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Evaluating the Relationship Between Myofascial Pain Syndrome (MPS) and Physical and Mental Health Status in Patients with Stroke
No full textBackground: Myofascial pain syndrome (MPS) is a non-inflammatory disorder with muscle stiffness and pain that occurs with the appearance of palpable and irritating nodules in the muscular system. Stroke is one of the most common neurological diseases that in many cases leads to disability and reduction of quality of life (QOL). Objectives: This study aimed to evaluate the relationship between MPS and physical and mental health (MH) status in patients with stroke. Methods: Using available sampling method, this case-control study included 260 patients with stroke. To collect data, demographic characteristics, Visual Analogue Scale (VAS), 36-item Short Form Survey (SF-36), and Depression, Anxiety and Stress Scale (DASS-21) were used. Data analysis was performed using SPSS 16. Mean and standard deviation were used for descriptive statistics and independent t-test, paired t-test, and analysis of variance (ANOVA) were used for inferential tests. Results: While the pain score was 6.35 (1.39), QOL score was 38.86 (11.69), and MH score was 16.26 (2.75) in the intervention group, these scores were 2.15 (0.96), 63.96 (17.52), and 9.02 (4.63), respectively, in the control group. The results showed no statistically significant relationship between MPS and QOL. But there was a statistically significant relationship between MPS and MH, so that the MH status of patients with MPS was lower than the MH status of other patients. Conclusions: Necessary interventions have been done to improve the health status of patients with MPS, which will lead to an increase in the health status of these patients
Heteroresistance to clarithromycin and metronidazole in patients with a Helicobacter pylori infection: a systematic review and meta-analysis
No full textBackground Antimicrobial resistance of H. pylori can lead to treatment failure. Importantly, several studies have reported on heteroresistance, i.e. the presence of resistant and susceptible H. pylori populations in the same sample and/or a difference in the susceptibility patterns between biopsy samples. This meta-analysis aims to provide comprehensive data on the prevalence of metronidazole and clarithromycin heteroresistance and the approaches to their detection. Material and methods A systematic review was performed after the search of MEDLINE, Scopus and Web of Science. The study outcomes were the weighted pooled prevalence of heteroresistance to clarithromycin and metronidazole in H. pylori positive samples and/or isolates with a subanalysis by continent. Results A total of 22 studies that had investigated 3852 H. pylori positive patients were included in the meta-analysis. Heteroresistance to clarithromycin was reported in 20 studies, with a weighted pooled prevalence of 6.8 (95 CI 5.1-8.6; 3654 H. pylori positive patients; the substantial heterogeneity I-2 = 55.6). Heteroresistance to metronidazole was reported in 12 studies, with a weighted pooled prevalence of 13.8 (95 CI 8.9-18.6; 1670 H. pylori positive patients; the substantial heterogeneity I-2 = 60.9). The weighted pooled prevalence of clarithromycin heteroresistance was similar in Asia and Europe (p = 0.174584), however, metronidazole heteroresistance was detected more often in Europe (p < 0.00001). Clarithromycin heteroresistance was detected more often by phenotype rather than by using genotyping methods (12 vs 8 studies), whereas heteroresistance to metronidazole was detected only by phenotype. Conclusion The prevalence of heteroresistance to clarithromycin and/or metronidazole is not negligible and can be detected in approximately 7 and 14 of H. pylori positive samples, respectively. These findings highlight the need to raise the awareness of gastroenterologists and microbiologists to the heteroresistance to clarithromycin and metronidazole in patients with a H. pylori infection
Refeeding Syndrome and Its Related Factors in Critically Ill Coronavirus Disease 2019 Patients: A Prospective Cohort Study
No full textBackground and AimMalnutrition and its complications is usually neglected in critically ill COVID-19 patients. We conducted the present study to investigate the prevalence of refeeding syndrome and its related factors in this group of patients. MethodsIn this prospective cohort study, 327 patients were assessed for being at risk and developing refeeding syndrome. The criteria was ASPEN consensus recommendations for refeeding syndrome released in 2020. Malnutrition was assessed based on global leadership initiative on malnutrition (GLIM) criteria. The relation between actual protein, calorie intake, and refeeding syndrome was also evaluated via cox regression model. The data concerning calorie and protein intake were gathered for 5 days after initiating feeding. The daily protein and calorie intake were divided by kilogram body weight in order to calculate the actual protein (g/kg/day) and energy (kcal/kg/day) intake. ResultsAmong the subjects, 268 (82) were at risk of refeeding syndrome and 116 (36) got involved in this syndrome. Malnutrition, according to the GLIM criteria, was found in 193 (59) of the subjects. In the at-risk population, the risk of refeeding syndrome was reduced by 90 with the rise in protein intake (CI; 0.021-0.436, P = 0.002), increased by 1.04 times with the increase in age (CI; 1.032-1.067, P < 0.001), and by 1.19 times with the rise in the days from illness onset to admission (CI; 1.081-1.312, P < 0.001) in adjusted cox model analysis. ConclusionThe incidence of refeeding syndrome is relatively high, which threatens the majority of critically ill COVID-19 patients. Increased protein intake was found to reduce the occurrence of refeeding syndrome
