Background: Whole body CT-scan (WBCT) is increasingly used in the setting of severe blunt trauma ... more Background: Whole body CT-scan (WBCT) is increasingly used in the setting of severe blunt trauma due higher sensitivity for detecting occult injuries in comparison to conventional radiography and ultrasound. But the real impact of routine CT-scan on patient outcome is still unclear. Considering the high radiation exposure due to routine CT-scan, this study was conducted to assess the effect of performing routine chest and abdominopelvic CT-scan on patient admission time and complications in blunt trauma. Methods: One hundred and forty conscious and hemodynamically stable blunt trauma patients were included in this randomized controlled study. For seventy patients, routine chest and abdominopelvic CT-scan was requested in addition to conventional radiography and ultrasound. For the other 70 patients, selective CT-scan was ordered according to the clinical presentation. Patient admission times in the emergency room and surgery ward, complications and surgical procedures were assessed. "Missed injuries" defined as additional findings on CT-scan which were not evident on radiography or ultrasound were assessed. Results: Admission time in the emergency ward was significantly shorter in the intervention group with 3.7 ± 0.9 hours in comparison to 4.9 ± 0.8 hours in the control group. Also mean admission time in hospital was only 5.4 ± 2.4 in the intervention group in comparison to 7 ± 3.3 days in the control group. On abdominopelvic CT-scan, 9 (7.8%) additional injuries were detected. All these 9 patients had a positive clinical examination. Chest CT-scan in the intervention group led to additional diagnoses in 17 patients (24.28%) leading to tube thoracostomy insertion in 13 patients (18.57%). Conclusions: Performing routine chest and abdominopelvic CT-scan in conscious blunt trauma patients decreases the hospitalization time but has no effect on patient complications and final outcome. Using a selective approach and performing CT-scan only for symptomatic patients, would be an appropriate option to decrease radiation dose and facility overuse. Nevertheless, the concern of missing occasionally a life threatening injury still remains. Each trauma center should make the decision whether to perform CT-scan or not according to all the pros and contras of this imaging modality. This is an abstract presented in the 33rd Iranian congress of radiology (ICR) and the 15th congress of Iranian radiographic science association (IRSA).
Purpose: Despite advances in medical technology, radiation-induced dermatitis occurs in 95% of ca... more Purpose: Despite advances in medical technology, radiation-induced dermatitis occurs in 95% of cancer patients receiving radiation therapy. Currently, there is no standard and effective treatment for the prevention or control radiation dermatitis The aim of this study was to determine the efficacy of nano-curcumin in alleviating the radiation-induced skin reactions (RISRs) in breast cancer patients. Methods: A randomized, triple-blinded, placebo-controlled clinical trial was performed on 42 patients with breast cancer. The patients were randomly allocated to receive radiotherapy plus placebo (control group) and radiotherapy plus 80 mg/day nano-curcumin capsules (treatment group) up to two weeks after the end of treatment. Then, the RISRs (graded by the radiation therapy oncology group (RTOG) scale) and pain level of the patients were evaluated at baseline and weekly. Finally, the results were analyzed by T-test and Pearson chi-square test. Results: According to the RTOG scale, 0%, 1...
Journal of Advances in Medical and Biomedical Research
10.30699/jambs.30.140.275 Background & Objective: Monoarthritis is the inflammation of a single j... more 10.30699/jambs.30.140.275 Background & Objective: Monoarthritis is the inflammation of a single joint. There is limited data on the etiology of monorthritis in Iran. This study was aimed to evaluate epidemiologic charecteristics of the patients with monorthritis in Kashan, Iran. Materials & Methods: This cross-sectional study was conducted on 227 patients with monorthritis referred to the rheumatology clinic of Kashan, Iran between 2018 and 2019. General, physical and rheumatological examinations were performed on all patients. synovial fluid samples were analyzed for viscosity, leucocyte count, Gram's staining, culture and microscopic evaluation of crystals. Results: Mean age of the patients at the baseline was 56.1±17.2 years, out of whom 44.1% were male. Acute and chronic monoarthritis cases were 51.5% and 48.5%, respectively. The most common involved joint was the knee (60.7%) followed by the ankle (32.2%). Pseudogout (39.3%) and gout (31.6%) were the most common causes of acute monoarthritis. There was no significant difference in etiology of acute monoarthritis between male and female (P value=0.33). Osteoarthritis (53.50%) and rheumatoid arthritis (25.50%) were the most common causes of chronic arthritis. A significant correlation was obtained between sex and causes of chronic monoarthritis (P value=0.012). Patients with various etiologies of chronic monoarthritis had significantly different mean age (P value<0.001). Conclusion: The knee joint was the most common site affected by monoarthritis. Pseudogout and osteoarthritis were the most common causes of acute and chronic arthritis, respectively.
