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PREVALENCE OF SPINAL FRACTURES AND ORTHOPEDIC FRACTURES CAUSED BY ROAD TRAFFIC INJURIES
No full textBackground: Road traffic injures (RTIs) are the third leading cause of death in the world after heart diseases and cancer. The aim of the present study was to determine the prevalence of spinal cord fractures (SCF) and other general orthopedic fractures (GOF) caused by road traffic injuries.Materials & Methods: This was a retrospective cross sectional study performed on patients with RTIs-related fractures or SCIs from January 2020 to January 2021.The study population consisted of the medical records of patients admitted to Imam Khomeini Hospital with a diagnosis of GOFs or SCFs. The participants were included in the study by census method. Inclusion criteria included RTIs-related orthopedic fractures or SCIs. The data was analyzed using the SPSS 16 software.Results: The study result showed, that the prevalence of two types of fracture in patients was 9.33. Also, the prevalence of spinal cord fractures was in the form of Multiple spinal levels with a rate of 88 (32.6) and the lowest rate was in the Dorsal spine area with a rate of 38 (14.1). Regarding general orthopedic fractures, the result showed Multiple Orthopedic regions with a rate of 67 (24.8) and the lowest rate was in the Pelvis region with a rate of 29 (10.7).Conclusions: The prevalence of spinal cord and general orthopedic fractures in the examined patients was high, so it is necessary to take corrective measures to prevent traffic accidents
High genetic heterogeneity of leukodystrophies in Iranian children: the first report of Iranian Leukodystrophy Registry
No full textLeukodystrophies (LDs) are a heterogeneous group of progressive neurological disorders and characterized by primary involvement of white matter of the central nervous system (CNS). This is the first report of the Iranian LD Registry database to describe the clinical, radiological, and genomic data of Persian patients with leukodystrophies. From 2016 to 2019, patients suspicious of LDs were examined followed by a brain magnetic resonance imaging (MRI). A single gene testing or whole-exome sequencing (WES) was used depending on the neuroradiologic phenotypes. In a few cases, the diagnosis was made by metabolic studies. Based on the MRI pattern, diagnosed patients were divided into cohorts A (hypomyelinating LDs) versus cohort B (Other LDs). The most recent LD classification was utilized for classification of diagnosed patients. For novel variants, in silico analyses were performed to verify their pathogenicity. Out of 680 registered patients, 342 completed the diagnostic evaluations. In total, 245 patients met a diagnosis which in turn 24.5 were categorized in cohort A and the remaining in cohort B. Genetic tests revealed causal variants in 228 patients consisting of 213 variants in 110 genes with 78 novel variants. WES and single gene testing identified a causal variant in 65.5 and 34.5 cases, respectively. The total diagnostic rate of WES was 60.7. Lysosomal disorders (27.3; GM2-gangliosidosis-9.8, MLD-6.1, KD-4.5), amino and organic acid disorders (17.15; Canavan disease-4.5, L-2-HGA-3.6), mitochondrial leukodystrophies (12.6), ion and water homeostasis disorders (7.3; MLC-4.5), peroxisomal disorders (6.5; X-ALD-3.6), and myelin protein disorders (3.6; PMLD-3.6) were the most commonly diagnosed disorders. Thirty-seven percent of cases had a pathogenic variant in nine genes (ARSA, HEXA, ASPA, MLC1, GALC, GJC2, ABCD1, L2HGDH, GCDH). This study highlights the most common types as well as the genetic heterogeneity of LDs in Iranian children
Toxin-antitoxin Genes Expression in Multidrug-resistant Mycobacterium tuberculosis Isolates under Drug Exposure
No full textINTRODUCTION: Toxin-antitoxin systems (TAs) are highly conserved in Mycobacterium tuberculosis (Mtb). The TAs role in maintaining and disseminating drug resistance in bacterial populations has been indicated. So, we aimed to analyze the expression level of mazEF-related genes in drugsusceptible and multidrug-resistant (MDR) Mtb isolates under isoniazid (INH) and rifampin (RIF) stress. METHODS: We obtained 23 Mtb isolates, including 18 MDR and 5 susceptible isolates, from the Ahvaz Regional TB Laboratory collection. The expression levels of mazF3, mazF6, and mazF9 toxin genes, and mazE3, mazE6, and mazE9 antitoxin genes in MDR and susceptible isolates were evaluated by quantitative real-time PCR (qRT-PCR) after exposure to RIF and