relapse risk and treatment response in AQP4-IgG positive and seronegative NMOSD: A multicentre study
No full textBACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) can be categorised into aquaporin-4 antibody (AQP4-IgG) NMOSD or seronegative NMOSD. While our knowledge of AQP4-IgG NMOSD has evolved significantly in the past decade, seronegative NMOSD remains less understood. This study aimed to evaluate the predictors of relapses and treatment responses in AQP4-IgG NMOSD and seronegative NMOSD. METHODS: This was a multicentre, international, retrospective cohort study using the MSBase registry. Recurrent relapse risk was assessed using an Andersen-Gill model and risk of first relapse was evaluated using a Cox proportional hazards model. Covariates that putatively influence relapse risk included demographic factors, clinical characteristics and immunosuppressive therapies; the latter was assessed as a time-varying covariate. RESULTS: A total of 398 patients (246 AQP4-IgG NMOSD and 152 seronegative NMOSD) were included. The AQP4-IgG NMOSD and seronegative NMOSD patients did not significantly differ by age at disease onset, ethnicity or annualised relapse rate. Both low-efficacy and high-efficacy immunosuppressive therapies were associated with significant reductions in recurrent relapse risk, with notably greater protection conferred by high-efficacy therapies in both AQP4-IgG NMOSD (HR 0.27, 95 CI 0.15 to 0.49, p<0.001) and seronegative NMOSD (HR 0.21, 95 CI 0.08 to 0.51, p<0.001). Longer disease duration (HR 0.97, 95 CI 0.95 to 0.99, p<0.001) and male sex (HR 0.52, 95 CI 0.34 to 0.84, p=0.007) were additional protective variables in reducing the recurrent relapse risk for the AQP4-IgG NMOSD group. CONCLUSION: Although further studies are needed to improve our understanding of seronegative NMOSD, our findings underscore the importance of aggressive treatment with high-efficacy immunotherapies in both NMOSD subtypes, regardless of serostatus
Breaking down barriers and building up facilitators of lecture free curriculum in medical education: An interpretive structural modeling
No full textINTRODUCTION: The field of medical education has seen a growing interest in lecture free curriculum. However, it comes with its own set of challenges and obstacles. In this article, we aim to identify the prerequisites, facilitators, challenges, and barriers of lecture-free curriculum in medical education and examine their interrelationships using interpretive structural modeling (ISM) technique. METHODS: In this mixed-method study initially, we performed a scoping review and semi-structured interviews and determined the main prerequisites, facilitators, challenges, and barriers of lecture-free curriculum in medical education using qualitative content analysis approach. The interrelationships among these components were investigated using ISM. Therefore, self-interactive structural matrices were formed, initial and final reachability matrices were achieved, and MICMAC analysis was conducted to classify the factors. RESULTS: Finally, two ISM models of prerequisites and facilitators with 27 factors in 10 levels and challenges and obstacles with 25 factors in eight levels were developed. Each of the models was divided into three parts: key, strategic, and dependent factors. 'Providing relevant evidence regarding lecture free curriculum' emerged as the most important prerequisite and facilitator, and 'insufficient support from the university' was identified as the most critical barrier and challenge. CONCLUSIONS: The study highlights the significant importance of lecture-free curriculum in medical education and provides insights into its prerequisites, facilitators, challenges, and barriers. The findings can be utilized by educational managers and decision-makers to implement necessary changes in the design and implementation of lecture-free in medical education, leading to more effective improvements in the quality and success of education
Examining the Adherence to the Guidelines of the European Urology Association in Thromboembolic Events Prophylaxis, the Latest Edition of 2022, in Patients Undergoing Urological Surgery in Al-Zahra Hospital in 2022
No full textBackground: Many guidelines, such as the European Society of Urology, recommend preventing thromboembolic events in urological surgery patients. However, many healthcare providers are not fully following these guidelines. For this purpose, the present study investigated the adherence to the approaches of the European Urological Association, the latest edition of 2022, in patients undergoing urological procedures. Methods: To conduct this descriptive cross-sectional study, we used data from patients who had urological surgery at Al-Zahra Teaching Hospital in Isfahan during the first three months of 2022. We used a checklist to gather information on patients' demographic details, risk factors associated with thromboembolism, and data on prophylaxis management. Findings: During the specified time, 334 patients were identified (69.5 male; mean age 54.28 ± 16.93). The results indicated an 89.2 compliance with the guideline among patients with a strong recommendation for prophylaxis. For patients with a weak recommendation, the adherence rate was calculated at 85.2. The compliance rate with the duration of prophylaxis was 60.6. The most prescribed procedures were partial open nephrectomy and open radical nephrectomy, both below the limit (33), while laparoscopic radical nephrectomy (53.8) and sling surgery (37.5) had higher than expected prescription rates. Conclusion: In general, the study's results indicated proper adherence to the mentioned guidelines. However, more research is needed in this field to outline the conditions for prescribing thromboembolism prophylaxis. © 2025 Isfahan University of Medical Sciences(IUMS). All rights reserved