Objective: Osteoarthritis is the most prevalent joint disease. Its diagnosis is based on clinical... more Objective: Osteoarthritis is the most prevalent joint disease. Its diagnosis is based on clinical signs and radiological findings. Carboxyl-Terminal Collagen Type 2 (CTX-II) is a measurable product of the cartilage destruction that occurs during this disease. This study was done to evaluate the correlation between this biomarker and the severity of a patient’s osteoarthritis. Material and Methods: This cross-sectional study was done on 110 patients above the age of 45 years, diagnosed with knee osteoarthritis according to American College of Rheumatology (ACR) criteria. After obtaining informed consent from the patients and recording their demographic data, 5 ml blood samples were sent to the laboratory to measure the level of CTX-II. To measure the severity of their osteoarthritis, radiographies were taken of the patients’ knees in a standing position. The disease was then classified into four different grades after radiography. Results: 32.7% of patients were in grades I, II (mild...
Background: Considering the high number of cataract surgery and the posterior capsular opacity as... more Background: Considering the high number of cataract surgery and the posterior capsular opacity as its complication which needs laser capsulotomy and also the rising of intraocular pressure (IOP) after such surgeries, the purpose of this study was to evaluate and compare the effects of apraclonidine and timolol separately in decreasing IOP after laser capsulotomy in Matini hospital of Kashan during 2010-11. Materials and Methods: In this clinical trial study, 200 eyes of patients with posterior capsular opacity were randomly divided into two groups and each group treated by timolol or apraclonidine before YAG laser capsulotomy. Then, the tonometer was used to record the intraocular pressure, 1 hour before, 6 and 24 hours after the capsulotomy. Results: One-hundred forty (70%) of the patients were women and 60 (30%) men. The interaction between the two drugs and time was not significant (P=0.104). There was no significant difference between the two groups for mean IOP at any time. (P=...
Background: Breast cancer (BC) is the most common cancer among women. Early diagnosis, treatment ... more Background: Breast cancer (BC) is the most common cancer among women. Early diagnosis, treatment and prevention of BC is among the most debated topics in the world. Early diagnosis and appropriate treatment of BC can decrease the mortality rate to 2.2 per year. The aim of this study was to analyze the survival of patients with BC treated with anthracycline alone and combined to Taxane. Materials and Methods: In this historic cohort study the BC cases (n=160) referred to oncology clinics during 2004-2012 were divided to two treatment groups (Anthracycline alone and Anthracycline+Taxane). Patients were followed-up until death or exclusion from study. On demand, every 6 months a bone scan and CT was taken; every 3 months using blood tests the cases were followed-up. The samples were analyzed for estrogen, progesterone and HER2 Neu receptor and then survival analysis. Result: All cases (n=160) were divided into two equal treatment groups (Mean age: 47.4 years). While no significant diff...
Sexual performance refers to activities served by sexual capacity and motivation. As a culturally... more Sexual performance refers to activities served by sexual capacity and motivation. As a culturally sensitive issue, to date the scalar invariance of sexual performance has not been examined for Iranians with spinal cord injuries (SCIs). Aim: To develop and assess properties of an instrument evaluating sexual performance of an Iranian population with SCIs.,
Background: Breast density is routinely reported on mammograms, while breast nodularity is seldom... more Background: Breast density is routinely reported on mammograms, while breast nodularity is seldom reported on clinical examination, and there is no standard system for its classification. Objectives: The aim of this study was to evaluate the agreement of mammographic density with nodularity on clinical breast examination (CBE). In addition, the relationship of mammographic density with age, menopausal status, and number of parities were assessed. Methods: This cross-sectional study was conducted from September 2013 to February 2014, on 30-70-year-old women who referred for screening or diagnostic mammography to Shahid Beheshti Hospital, Kashan, Iran. Nodule size, nodule consistency, and mammographic density were assessed, and Cohen's kappa coefficient was calculated. The Chi-square test was also used to assess the relationship of mammographic density with age, menopausal status, and a number of parities. Results: In this study, 320 women with an age mean value of 46.01 ± 7.73 underwent mammography and CBE. Mammographic density showed a statistically significant weak agreement with nodule size (Kappa coefficient = 0.275; P < 0.001) and nodule consistency (Kappa coefficient = 0.256; P < 0.001). Moreover, mammographic density was inversely related to age, menopausal status, and number of parities (P < 0.001). Conclusions: Breast nodularity on clinical examination has only a weak agreement with mammographic density. Further studies are needed to develop more comprehensive instruments for assessing not only nodule size and consistency but also nodules distribution in all breast quadrants.
Background: Parents are the first line mediators in sexuality development of children. However, t... more Background: Parents are the first line mediators in sexuality development of children. However, the majority of parents tend to have close supervision on children sexual behaviors, particularly in the conservative cultures. This article describes the development and psychometric evaluation of an instrument to measure Iranian parents’ competence in caring and nurturing their children sexually. Methods: The questionnaire was designed based on the principles in measurement, Waltz’stheory. The Iranian version of Children’s Sexual Behavior Questionnaire (CSBQ-IR) was developed and completed by 386 mothers and 101 fathers who participated in a community based sexuality education program in Tehran, capital of Iran. Reliability was assessed by Kuder-Richardson reliability coefficient and Split half. CSBQ-IR was evaluated for its construct, inclusiveness and content validity by principal component analysis. Results: The Kuder-Richardson reliability coefficient and Split half reliability were...