INH. RESULTS: The mazF3, F6, and F9 toxin genes were overexpressed in at least two MDR isolates in the presence of RIF and INH, in contrast to mazE antitoxin genes. More MDR isolates were induced to overexpress mazF genes by RIF than INH (72.2 vs. 50). Compared to the H37Rv strain and susceptible isolates, the expression levels of mazF3,6 by RIF and mazF3,6,9 by INH were significantly upregulated in MDR isolates (p<0.05), but no remarkable difference was detected in the expression level of mazF9 genes by INH between these groups. In susceptible isolates, the expression levels of mazE3,6 by RIF and mazE3,6,9 by INH were induced and enhanced significantly compared to MDR isolates, but there was no difference between MDR and H37Rv strain. CONCLUSION: Based on the results, we propose that mazF expression under RIF/INH stress may be associated with drug resistance in Mtb in addition to mutations, and the mazE antitoxins may be related to enhanced susceptibility of Mtb to INH and RIF. Further experiments are needed to investigate the exact mechanism underlying the TA system's role in drug resistance
Risk Factors for Suicide Attempts in Patients Hospitalized in Mostafa Hospital, Ilam: A Qualitative Study
No full textBackground: Suicide is a complicated multifactorial phenomenon. Researchers have attempted to identify the reasons for suicide in different communities. The present study aimed to identify and scrutinize the risk factors for suicide among hospitalized patients. Methods: This qualitative grounded theory study was conducted using in-depth interviews with 53 hospitalized patients in Mostafa Hospital in Ilam, Iran in 2021. Semi-open questions were asked by a psychologist. The interviews continued until reaching the saturation point and achieving the specific objectives of the study. Finally, coding was performed using the grounded theory method. Results: A history of suicide attempts was reported by almost two-thirds of the individuals. The results of the primary coding of the items showed that the most important categories paving the path for committing suicide were social, financial, and family factors. Conclusion: According to the results of the present study, the most important causal conditions contributing to suicide attempts were psychological factors, addiction and its related problems, divorce and its related problems, and love failure. © 2023 The Author(s); Published by Kerman University of Medical Sciences
A Comparative Study on the Effect of Intrathecal Bupivacaine vs. Ropivacaine on Maternal and Neonatal Outcomes After Cesarean Section: A Systematic Review and Meta-analysis
No full textContext: The type of anesthesia in cesarean section can affect the mother and baby. This study aimed to determine the comparative effect of intrathecal hyperbaric bupivacaine vs. hyperbaric ropivacaine on maternal and neonatal outcomes after cesarean section. Evidence Acquisition: PubMed, Web of Science, Embase, Google Scholar, IranDoc, MagIran, and Scopus databases were searched from 1 September 2022 to 1 November 2022. Eighteen clinical trials with 1542 patients were included in the analysis. Results: There was no statistically significant difference in hypotension, bradycardia, and Apgar score between the 2 groups (P > 0.05). The risk of nausea (relative risk (RR), 1.526; 95 CI, 1.175-1.981; P = 0.001) and vomiting (RR, 1.542; 95 CI, 1.048-2.268; P = 0.02) caused by bupivacaine was 0.53 and 0.54 higher than that of ropivacaine. The incidence of shivering (RR, 2.24; 95 CI, 1.480-3.39; P = 0.00) was 2.24 times higher in the bupivacaine group than in the ropivacaine group. The average onset time of sensory block (standardized mean difference (SMD),-0.550; 95 CI,-1.054 to-0.045; P = 0.032) and motor block (SMD,-0.812; 95 CI,-1.254 to-0.371; P = 0.000) was significantly lower in the bupivacaine group than in the ropivacaine group. Conclusions: Despite the fact that ropivacaine and bupivacaine are effective in cesarean section, ropivacaine is more favorable because of less hemodynamic changes, less duration of sensory and motor block, and fewer side effects, which are effective in patient recovery. © 2023, Author(s)
Impact of case study-based teaching on academic enthusiasm of midwifery students toward ectopic pregnancy: A cross-sectional study
