Repository of Research and Investigative Information Isfahan University of Medical Sciences
Not a member yet
23244 research outputs found
Sort by
Policy analysis of self-care program: a qualitative study protocol
No full textBackgroundOver the recent years, the self-care program has been a significant policy in the field of health. The WHO recommended self-care for every country and economic setting for reaching universal health coverage, promoting health, keeping the world safe and serving the vulnerable. Conducting a policy analysis study can be useful in closely examining the self-care program's content, process, context and actors.MethodsA qualitative policy analysis will be conducted in four phases to analyse the self-care program, focussing in Iran. The first phase will involve a scoping review to identify policies related to self-care worldwide. In the second phase, a qualitative study will be conducted to determine the status of the self-care program in Iran. The third phase will involve analysing the self-care program in Iran using the policy triangle framework of Walt and Gilson (1994). In the final phase, initial policy recommendations related to the self-care program will be formulated, and validation and finalization of the initial recommendations will be carried out in a panel of experts.DiscussionTo thoroughly examine the self-care program's content, process, context and actors, a policy analysis study can be helpful. Therefore, this study will aim to analyse the self-care program using policy analysis approach. By identifying the challenges of the program's content, process, context and actors, corrective solutions to improve the program's current status, as well as policy recommendations appropriate to the country's context, will be provided. In addition, policy-makers in various authorities at the national, regional and provincial levels would benefit from the results of this study
Headache in radiologically isolated syndrome: a hint toward imminent conversion: a case report
No full textBackgroundHeadaches are more prevalent in patients with multiple sclerosis compared with the general population. However, headaches are still considered a rare symptom of multiple sclerosis, especially when they appear as an initial symptom. The occurrence of a headache as a symptom of radiologically isolated syndrome (RIS) is uncommon, and it can significantly increase the likelihood of developing multiple sclerosis.Case presentationWe report the case of a 36-year-old Iranian woman experiencing severe unilateral headaches without other multiple sclerosis symptoms. Despite normal physical and laboratory exams, cerebrospinal fluid analysis showed positive oligoclonal bands. Magnetic resonance imaging (MRI) revealed multiple demyelinating plaques consistent with RIS. She was treated with dimethyl fumarate. Subsequent MRI confirmed multiple sclerosis by showing new gadolinium-enhanced lesions. After 3 months of dimethyl fumarate treatment, her headache intensity decreased, and she remained otherwise symptom free. Written informed consent was obtained from the patient.ConclusionEffectively managing headaches in patients with RIS is a challenge for clinicians to improve their quality of life and delay the progression of multiple sclerosis
Major heavy metals and human gut microbiota composition: a systematic review with nutritional approach
No full textBackgroundThe human gut microbiota has a critical role in several aspects of host homeostasis, such as immune development, metabolism, nutrition, and defense against pathogens during life. It can be sensitive to xenobiotics including drugs, diet, or even environmental pollutants, especially heavy metals (HMs). The findings of some previous studies are heterogeneous due to the inclusion of various types of study (human, and animal studies) and wide exposures (phthalate, bisphenol A, HMS, etc.), and no comprehensive systematic review has investigated the association between HMs exposure and human gut microbiota composition. Therefore, we carried out a systematic review of human observational studies to examine this association.Main body of the abstractPubMed, Scopus, ISI Web of Science, and Google Scholar were searched using Medical Subject Headings (MeSH) and non-MeSH terms. Eventually, 12 studies for arsenic (As), lead (Pb), mercury (Hg), and cadmium (Cd) were included in this study. No eligible study was found for Aluminium.Short conclusionThe findings showed exposure to HMs disturbs the composition of gut microbiota and can lead to dysbiosis. Exposure to high levels of As, Pb, and Hg increased the abundance of Collinsella as pathobionts. Evidently, it is related to leaky gut, oxidative stress, and several diseases such as inflammatory bowel disease and cancers. Probiotic treatment and nutritional strategies such as high fiber intake and following antioxidant-rich diets should be considered in terms of HMs exposure
Life Quality of Pediatric Patients with Central Nervous System Infections: A 1-Year Follow-up
No full textMethods: A longitudinal study was conducted on 94 children (aged 6 - 15 years) with CNS infection symptoms who were admitted to referral hospitals in Isfahan, Iran. Parents completed questionnaires assessing quality of life and neurological deficits at 6 and 12 months after discharge. All patients were evaluated by the corresponding physician for a final assessment. Results: Attention deficit-hyperactivity disorder symptoms were diagnosed in 30 patients, with viral encephalitis being the most common infection. The quality of life in children with CNS infections was significantly lower compared to that of healthy children