Toxicology and Environmental Health Sciences, 2016
A comprehensive study conducted for investigating the presence of polycyclic aromatic hydrocarbon... more A comprehensive study conducted for investigating the presence of polycyclic aromatic hydrocarbons (PAHs) in bitumen contaminated (BC) and industrial contaminated (IC) soils of Kermanshah province to evaluate their sources and health risk assessment. Forty-two surface soil (0-30 cm) samples were collected and analyzed for 16 PAHs. The total PAHs concentrations, show a mean value of 31.33 mg/kg and 56.31 mg/kg, ranging from 7.35 to 291.38 mg/kg and 6.59 to 662.83 mg/kg in BC and IC soil samples respectively. Positive matrix factorization model (PMF) was used to investigate the source apportionment of PAHs. PMF analysis identified four sources of PAHs as; fossil fuel combustion and unburned petroleum (28.76%), biomass/coal burning (23.55%), vehicular emissions (23.67%) and creosotes (24.01 %) in BC soils and biomass combustion (44.11%), unburned petroleum and coal combustion (17.54%), fossil fuel combustion (19.02%) and creosotes (19.32 %) in IC soils. Ecological risk assessment of PAHs showed that all of the PAHs levels are higher than the effects range low (ERL) values, except for benzo(a)anthracene. Three rings and fluoranthene of the PAHs in IC soils and Nap, Acy, Ace, Phe, Ant, Flt and DBA in BC soil samples reveal higher concentrations than the effects range median (ERM) values. Benzo(a)pyrene equation (BaP eq) values indicate that the carcinogenic potency of PAHs should be given more awareness due to impending environmental risk in the study area. The total incremental life time cancer risk (ILCR) of exposure to PAHs is 9.21 × 10-3 for adult and 9.54 × 10-3 for children in BC soil samples and 1.13 × 10-2 for adult and 1.17 × 10-2 for children in IC soil samples. Estimated results of ILCR indicate that soil samples are potentially exposed to high cancer risk via both ingestion and dermal contact.
European Journal of Trauma and Emergency Surgery, 2017
might lead to overtreatment of occult injuries. The option of using a selective approach should b... more might lead to overtreatment of occult injuries. The option of using a selective approach should be further evaluated to decrease radiation exposure and facility overuse.
International Journal of Preventive Medicine, 2016
Background: Untreated or poorly controlled gestational diabetes can cause serious complications f... more Background: Untreated or poorly controlled gestational diabetes can cause serious complications for mother and newborn. Glibenclamide is rarely used in treating mothers with this disease. This study aimed at comparing the effect of glibenclamide and insulin on neonatal outcomes in women with gestational diabetes mellitus. Methods: In this randomized controlled clinical trial, 249 pregnant women aged 18-45 years within the 11 th-33 rd weeks of gestation with gestational diabetes, single fetus pregnancy, and in need of hyperglycemia treatment were entered and grouped randomly as either glibenclamide or insulin. In the insulin group (n = 129), insulin was administered with an initial dose of 0.2 IU/kg subcutaneously twice per day, whereas in the glibenclamide group (n = 120), 1.25 mg oral glibenclamide was administered once daily and increased if needed. Results: The results showed no significant difference in means age, gestational age, and body mass index between women in the two groups. In addition, there were no significant differences in the frequency of neonatal hypoglycemia, anomaly, hyperbilirubinemia, admission in Neonatal Intensive Care Unit (NICU), and neonatal respiratory distress between two groups. Macrosomia was lower in the glibenclamide group than the insulin group (3.3% vs. 13.2%, respectively, P = 0.005). Regression logistics model results showed that the type of treatment (odds ratio [OR]: 4.62; confidence interval [CI]: 1.45-14.02; P = 0.01) and gestational age at delivery (OR: 1.41; CI: 1.04-1.74; P = 0.01) were as predictor factors of macrosomia. Conclusions: The results of this study revealed that glibenclamide is able to reduce the risk of fetal macrosomia without increasing neonatal anomalies, jaundice, hypocalcemia, infant respiratory distress, and NICU admission.
Multiple sclerosis is a neurodegenerative disease characterized by the present of leukocytes in t... more Multiple sclerosis is a neurodegenerative disease characterized by the present of leukocytes in the brain tissue and subsequently the formation of sclerotic plaques. Leukocytes penetration into the blood-brain barrier is related to several factors, such as, the conversion of leukocyte gene expression or plasma characteristics. In this frame, we explore alteration of matrix metalloproteinase-2 (MMP-2), transforming growth factor beta (TGF-β) family, and Claudin-11 (as a main myelin structural protein) in leukocytes and blood plasma of multiple sclerosis patients compared to the normal group. Blood samples were collected from thirteen men affected by MS and fifteen healthy men. Leukocyte gene expression was measured using real-time PCR and plasma parameters were examined by ELISA. The results of this study showed that the gene expression of Claudin-11 was significantly higher in MS group compared with normal. Interestingly, the MMP-2 pattern was similar to Claudin-11 and correlated positively with it. It was observed that, although the expressions of TGF-β1 and TGF-β2 are down-regulated in the leukocytes of subjects with MS, they showed higher levels of these cytokines in blood plasma. The plasma level of TGF-β3 in MS patients was higher than normal and correlated with Claudin-11 concentration. In conclusion, the aberrant pattern of Claudin-11, TGF-βs family, and MMP-2 expression in leukocytes of the MS patients was observed in this study. Moreover, the plasma levels of TGF-βs family increased in the MS group. The findings of this study provide clues for further investigations to assay MS pathogenesis.