Association between Maternal Birth Weight and Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis
No full textBackground and Aims Gestational diabetes mellitus is one of the most important issue related to health status of mothers and their children throughout life. This meta-analysis has been conducted to assess relationship between maternal birth weight and gestational diabetes. Methods and Results This article is written using PRISMA guideline for systematic review and meta-analysis. We searched epidemiological studies without a time limit from following databases - Scopus, PubMed, Science Direct, Embase, Web of Science, CINAHL, Cochrane, EBSCO, and Google Scholar search engine using MESH keywords. Heterogeneity was determined using the Cochran Q test and I-2 index. Data were analyzed using comprehensive meta-analysis, version 2. The significance level of the tests was considered as P < 0.05. Results The result of combining ten studies with a sample size of 228,409 cases using a fixed-effect model showed that low maternal birth weight increased the risk of gestational diabetes mellitus (1.71 95% CI 1.43-2.06, P < 0.001). In addition, the result of combining nine studies with a sample size of 227,805 cases using a random-effects model showed that macrosomia did not increase the risk of gestational diabetes mellitus, and there was no significant relationship between them (1.04 95% CI 0.79-1.38; p value: 0.730). Conclusion The results of this systematic review and meta-analysis showed that low maternal birth weight could be a risk factor for gestational diabetes in adulthood
Explaining Challenges Experienced and Evaluation of the Working Condition of Midwives: A Mixed-Method Study Protocol
No full textThe present study aims to: (a) explain challenges experienced by midwives; (b) evaluate the working condition in midwifery working settings. This exploratory sequential mixed-methods study is conducted in three stages (qualitative, quantitative, and nominal group), in Tabriz and Ilam. A qualitative study will be carried out to explain challenges experienced by midwives and the subjects selected through purposive sampling; moreover, in-depth individual interviewing will be used for data collection. The quantitative phase will be used a cross-sectional approach for evaluating the working condition in midwifery working settings. Finally, using findings of the two phases and nominal group technique some strategies will be given to reduce challenges of the midwifery working settings. The results can be used to develop strategies for creating suitable working conditions. It is hoped that the strategy proposed in the current study could lead to improvements in midwives' satisfaction and health care services
Evaluation of Laboratory Variables Related to Diffuse Axonal Injury: A Cross-Sectional Study
No full textBackground: Diffuse axonal injury (DAI) is an injury that occurs after the onset of traumatic brain injury (TBI), leading to many problems for patients and imposing high costs on the treatment system. Objectives: This study was conducted to investigate the status of laboratory variables in patients with DAI. Methods: This cross-sectional study included 140 patients. Data collection tools were a demographic profile form and magnetic resonance imaging (MRI). Laboratory tests, including glucose, LDL-C, HDL-C, total cholesterol, triglycerides, Hb, HCT, PT, PTT, INR, BUN, creatinine, and CRP were evaluated. Also, specialized devices were used to study the laboratory and radiology variables. Results: Most (61.5) of the patients were male, 47.1 had a non-governmental occupation, and 55.7 were less than 30 years old. Also, in 87.9 of cases, traffic accidents were the cause of DAI and in 65 of patients, the Glasgow Coma Scale (GCS) was less than 7. In all the laboratory variables differences were observed between the experimental and the control groups. Conclusions: The laboratory variables in patients with DAI had a statistically significant difference compared to the case group, which indicates the negative effect of DAI on laboratory variables. Further studies are required to confirm our results
Anti-biofilm properties of eucalyptol in combination with antifungals against Candida albicans isolates in patients with hematological malignancy
No full textOral candidiasis is a fungal infection caused mainly by Candida albicans and it is a major problem among hematologic malignancy patients. Biofilm formation is an attributable factor to both virulence and drug resistance of Candida species. The aim of the study was to evaluate the biofilm-producing ability of oral C. albicans isolates and to evaluate the inhibitory activity of eucalyptol on Candida biofilm, alone and in combination with antifungal agents. Samples were collected from the oral cavity of 106 patients with hematologic malignancy. The isolated yeasts were identified by PCR-sequencing. Then C. albicans isolates were analyzed for their biofilm-producing ability by crystal violet staining and MTT assay. The minimum biofilm inhibition concentrations (MBIC) of eucalyptol, amphotericin B, itraconazole, and nystatin and the in vitro interaction of eucalyptol with these drugs were tested according to CLSI-M-27-A3 protocol and checkerboard methods, respectively. From 106 patients, 50 (47.2) were confirmed for oral candidiasis mean +/- SD age 39 +/- 14 years; female 31 (62%) and male 19 (38%). C. albicans was isolated from 40 of 50 (80%) patients. From 40 C. albicans isolates, 24 (60%) and 16 (40%) were moderate and weak biofilm producer, respectively. The geometric mean MBIC of amphotericin B, itraconazole, nystatin and eucalyptol were 3.93 mu g/mL, 12.55 mu g/mL, 0.75 mu g/mL and 798 mu g/mL, respectively. Eucalyptol interacted synergistically with amphotericin B, itraconazole and nystatin against 12.5, 10, and 22.5% of isolates, respectively. Eucalyptol demonstrated promising activity against biofilm of C. albicans when tested alone or combined with antifungal drugs