The prevalence of sexual dysfunction and erectile dysfunction in men with multiple sclerosis: A systematic review and meta-analysis
No full textBackground: The prevalence of sexual dysfunction (SD) in men with multiple sclerosis (MS) is reported variously in different studies. The most common form of SD in these patients is erectile dysfunction (ED). The goal of this systematic review and meta-analysis is to determine the pooled prevalence of SD and ED in men suffering from MS. Methods: We searched PubMed, Scopus, EMBASE, CINAHL, Web of Science, and gray literature (references of references, and congress abstracts) up to 14th November 2020. Results: We found 3163 studies by primary search, 2246 were included after deletion of duplicates. Finally, 29 studies were included for meta-analysis. A total of 3349 patients were evaluated. The pooled prevalence of SD was 66 (95 CI: 64-69). The pooled prevalence of erectile dysfunction was 49 (95 CI: 47-50). Conclusion: Sexual dysfunction is a prevalent complication of MS in male patients which should be considered by clinicians. (c) 2022 Published by Elsevier Espa & ntilde;a, S.L.U. on behalf of Sociedad Espa & ntilde;ola de Neurolog & iacute;a
Elevated risk of possible sarcopenia and weak muscle strength with higher dietary inflammatory index in Iranian breast cancer survivors: a cross-sectional study
No full textBackground Increased levels of inflammation in cancer patients and survivors can make them more prone to muscle wasting and sarcopenia. Diet can be an appropriate treatment for alleviating patient complications. Therefore, this study was performed to determine the association between sarcopenia and its components with the dietary inflammatory index (DII) among breast cancer survivors. Methods A total of 223 female breast cancer survivors were included in this research at the Cancer Prevention Research Center of Seyyed Al-Shohada Hospital and the Iranian Cancer Control Charity Institute (MACSA). Forty-three items of dietary inflammatory index (DII) were extracted from the Food Frequency Questionnaire. Sarcopenia detection was performed according to the Asian criteria. The linear and binary logistic regression was used to assess the association between sarcopenia and its components with DII. Results Participants in the highest DII quartile had significantly elevated risk of impaired hand grip strength and calf circumference in both crude and adjusted models. Moreover, individuals consuming a more pro-inflammatory diet displayed a greater risk of abnormal appendicular skeletal muscle index in the crude model. After controlling for potential confounders, participants in the top quartile of DII had a 2.992-fold greater risk of possible sarcopenia than those in the bottom quartile (P value = 0.035). In addition, a decreasing linear trend was observed between higher DII score and 0.059 and 0.349- units lower in appendicular skeletal muscle mass index and hand grip strength variables in the crude Model (P-value < 0.05). Conclusion Diets with more pro-inflammatory features might be associated with increased risk of possible sarcopenia, as well as its components especially muscle mass and strength in women recovering from breast cancer
The brown alga Padina pavonica methanol and hexane partitions prevented depressive behavior induced by dexamethasone in mice
No full textBackground and purpose:Padina pavonica, a brown alga, displays protection against oxidative stress, neuroinflammation, and neurodegenerative disorders. Considering the beneficial effects of P. pavonica and since its antidepressant effects have not yet been studied, we investigated its methanol and hexane partitions (PMP and PHP) in mice model.Experimental approach:In male mice (25 +/- 2 g), depression was initiated by administrating dexamethasone (15 mu g/kg) subcutaneously. PMP or PHP (80-160 mg/kg) was administered intraperitoneally. All the injections continued for two weeks. After the locomotor test, different depression criteria were evaluated by forced swim test (FST), marble burying test (MBT), sucrose preference (SP) test, and novelty-suppressed feeding test (NSFT).Findings/Results:PMP (160 mg/kg) showed antidepressant effects, immobility time decreased significantly during FST (84.6 +/- 10.4 s) compared to the control, food intake increased significantly during NSFT (21.1 +/- 2.5 mg/g) versus the control, and SP was 81. PHP (80 mg/kg) reduced immobility time to 124.5 +/- 6.7 s compared to the vehicle and increased the SP to 85. Dexamethasone-induced depression. While co-treatment with PMP or PHP prevented depression initiated by dexamethasone. Only PHP reduced the number of buried marbles after 30 min against the control. The applied doses did not cause significant changes in the locomotor activity.Conclusion and implications:PMP and PHP exhibited antidepressant-like effects in mice. PHP also reduced the number of buried marbles, implying a reduction in obsessive-like behavior. These observations underscore the constituents inherent in PMP and PHP, which merit further exploration to elucidate their potential therapeutic applications
Predicting In-Hospital Mortality in Patients With Acute Myocardial Infarction: A Comparison of Machine Learning Approaches