Background: Attention deficit hyperactivity disorder (ADHD) is one of the prevalent disorders in ... more Background: Attention deficit hyperactivity disorder (ADHD) is one of the prevalent disorders in child psychiatry with the potential of damage to mental talent evolution process and socio-emotional skills. This study aimed to examine the effect of an aerobic running program on ADHD among the primary school girls. Materials and Methods: In this clinical trial study, 120 female students with ADHD were purposefully selected from the primary schools in Kashan during 2011-12. The child symptom inventory-DSM-IV version (CSI-4) was completed by the students' teachers and parents and then 30 students with the severe ADHD were divided into the control and experimental groups using the randomized block method. The experimental group performed a 12-week interval running program, 3 times per week, with a maximum heart rate of 60-85%. Data were analyzed using covariance analysis. Results: Results showed that a 12-week interval running program had beneficial effects on ADHD in the experimental compared to the control group (P<0.001). Conclusion: It seems that an aerobic training as a non-invasive and non-drug alternative has a positive effect on the alleviation of ADHD.
Twin pregnancies are commonly associated with low birth weight (LBW) infants. Most studies focus ... more Twin pregnancies are commonly associated with low birth weight (LBW) infants. Most studies focus on growth of LBW compared with normal infants in singleton. However, there has not been any study on twins to compare LBW with normal birth weight (NBW) infants as a match control of the same twin. This cohort study was conducted at Healthcare centers of Kashan, in 2013. Twins differing in birth weight (one with LBW and the other with NBW) were assessed using the care charts in Well Care program in regard to weight, height and head circumference measurements at birth and after 6, 12, 24 months of age and were compared separately between all matched pairs and in four sex-twin subgroups which was defined according to the sex of each twin in pairs; SF (Same-sex: Female), SM (Same-sex: Male), LF (LBW: Female) and LM (LBW: Male). Incidence of dissimilar twins in birth weight was 28.4%. The weight of LBW was significantly lower than the NBW cohort in SF and LF subgroups up to 24 months. The he...
Background: In previous studies, the diagnostic value of Focused Assessment with Sonography for T... more Background: In previous studies, the diagnostic value of Focused Assessment with Sonography for Trauma (FAST) has been evaluated but few studies have been performed on the relationship between the amount of free intra-abdominal fluid and organ injury in blunt abdominal trauma. To select patients with a higher probability of intra-abdominal injuries, several scoring systems have been proposed based on the results of FAST. Objectives: The aim of this study was to determine the prognostic value of FAST according to the Huang scoring system and to propose a cutoff point for predicting the presence of intra-abdominal injuries on the Computed Tomography (CT) scan. The correlation between age and Glasgow Coma Scale (GCS) and the presence of intra-abdominal injuries on the CT scan was also assessed. Patients and Methods: This study was performed on 200 patients with severe blunt abdominal trauma who had stable vital signs. For all patients, FAST-ultrasound was performed by a radiologist and the free fluid score in the abdomen was calculated according to the Huang score. Immediately, an intravenous contrast-enhanced abdominal CT scan was performed in all patients and abdominal solid organ injuries were assessed. Results were analyzed using Kruskal-Wallis test, Mann-Whitney test and ROC curves. The correlation between age and GCS and the presence of intra-abdominal injuries on CT-scan was also evaluated. Results: The mean age of the patients was 29.6 ± 18.3 years and FAST was positive in 67% of the subjects. A significant correlation was seen between the FAST score and the presence of organ injury on CT scan (P < 0.001). Considering the cutoff point of 3 for the free fluid score (with a range of 0-8), sensitivity, specificity, positive predictive value and negative predictive value were calculated to be 0.83, 0.98, 0.93, and 0.95, respectively. Age and GCS showed no significant correlation with intra-abdominal injuries. Conclusions: It seems that FAST examination for intra-abdominal fluid in blunt trauma patients can predict intra-abdominal injuries with very high sensitivity and specificity. Using the scoring system can more accurately determine the probability of the presence of abdominal injuries with a cutoff point of three.