Piriform Sinus Neurofibroma in a Patient with Neurofibromatosis Type 1: A Case Report
No full textBackground and Objective: Neurofibromatosis is a medical disorder associated with nerve and skin tumors. These tumors can affect the brain, spinal cord and peripheral nerves. The present study was conducted to introduce a rare case of piriform sinus neurofibroma in a patient with neurofibromatosis type 1. Case Report: The patient is an 11-year-old boy who had a history of surgery for neurofibroma on the right side of the neck and was referred for mass removal surgery due to a palpable mass on the left side of the neck, with no other specific symptoms. During the preparation for the surgery, the anesthesiologist noticed a mass in the larynx area, which led to surgery cancellation and the MRI images were reviewed again. After two weeks, the patient returned to the hospital to have the laryngeal mass removed. During laryngoscopy, the surgeon identified and removed a submucosal mass in the larynx area. After examination of the lesion by a pathologist, asymptomatic neurofibroma was diagnosed. The primary treatment for this patient included surgery to remove the neurofibromatosis-associated tumors. The result of the treatment was successful, and a one-year follow-up treatment was carried out, which included post-surgery care, periodical imaging, evaluation of the nervous system and examination of other symptoms of neurofibromatosis along with close monitoring. Conclusion: Based on the results of this study, the identification of neurofibromatosis-associated masses in uncommon places such as the larynx requires precision in imaging and surgical evaluations. © 2024 Babol University of Medical Sciences. Published by Babol University of Medical Sciences
Comparison of Macrophage Frequency in Common Oral Cavity Reactive Lesions
No full textBackground and Objective: Oral reactive lesions are the most common oral disease. Recent studies have insisted on the presence of macrophages as a crucial component of oral reactive lesions’ microenvironment. The aim of the present study was to compare the macrophages frequency in three common oral reactive lesions by marker CD68 in order to determine the relationship between the frequency of macrophages and the type of the lesion. Methods: In this cross-sectional analytic study, 20 samples of each of the three groups of pyogenic granuloma (PG), irritation fibroma (IF), and peripheral ossifying fibroma (POF), which were prepared by excisional biopsy, were retrieved from the Department of Oral Pathology of Isfahan Dental School. Clinical information including age, gender, and location of the lesions was extracted. In order to determine the frequency of macrophages, immunohistochemical staining for CD68 was performed and the expression level was determined by two oral pathologists with a light microscope blindly and simultaneously based on the SID (Staining intensity distribution) index. Findings: The mean SID±SD indices for PG, IF and POF were 9.15±3.86, 2.2±3.69 and 6.4±4.55, which showed a statistically significant difference regarding the type of the lesions (p<0.001). Furthermore, there was a significant difference between CD68 expression of PG with IF, PG with POF and POF with (p<0.001, p=0.027, p<0.001). Conclusion: According to the results of this study, macrophages are present as an important part of PG, POF and IF microenvironments in different levels. Therefore, they might be associated with the development of the disease, as well as being used in identifying the type of oral lesion. © 2024 Babol University of Medical Sciences
Botulinum Toxin Injection for Treating Spasticity in Multiple Sclerosis Patients: A Systematic Review and Meta-Analysis
No full textBackground: Spasticity is a disabling condition commonly experienced by patients with multiple sclerosis (MS), significantly impacting their quality of life. Botulinum toxin (BT) has emerged as a potential therapeutic agent due to its ability to inhibit presynaptic acetylcholine release; however, its efficacy in MS patients remains inconsistent across the literature. Objectives: This systematic review and meta-analysis aimed to evaluate the overall efficacy of BT in reducing spasticity in MS patients, focusing on outcomes such as the Expanded Disability Status Scale (EDSS) and the Modified Ashworth Scale (MAS). The goal was to consolidate the available evidence to provide clearer clinical guidance. Methods: A systematic search of databases including Medline, Scopus, Embase, and Web of Science was conducted from January 2000 to April 2023. Additionally, references to the included studies were examined to ensure a comprehensive capture of relevant research. Data were extracted on total participants, publication date, country of origin, mean age, disease duration, EDSS