No full textBackground & Objective: There has always been controversy surrounding the teaching of diagnostic and treatment measures for novel diseases and rare treatment side effects through articles. Efficient training methods are one of the effective factors in students' academic enthusiasm. The present study was conducted to investigate the impact of case study-based training on the academic enthusiasm of midwifery students. Materials & Methods: This cross-sectional interventional controlled study was conducted on 20 midwifery students of Ilam University of Medical Sciences, Ilam, Iran, over two semesters. Sampling was carried out in the form of the total population sampling method, and the samples were randomly assigned to the intervention and control groups. The intervention group underwent routine training and the review of case report articles on rare types of ectopic pregnancy, whereas the control group only received routine training. Data were collected through a demographic form and the Academic Enthusiasm Questionnaire. Data analysis was performed in SPSS21 software. Independent t-test was used for inter-group comparison and paired t-test for intra-group comparison. Results: The results of comparing inter-group and intra-group mean scores of academic enthusiasm showed no significant difference between the intervention and control groups in either phase one or phase two of the study (P<0.05). Conclusion: Case study-based teaching of ectopic pregnancy had no impact on the academic enthusiasm of midwifery students in the clinical environment. Further studies are recommended to explore how case report articles on different topics affect the academic enthusiasm of students in other medical sciences in clinical settings. © 2023 Zanjan University of Medical Sciences
Cytokine changes and embryo attachment in mouse endometrial cells following treated with peripheral blood mononuclear cells (PBMCs) expressing ectopic hCG, and hCG-activated PBMCs
No full textObjective: To compare the effect of human chorionic gonadotropin (hCG)-producing peripheral blood mononuclear cells (PBMCs) and PBMCs activated by hCG in vitro and expressions of related immune genes in mouse implantation. Methods: hCG-producing PBMCs (transfected PBMC) and PBMCs activated by hCG in vitro were introduced into isolated mouse endometrial cells, while cell cultures were divided into four groups: the control, PBMC, transfected, and activated PBMC groups. The expression of studied genes (IL-1β, IL-6, Lif, and Vegf) was evaluated and blastocyst attachment on the cocultured cells (isolated endometrial cells and PBMC cells) was monitored in all four groups. Results: Data showed that expression decreased in the PBMC group compared to the treated PBMC (transfected and activated PBMCs) and increased in transfected PBMC compared to the activated PBMC. Attachment and migration of blastocysts were dramatically enhanced in the transfected PBMC group compared to the activated PBMC group (P<0.05). Conclusions: Use of hCG-producing PBMCs (transfected PBMC) has more influence on endometrial receptivity. ©2023 Asian Pacific Journal of Reproduction Produced by Wolters Kluwer- Medknow
Predicting intubation risk among COVID-19 hospitalized patients using artificial neural networks
No full textBACKGROUND: Accurately predicting the intubation risk in COVID-19 patients at the admission time is critical to optimal use of limited hospital resources, providing customized and evidence-based treatments, and improving the quality of delivered medical care services. This study aimed to design a statistical algorithm to select the best features influencing intubation prediction in coronavirus disease 2019 (COVID-19) hospitalized patients. Then, using selected features, multiple artificial neural network (ANN) configurations were developed to predict intubation risk.MATERIAL AND METHODS: In this retrospective single-center study, a dataset containing 482 COVID-19 patients who were hospitalized between February 9, 2020 and July 20, 2021 was used. First, the Phi correlation coefficient method was performed for selecting the most important features affecting COVID-19 patients' intubation. Then, the different configurations of ANN were developed. Finally, the performance of ANN configurations was assessed using several evaluation metrics, and the best structure was determined for predicting intubation requirements among hospitalized COVID-19 patients.RESULTS: The ANN models were developed based on 18 validated features. The results indicated that the best performance belongs to the 18-20-1 ANN configuration with positive predictive value (PPV) = 0.907, negative predictive value (NPV) = 0.941, sensitivity = 0.898, specificity = 0.951, and area under curve (AUC) = 0.906.CONCLUSIONS: The results demonstrate the effectiveness of the ANN models for timely and reliable prediction of intubation risk in COVID-19 hospitalized patients. Our models can inform clinicians and those involved in policymaking and decision making for prioritizing restricted mechanical ventilation and other related resources for critically COVID-19 patients