Background: In the recent decades, healthcare providers had a perspective of benevolent paternali... more Background: In the recent decades, healthcare providers had a perspective of benevolent paternalism. Nowadays, the patients' role has changed and they have a significant obligation to participate in their caring decisions. Objectives: The current study aimed to investigate the involvement of patients and public in the patient safety and treatment process in hospitals affiliated to
Background: Computerized Tomography (CT) scan is gaining more importance in the initial evaluatio... more Background: Computerized Tomography (CT) scan is gaining more importance in the initial evaluation of patients with multiple trauma, but its effect on the outcome is still unclear. Until now, no prospective randomized trial has been performed to define the role of routine chest CT in patients with blunt trauma. Objectives: In view of the considerable radiation exposure and the high costs of CT scan, the aim of this study was to assess the effects of performing the routine chest CT on the outcome as well as complications in patients with blunt trauma. Patients and Methods: After approval by the ethics board committee, 100 hemodynamically stable patients with high-energy blunt trauma were randomly divided into two groups. For group one (control group), only chest X-ray was requested and further diagnostic work-up was performed by the decision of the trauma team. For group two, a chest X-ray was ordered followed by a chest CT, even if the chest X-ray was normal. Injury severity, total hospitalization time, Intensive Care Unit (ICU) admission time, duration of mechanical ventilation and complications were recorded. Data were evaluated using t-test, Man-Whitney and chi-squared test. Results: No significant differences were found regarding the demographic data such as age, injury severity and Glasgow Coma Scale (GCS). Thirty-eight percent additional findings were seen in chest CT in 26% of the patients of the group undergoing routine chest CT, leading to 8% change in management. The mean of in-hospital stay showed no significant difference in both groups with a P value of 0.098. In addition, the mean ICU stay and ventilation time revealed no significant differences (P values = 0.102 and 0.576, respectively). Mortality rate and complications were similar in both groups. Conclusions: Performing the routine chest CT in high-energy blunt trauma patients (with a mean injury severity of 9), although leading to the diagnosis of some occult injuries, has no impact on the outcome and does not decrease the in-hospital stay and ICU admission time. It seems that performing the routine chest CT in these patients may lead to overtreatment of nonsignificant injuries. The decision about performing routine CT scan in a trauma center should be made cautiously, considering the detriments and benefits.
Background: The aim of family planning is to prevent unwanted pregnancy. Using safe and effective... more Background: The aim of family planning is to prevent unwanted pregnancy. Using safe and effective contraceptive methods is necessary to achieve this goal. This study was conducted to determine the most causes of high application of unsafe contraception methods in Kashan city using a regression model. Materials and Methods: In a case control study 261 married women referring to health centers and using unsafe contraceptive methods (condom and withdrawal) were selected randomly. Also 261 women using safe methods (hormonal, ligation and intrauterine device) were selected as control group. Using multistage (cluster and simple random) sampling we collected data including age, job, educational level of women and their spouse, marriage duration, number of children, age of the last child and satisfaction about gender of children. The data were analyzed using Chi square and t-Student test in univariate step and then binary logistic regression at multivariate model. Results: women's job a...
Background: Whole body CT-scan (WBCT) is increasingly used in the setting of severe blunt trauma ... more Background: Whole body CT-scan (WBCT) is increasingly used in the setting of severe blunt trauma due higher sensitivity for detecting occult injuries in comparison to conventional radiography and ultrasound. But the real impact of routine CT-scan on patient outcome is still unclear. Considering the high radiation exposure due to routine CT-scan, this study was conducted to assess the effect of performing routine chest and abdominopelvic CT-scan on patient admission time and complications in blunt trauma. Methods: One hundred and forty conscious and hemodynamically stable blunt trauma patients were included in this randomized controlled study. For seventy patients, routine chest and abdominopelvic CT-scan was requested in addition to conventional radiography and ultrasound. For the other 70 patients, selective CT-scan was ordered according to the clinical presentation. Patient admission times in the emergency room and surgery ward, complications and surgical procedures were assessed. "Missed injuries" defined as additional findings on CT-scan which were not evident on radiography or ultrasound were assessed. Results: Admission time in the emergency ward was significantly shorter in the intervention group with 3.7 ± 0.9 hours in comparison to 4.9 ± 0.8 hours in the control group. Also mean admission time in hospital was only 5.4 ± 2.4 in the intervention group in comparison to 7 ± 3.3 days in the control group. On abdominopelvic CT-scan, 9 (7.8%) additional injuries were detected. All these 9 patients had a positive clinical examination. Chest CT-scan in the intervention group led to additional diagnoses in 17 patients (24.28%) leading to tube thoracostomy insertion in 13 patients (18.57%). Conclusions: Performing routine chest and abdominopelvic CT-scan in conscious blunt trauma patients decreases the hospitalization time but has no effect on patient complications and final outcome. Using a selective approach and performing CT-scan only for symptomatic patients, would be an appropriate option to decrease radiation dose and facility overuse. Nevertheless, the concern of missing occasionally a life threatening injury still remains. Each trauma center should make the decision whether to perform CT-scan or not according to all the pros and contras of this imaging modality. This is an abstract presented in the 33rd Iranian congress of radiology (ICR) and the 15th congress of Iranian radiographic science association (IRSA).