Economic Evaluation of Denosumab for Treatment of Postmenopausal Osteoporosis: A Systematic Review
No full textBackground: We aimed to review the systematic economic evaluation of denosumab versus than alternative drugs and oral bisphosphonates of postmenopausal osteoporosis in women and help health system policy makers for prioritizing and optimally allocate limited health resources. Methods: We examined the databases of PubMed, Web of Science, Embase, Scopus, Cochrane Library, ProQuest. Strategy search was designed based on keywords. Inclusion criteria were: studies that conducted economic evaluation denosumab compared to oral bisphosphonates for the treatment of osteoporosis in postmenopausal women. Cost-effectiveness studies conducted using decision analysis models based on the economic evaluation approach; studies with available full-text papers; and studies written in English and published between 2010 and 2020. After selecting articles based on inclusion and exclusion criteria, data were extracted and the results were summarized. The quality of the articles was evaluated using the CHEERS checklist. Results: Among 214 initial studies, 8 studies met the inclusion criteria. Most studies focused on the costeffectiveness of denosumab compared with oral bisphosphonates for the treatment of osteoporosis. The study agreed interval ranged from 3 months to 5 years. The costs investigated in the studies were direct medical costs. In most studies, the use of denosumab significantly prevented fractures. Conclusion: Denosumab is generally more cost-effective than alternative drugs and oral bisphosphonates (alendronate, risedronate, strontium ranelate, ibandronate, and untreated)
Nephroprotective activity of naringin against chemical-induced toxicity and renal ischemia/reperfusion injury: A review
No full textObjective: The kidney is well-known as the vital organ which is responsible for maintaining body homeostasis and secretion of toxic metabolites. Renal injury is accompanied by oxidative stress which results in cellular apoptosis, lipid peroxidation, and reduction of antioxidant levels. Plant extracts and their phytoconstituents, owing to free radical scavenging properties, seem to be valuable against modern synthetic and chemical drugs. Naringin is a flavonoid present in citrus fruits with pharmacologic effects including antioxidant, anti-inflammatory, and antiapoptotic properties. This review summarizes the renoprotective effects of naringin and discusses mechanisms of its action against renal injury. Materials and Methods: For this paper, original subject-related articles published up to October 2020 have been reviewed in the databases, including PubMed, Scopus, and Web of Science, and Google Scholar. Results: Naringin increases antioxidant enzyme activity, and glutathione content, reduces lipid peroxidation and inhibits inflammatory cytokines. In the molecular investigation, naringin activates the Nrf-2 signaling, prevents apoptosis signaling, and inhibits the autophagy pathway. Besides, naringin could protect the kidney through modulating microRNA-10a in the kidney tissue in an acute kidney injury model. Conclusion: This review recommends that naringin can be considered a promising candidate to treat kidney dysfunction induced by oxidative stress in the future
Developing the minimum data set of the corrosive ingestion registry system in Iran
No full textBackground Corrosive ingestion is still a major health problem, and its outcomes are often unpredicted. The implementation of a registry system for poisoning with corrosive substances may improve the quality of patient care and might be useful to manage this type of poisoning and its complications. Therefore, our study aimed to establish a minimum data set (MDS) for corrosive ingestion. Methods This was an applied study performed in 2022. First, a literature review was conducted to identify the potential data items to be included in the corrosive ingestion MDS. Then, a two-round Delphi survey was performed to attain an agreement among experts regarding the MDS content, and an additional Delphi step was used for confirming the final MDS by calculating the individual item content validity index (CVI) and content validity ratio (CVR) and by using other statistical tests. Results After the literature review, 285 data items were collected and sent to a two-round Delphi survey in the form of a questionnaire. In total, 75 experts participated in the Delphi stage, CVI, kappa, and CVR calculation. Finally, the MDS of the corrosive ingestion registry system was identified in two administrative and clinical sections with 21 and 152 data items, respectively. Conclusions The development of an MDS, as the first and most important step towards developing the corrosive ingestion registry, can become a standard basis for data collection, reporting, and analysis of corrosive ingestion. We hope this MDS will facilitate epidemiological surveys and assist policymakers by providing higher quality data capture to guide clinical practice and improve patient-centered outcomes