The Effect of a Non-Pharmacological Multicomponent Pain Management Program on Pain Intensity and Quality of Life in Community-Dwelling Elderly Men With Chronic Musculoskeletal Pain
No full textBACKGROUND AND AIM: Improving the level of care for the elderly with musculoskeletal pain requires pharmacological and non-pharmacological pain control methods. This study aimed to investigate the effect of a non-pharmacological pain management intervention on pain intensity and quality of life in community-dwelling older men with musculoskeletal pain who were referred to comprehensive healthcare centers in the city of Ilam, Iran. MATERIALS AND METHODS: A quasi-experimental study with pre and post-test design was performed on 65 older men with chronic musculoskeletal pain. The samples were selected regarding inclusion criteria as available and randomly assigned to either the control (usual care) or the experimental group (educational intervention plus physical exercises). Baseline characteristics of participants, the Visual Analogue Scale, and the CASP-19 Quality of Life were used to collect data. Data were analyzed by SPSS software using the ANCOVA, independent and paired t-test, and chi-square test at the statistically significant level of 5 . RESULTS: According to the findings, there was a significant difference between the experimental and control groups in terms of quality of life (p < .05) and pain intensity (p < .05) after the intervention. No relevant differences were found between groups regarding demographic characteristics at baseline. CONCLUSIONS: A six-week physical activity and education program for community-dwelling older men with chronic musculoskeletal pain could improve quality of life and decrease pain intensity after a one-month follow-up compared with usual care. Therefore, it seems necessary to consider pain management programs in the elderly care program and familiarize health care professionals with these pain control methods
Green decorated gold nanoparticles on magnetic nanoparticles mediated by Calendula extract for the study of preventive effects in streptozotocin-induced gestational diabetes mellitus rats
No full textHerein, a bio-inspired synthesis of AuNPs immobilized magnetic ferrite nanocomposite has been demonstrated to be templated over Calendula persica flower extract. The plant phytomolecules facilitated the eco-friendly reduction and stabilization of the Fe3O4/Au hybrid nanomaterial. Thereafter, it was characterized by a range of analytical methods like SEM, TEM, EDX, elemental mapping, VSM, XRD and ICP-OES. In vivo design, the model of gestational diabetes mellitus rats were established with streptozotocin by intraperitoneal injection. Model rats were randomly divided into Fe3O4/AuNPs 20 μg/kg group, 40 μg/kg group, 80 mg/kg group, gestational diabetes mellitus group and normal pregnancy group (n = 15). Fe3O4/AuNPs were applied by intragastric administration for 25 days. On the last day, serum levels of samples blood Glucose, ALT (alanine aminotransferase), AST (aspartate aminotransferase) and ALP (alkalinephosphatase) enzymes were measured. After tissue processing, 5 μm sections of the liver were prepared and the total volume of the liver, hepatocytes, sinusoids, portal vein, central vein, hepatic arteries and bile ducts were estimated. Fe3O4/AuNPs could decrease the raised levels of AST and ALP enzymes in a dose-dependent manner. The fasting blood glucose level decreased in gestational diabetes rats treated with Fe3O4/AuNPs as compared to the model group. The volume of the hepatocytes and sinusoids which was increased significantly by administration of streptozotocin, show a significant decrease after the treatment of a high dose of Fe3O4/AuNPs. The volume of the portal vein and bile ducts did not show significant changes in experimental groups, but the volume of the central vein and hepatic arteries indicated changes in Fe3O4/AuNPs groups. The present research demonstrates the hepatoprotective and antidiabetic properties of the AuNPs, offering to use as a hepatoprotective and antidiabetic supplement for preventing gestational diabetes mellitus. © 2023 Elsevier B.V