Purpose: Despite advances in medical technology, radiation-induced dermatitis occurs in 95% of ca... more Purpose: Despite advances in medical technology, radiation-induced dermatitis occurs in 95% of cancer patients receiving radiation therapy. Currently, there is no standard and effective treatment for the prevention or control radiation dermatitis The aim of this study was to determine the efficacy of nano-curcumin in alleviating the radiation-induced skin reactions (RISRs) in breast cancer patients. Methods: A randomized, triple-blinded, placebo-controlled clinical trial was performed on 42 patients with breast cancer. The patients were randomly allocated to receive radiotherapy plus placebo (control group) and radiotherapy plus 80 mg/day nano-curcumin capsules (treatment group) up to two weeks after the end of treatment. Then, the RISRs (graded by the radiation therapy oncology group (RTOG) scale) and pain level of the patients were evaluated at baseline and weekly. Finally, the results were analyzed by T-test and Pearson chi-square test. Results: According to the RTOG scale, 0%, 1...
Journal of Advances in Medical and Biomedical Research
10.30699/jambs.30.140.275 Background & Objective: Monoarthritis is the inflammation of a single j... more 10.30699/jambs.30.140.275 Background & Objective: Monoarthritis is the inflammation of a single joint. There is limited data on the etiology of monorthritis in Iran. This study was aimed to evaluate epidemiologic charecteristics of the patients with monorthritis in Kashan, Iran. Materials & Methods: This cross-sectional study was conducted on 227 patients with monorthritis referred to the rheumatology clinic of Kashan, Iran between 2018 and 2019. General, physical and rheumatological examinations were performed on all patients. synovial fluid samples were analyzed for viscosity, leucocyte count, Gram's staining, culture and microscopic evaluation of crystals. Results: Mean age of the patients at the baseline was 56.1±17.2 years, out of whom 44.1% were male. Acute and chronic monoarthritis cases were 51.5% and 48.5%, respectively. The most common involved joint was the knee (60.7%) followed by the ankle (32.2%). Pseudogout (39.3%) and gout (31.6%) were the most common causes of acute monoarthritis. There was no significant difference in etiology of acute monoarthritis between male and female (P value=0.33). Osteoarthritis (53.50%) and rheumatoid arthritis (25.50%) were the most common causes of chronic arthritis. A significant correlation was obtained between sex and causes of chronic monoarthritis (P value=0.012). Patients with various etiologies of chronic monoarthritis had significantly different mean age (P value<0.001). Conclusion: The knee joint was the most common site affected by monoarthritis. Pseudogout and osteoarthritis were the most common causes of acute and chronic arthritis, respectively.
Objective: Osteoarthritis is the most prevalent joint disease. Its diagnosis is based on clinical... more Objective: Osteoarthritis is the most prevalent joint disease. Its diagnosis is based on clinical signs and radiological findings. Carboxyl-Terminal Collagen Type 2 (CTX-II) is a measurable product of the cartilage destruction that occurs during this disease. This study was done to evaluate the correlation between this biomarker and the severity of a patient’s osteoarthritis. Material and Methods: This cross-sectional study was done on 110 patients above the age of 45 years, diagnosed with knee osteoarthritis according to American College of Rheumatology (ACR) criteria. After obtaining informed consent from the patients and recording their demographic data, 5 ml blood samples were sent to the laboratory to measure the level of CTX-II. To measure the severity of their osteoarthritis, radiographies were taken of the patients’ knees in a standing position. The disease was then classified into four different grades after radiography. Results: 32.7% of patients were in grades I, II (mild...
Background: Considering the high number of cataract surgery and the posterior capsular opacity as... more Background: Considering the high number of cataract surgery and the posterior capsular opacity as its complication which needs laser capsulotomy and also the rising of intraocular pressure (IOP) after such surgeries, the purpose of this study was to evaluate and compare the effects of apraclonidine and timolol separately in decreasing IOP after laser capsulotomy in Matini hospital of Kashan during 2010-11. Materials and Methods: In this clinical trial study, 200 eyes of patients with posterior capsular opacity were randomly divided into two groups and each group treated by timolol or apraclonidine before YAG laser capsulotomy. Then, the tonometer was used to record the intraocular pressure, 1 hour before, 6 and 24 hours after the capsulotomy. Results: One-hundred forty (70%) of the patients were women and 60 (30%) men. The interaction between the two drugs and time was not significant (P=0.104). There was no significant difference between the two groups for mean IOP at any time. (P=...
Background: Breast cancer (BC) is the most common cancer among women. Early diagnosis, treatment ... more Background: Breast cancer (BC) is the most common cancer among women. Early diagnosis, treatment and prevention of BC is among the most debated topics in the world. Early diagnosis and appropriate treatment of BC can decrease the mortality rate to 2.2 per year. The aim of this study was to analyze the survival of patients with BC treated with anthracycline alone and combined to Taxane. Materials and Methods: In this historic cohort study the BC cases (n=160) referred to oncology clinics during 2004-2012 were divided to two treatment groups (Anthracycline alone and Anthracycline+Taxane). Patients were followed-up until death or exclusion from study. On demand, every 6 months a bone scan and CT was taken; every 3 months using blood tests the cases were followed-up. The samples were analyzed for estrogen, progesterone and HER2 Neu receptor and then survival analysis. Result: All cases (n=160) were divided into two equal treatment groups (Mean age: 47.4 years). While no significant diff...