No full textBackground Acute myocardial infarction (AMI) remains a leading global cause of mortality. This study explores predictors of in-hospital mortality among AMI patients using advanced machine learning (ML) techniques. Methods Data from 7422 AMI patients treated with percutaneous coronary intervention (PCI) at Tehran Heart Center (2015-2021) were analyzed. Fifty-eight clinical, demographic, and laboratory variables were evaluated. Seven ML algorithms, including Random Forest (RF), logistic regression with LASSO, and XGBoost, were implemented. The data set was divided into training (70) and testing (30) subsets, with fivefold cross-validation. The class imbalance was addressed using the synthetic minority oversampling technique (SMOTE). Model predictions were interpreted using SHapley Additive exPlanations (SHAP). Results In-hospital mortality occurred in 129 patients (1.74). RF achieved the highest predictive performance, with an area under the curve (AUC) of 0.924 (95 CI 0.893-0.954), followed by XGBoost (AUC 0.905) and logistic regression with LASSO (AUC 0.893). Sensitivity analysis in STEMI patients confirmed RF's robust performance (AUC 0.900). SHAP analysis identified key predictors, including lower left ventricular ejection fraction (LVEF; 33.24 vs. 43.46 in survivors, p < 0.001), higher fasting blood glucose (190.38 vs. 132.29 mg/dL, p < 0.001), elevated serum creatinine, advanced age (70.92 vs. 61.88 years, p < 0.001), and lower LDL-C levels. Conversely, BMI showed no significant association (p = 0.456). Conclusion ML algorithms, particularly RF, effectively predict in-hospital mortality in AMI patients, highlighting critical predictors such as LVEF and biochemical markers. These insights offer valuable tools for enhancing clinical decision-making and improving patient outcomes
Development of a Catalyst-Free Ultrasound-Assisted Derivatization Method for Detection of Valproic Acid in Epilepsy Patient's Serum Using High-Performance Liquid Chromatography: A Comparison With Chemiluminescence Immunoassay
No full textThe aim of this research was the therapeutic drug monitoring for valproic acid in epilepsy patient's serum samples by the common, sensitive, and accessible HPLC-UV method. Because of the absence of a suitable chromophore in the valproic acid structure, a facile, selective, and cost-effective pre-column derivatization was designed. This catalyst-free ultrasound-assisted derivatization assay can accomplish the derivatization very quickly only in 5.0 min and at a mild temperature of 60 degrees C. 2,4'-Dibromoacetophenone and nonanoic acid was used as derivatizing agent and internal standard, respectively. The effect of sample pH, buffer concentration, ultrasound exposure time, reaction temperature, and derivatizing agent amount were optimized. The proposed method exhibited a good linear range of 5.0-300.0 mu g/mL with acceptable correlation coefficients of 0.9981. The limit of detection was as low as 0.4 mu g/mL. Also, the limit of quantification was reported as 1.3 mu g/mL. Interday and intraday relative standard deviations (n = 10) were 1.1 and 0.3-7.0, respectively. In addition, the relative recovery ranged from 100.3 to 107.7. The measurement of valproic acid was performed in the presence of several epilepsy and non-epilepsy drugs by the developed protocol. This confirmed the specific and accurate determination of valproic acid in the patient's serum. A comparative evaluation was employed against the precise chemiluminescence immunoassay approach. The correlation coefficient between the two methods was 0.9992, which demonstrated the results were statistically the same
Treatment-resistant inflammatory demyelinating pseudotumor with Marburg-like features: A narrative review-based treatment approach
No full textInflammatory demyelinating pseudotumor (IDP) mimics intracranial neoplasms in terms of both clinical presentation and imaging features. IDP with Marburg-like features represents a severe form of inflammatory demyelinating encephalomyelitis, marked by a dramatic onset, aggressive course, absence of remission, and the presence of tumor-like central nervous system demyelinating lesions. Key features of IDP in brain magnetic resonance imaging include open or incomplete ring enhancement, low T2 rim, peripheral diffusion restriction, absent or mild mass effect, and perilesional edema. In brain magnetic resonance spectroscopy (MRS), elevated glutamate, choline, and lactate peaks are observed; however, brain MRS findings can be nonspecific and nondifferentiating. Pathologic findings show prominent perivascular lymphoid infiltrates consisting predominantly of leukocyte common antigen (LCA)+ and PAX5+ B lymphocytes in immunohistochemistry staining, parenchymal and perivascular macrophages (CD68+), some with visible myelin globules on Luxol Fast Blue staining, preferential loss of myelin with relative axonal preservation and the formation of axonal spheroids (swellings), reactive astrocytosis (GFAP+ and ATRX-), and remyelination with thinner myelin sheaths than background axons at the periphery of the plaque. A review of previous case reports revealed that prompt aggressive immunosuppression therapy in the IDP with Marburg-like features may lead to a favorable response. Initiating treatment with a cycle of high-dose corticosteroids followed by rescue immunosuppressive therapy using cyclophosphamide, mitoxantrone, rituximab, or alemtuzumab demonstrated positive outcomes. In addition, maintenance immunosuppressive therapy with B-cell-depleting agents, such as rituximab and ocrelizumab, showed potential for controlling disease activity and improving long-term prognosis