scores, and key findings. Results: The initial search yielded 1,618 articles, of which 684 were duplicates. After applying exclusion criteria, 17 articles were selected for the systematic review, with 4 deemed suitable for meta-analysis. Participants' ages ranged from 38 to 53 years, with follow-up durations spanning 1 to 36 months. The most frequently reported complication following BT injection was muscle weakness. The standardized mean difference (SMD) for the MAS demonstrated significant effectiveness of BT at week 4 (SMD:-0.42; 95 CI:-0.77 to-0.6) and week 12 (SMD:-1.16; 95 CI:-1.77 to-0.54). Conclusions: Intramuscular injection of BT appears to be an effective treatment option for reducing spasticity in MS patients. However, further well-designed studies are needed to validate these findings and optimize treatment protocols. © 2025, Emami Razavi et al
Medication errors in prescription of chemotherapy regimens: A prospective observational study among cancer patients at Iranian referral hospital
No full textBackground: Medication errors are a significant cause of adverse events in cancer patients. The study aimed to investigate unintentional medication errors during chemotherapy regimen prescription. Methods: During the six months’ follow-ups, 201 adult patients admitted to outpatients’ chemotherapy ward of Omid Hospital, Isfahan, Iran were examined. An information checklist by the aim of data gathering including patients' demographic information, laboratory data, medications history, chemotherapy drug doses and protocol of administration, pre-medications drugs, and supportive treatment was prepared. The data was compared by standard guidelines and data were presented in percent and frequency. Results: Among the enrolled patients, 327 errors were identified. Sixty-five percent of patients were females and the mean age of patients was 49.2±2.8 years old. Gastrointestinal and breast cancers were among the most frequently reported cancers. The highest frequency of errors (67.27) was attributed to the prescription of premedication drug administration primarily in the management of chemotherapy-induced nausea and vomiting. Medication errors in selection and volume of infused serums (20.18) and in adjusting the dosage of chemotherapy regimens (10.39) were the most observed errors. Conclusion: This study highlighted the important areas to improve cancer management at the medical center. By addressing these challenges and implementing necessary changes, the center can enhance the quality of care provided to cancer patients, ensure adherence to international standards, and improve patient outcomes. © The Author(s
The Relationship Between Happiness and Caring Behaviors in Nurses: A Descriptive-Analytical Study
No full textBackground: Caring behaviors encompass the supportive actions undertaken by nurses to assist patients, with the primary aim of reducing the duration of illness. Enhanced happiness may positively influence these behaviors, which are essential for nurses in maintaining and promoting patient health. Objectives: This study investigates the factors affecting the happiness of Iranian nurses and examines whether increased happiness correlates with improved caring behaviors. Methods: This descriptive-correlational study employed random sampling to survey 220 nurses in Isfahan, Iran, in 2024. Data were collected through questionnaires evaluating demographics, happiness (measured by the Oxford Happiness Questionnaire-Short Form), and caring behaviors. Data analysis was performed using descriptive statistics, independent t-tests, ANOVA, and Pearson correlation coefficients in SPSS V.23. Results: The Iranian nurses in this study demonstrated above-average happiness (mean score: 34.48 ± 5.82). Happiness showed a significant correlation with caring behaviors (P 0.05). Conclusions: Higher levels of nurse happiness are associated with improved caring behaviors, suggesting that initiatives aimed at enhancing nurse happiness can lead to better quality of patient care. It is imperative for government and healthcare organizations to prioritize programs and policies that focus on increasing nurse satisfaction to improve healthcare outcomes. © 2024, Rasooli et al
Cytotoxic Sulfoquinovosyl Glycerols from the Seaweed Sargassum Angustifolium from Persian Gulf
No full textBackgrounds: Seaweeds are an important source of marine organisms that produce a lot of bioactive compounds. Materials and Methods: In this research, the seaweed Sargassum angustifolium was collected from Bushehr province of Persian Gulf of Iran. The seaweed was extracted by methanol:ethyl acetate (1:1) using maceration method. The compounds were isolated with different column chromatography and HPLC(High Performance Liquid Chromatography) by silica gel and hexane:ethyl acetate as mobile phase. Results: The isolated compounds were elucidated structurally by various 1 and 2 D-NMR and MS spectra. Besides the cytotoxicity test was done against HeLa using standard MTT assay and normal cells. Conclusion: It afforded four known sulfoquinovosyl diacylglycerides and fucosterol. Compounds 1-5 showed cytotoxic effects against HeLa and HUVEC cell lines, with IC50 values of 12.2 ± 2.3, 25.8 ± 3.7, 14.9 ± 2.6, 9.8 ± 1.2 μM, and 5.6 ± 1.2, respectively. © 2024 Advanced Biomedical Research | Published by Wolters Kluwer - Medknow