Sexual performance refers to activities served by sexual capacity and motivation. As a culturally... more Sexual performance refers to activities served by sexual capacity and motivation. As a culturally sensitive issue, to date the scalar invariance of sexual performance has not been examined for Iranians with spinal cord injuries (SCIs). Aim: To develop and assess properties of an instrument evaluating sexual performance of an Iranian population with SCIs.,
Background: Breast density is routinely reported on mammograms, while breast nodularity is seldom... more Background: Breast density is routinely reported on mammograms, while breast nodularity is seldom reported on clinical examination, and there is no standard system for its classification. Objectives: The aim of this study was to evaluate the agreement of mammographic density with nodularity on clinical breast examination (CBE). In addition, the relationship of mammographic density with age, menopausal status, and number of parities were assessed. Methods: This cross-sectional study was conducted from September 2013 to February 2014, on 30-70-year-old women who referred for screening or diagnostic mammography to Shahid Beheshti Hospital, Kashan, Iran. Nodule size, nodule consistency, and mammographic density were assessed, and Cohen's kappa coefficient was calculated. The Chi-square test was also used to assess the relationship of mammographic density with age, menopausal status, and a number of parities. Results: In this study, 320 women with an age mean value of 46.01 ± 7.73 underwent mammography and CBE. Mammographic density showed a statistically significant weak agreement with nodule size (Kappa coefficient = 0.275; P < 0.001) and nodule consistency (Kappa coefficient = 0.256; P < 0.001). Moreover, mammographic density was inversely related to age, menopausal status, and number of parities (P < 0.001). Conclusions: Breast nodularity on clinical examination has only a weak agreement with mammographic density. Further studies are needed to develop more comprehensive instruments for assessing not only nodule size and consistency but also nodules distribution in all breast quadrants.
Background: Parents are the first line mediators in sexuality development of children. However, t... more Background: Parents are the first line mediators in sexuality development of children. However, the majority of parents tend to have close supervision on children sexual behaviors, particularly in the conservative cultures. This article describes the development and psychometric evaluation of an instrument to measure Iranian parents’ competence in caring and nurturing their children sexually. Methods: The questionnaire was designed based on the principles in measurement, Waltz’stheory. The Iranian version of Children’s Sexual Behavior Questionnaire (CSBQ-IR) was developed and completed by 386 mothers and 101 fathers who participated in a community based sexuality education program in Tehran, capital of Iran. Reliability was assessed by Kuder-Richardson reliability coefficient and Split half. CSBQ-IR was evaluated for its construct, inclusiveness and content validity by principal component analysis. Results: The Kuder-Richardson reliability coefficient and Split half reliability were...
Toxicology and Environmental Health Sciences, 2016
A comprehensive study conducted for investigating the presence of polycyclic aromatic hydrocarbon... more A comprehensive study conducted for investigating the presence of polycyclic aromatic hydrocarbons (PAHs) in bitumen contaminated (BC) and industrial contaminated (IC) soils of Kermanshah province to evaluate their sources and health risk assessment. Forty-two surface soil (0-30 cm) samples were collected and analyzed for 16 PAHs. The total PAHs concentrations, show a mean value of 31.33 mg/kg and 56.31 mg/kg, ranging from 7.35 to 291.38 mg/kg and 6.59 to 662.83 mg/kg in BC and IC soil samples respectively. Positive matrix factorization model (PMF) was used to investigate the source apportionment of PAHs. PMF analysis identified four sources of PAHs as; fossil fuel combustion and unburned petroleum (28.76%), biomass/coal burning (23.55%), vehicular emissions (23.67%) and creosotes (24.01 %) in BC soils and biomass combustion (44.11%), unburned petroleum and coal combustion (17.54%), fossil fuel combustion (19.02%) and creosotes (19.32 %) in IC soils. Ecological risk assessment of PAHs showed that all of the PAHs levels are higher than the effects range low (ERL) values, except for benzo(a)anthracene. Three rings and fluoranthene of the PAHs in IC soils and Nap, Acy, Ace, Phe, Ant, Flt and DBA in BC soil samples reveal higher concentrations than the effects range median (ERM) values. Benzo(a)pyrene equation (BaP eq) values indicate that the carcinogenic potency of PAHs should be given more awareness due to impending environmental risk in the study area. The total incremental life time cancer risk (ILCR) of exposure to PAHs is 9.21 × 10-3 for adult and 9.54 × 10-3 for children in BC soil samples and 1.13 × 10-2 for adult and 1.17 × 10-2 for children in IC soil samples. Estimated results of ILCR indicate that soil samples are potentially exposed to high cancer risk via both ingestion and dermal contact.
European Journal of Trauma and Emergency Surgery, 2017
might lead to overtreatment of occult injuries. The option of using a selective approach should b... more might lead to overtreatment of occult injuries. The option of using a selective approach should be further evaluated to decrease radiation exposure and facility overuse.
International Journal of Preventive Medicine, 2016
Background: Untreated or poorly controlled gestational diabetes can cause serious complications f... more Background: Untreated or poorly controlled gestational diabetes can cause serious complications for mother and newborn. Glibenclamide is rarely used in treating mothers with this disease. This study aimed at comparing the effect of glibenclamide and insulin on neonatal outcomes in women with gestational diabetes mellitus. Methods: In this randomized controlled clinical trial, 249 pregnant women aged 18-45 years within the 11 th-33 rd weeks of gestation with gestational diabetes, single fetus pregnancy, and in need of hyperglycemia treatment were entered and grouped randomly as either glibenclamide or insulin. In the insulin group (n = 129), insulin was administered with an initial dose of 0.2 IU/kg subcutaneously twice per day, whereas in the glibenclamide group (n = 120), 1.25 mg oral glibenclamide was administered once daily and increased if needed. Results: The results showed no significant difference in means age, gestational age, and body mass index between women in the two groups. In addition, there were no significant differences in the frequency of neonatal hypoglycemia, anomaly, hyperbilirubinemia, admission in Neonatal Intensive Care Unit (NICU), and neonatal respiratory distress between two groups. Macrosomia was lower in the glibenclamide group than the insulin group (3.3% vs. 13.2%, respectively, P = 0.005). Regression logistics model results showed that the type of treatment (odds ratio [OR]: 4.62; confidence interval [CI]: 1.45-14.02; P = 0.01) and gestational age at delivery (OR: 1.41; CI: 1.04-1.74; P = 0.01) were as predictor factors of macrosomia. Conclusions: The results of this study revealed that glibenclamide is able to reduce the risk of fetal macrosomia without increasing neonatal anomalies, jaundice, hypocalcemia, infant respiratory distress, and NICU admission.
Multiple sclerosis is a neurodegenerative disease characterized by the present of leukocytes in t... more Multiple sclerosis is a neurodegenerative disease characterized by the present of leukocytes in the brain tissue and subsequently the formation of sclerotic plaques. Leukocytes penetration into the blood-brain barrier is related to several factors, such as, the conversion of leukocyte gene expression or plasma characteristics. In this frame, we explore alteration of matrix metalloproteinase-2 (MMP-2), transforming growth factor beta (TGF-β) family, and Claudin-11 (as a main myelin structural protein) in leukocytes and blood plasma of multiple sclerosis patients compared to the normal group. Blood samples were collected from thirteen men affected by MS and fifteen healthy men. Leukocyte gene expression was measured using real-time PCR and plasma parameters were examined by ELISA. The results of this study showed that the gene expression of Claudin-11 was significantly higher in MS group compared with normal. Interestingly, the MMP-2 pattern was similar to Claudin-11 and correlated positively with it. It was observed that, although the expressions of TGF-β1 and TGF-β2 are down-regulated in the leukocytes of subjects with MS, they showed higher levels of these cytokines in blood plasma. The plasma level of TGF-β3 in MS patients was higher than normal and correlated with Claudin-11 concentration. In conclusion, the aberrant pattern of Claudin-11, TGF-βs family, and MMP-2 expression in leukocytes of the MS patients was observed in this study. Moreover, the plasma levels of TGF-βs family increased in the MS group. The findings of this study provide clues for further investigations to assay MS pathogenesis.
Background: Attention deficit hyperactivity disorder (ADHD) is one of the prevalent disorders in ... more Background: Attention deficit hyperactivity disorder (ADHD) is one of the prevalent disorders in child psychiatry with the potential of damage to mental talent evolution process and socio-emotional skills. This study aimed to examine the effect of an aerobic running program on ADHD among the primary school girls. Materials and Methods: In this clinical trial study, 120 female students with ADHD were purposefully selected from the primary schools in Kashan during 2011-12. The child symptom inventory-DSM-IV version (CSI-4) was completed by the students' teachers and parents and then 30 students with the severe ADHD were divided into the control and experimental groups using the randomized block method. The experimental group performed a 12-week interval running program, 3 times per week, with a maximum heart rate of 60-85%. Data were analyzed using covariance analysis. Results: Results showed that a 12-week interval running program had beneficial effects on ADHD in the experimental compared to the control group (P<0.001). Conclusion: It seems that an aerobic training as a non-invasive and non-drug alternative has a positive effect on the alleviation of ADHD.
Twin pregnancies are commonly associated with low birth weight (LBW) infants. Most studies focus ... more Twin pregnancies are commonly associated with low birth weight (LBW) infants. Most studies focus on growth of LBW compared with normal infants in singleton. However, there has not been any study on twins to compare LBW with normal birth weight (NBW) infants as a match control of the same twin. This cohort study was conducted at Healthcare centers of Kashan, in 2013. Twins differing in birth weight (one with LBW and the other with NBW) were assessed using the care charts in Well Care program in regard to weight, height and head circumference measurements at birth and after 6, 12, 24 months of age and were compared separately between all matched pairs and in four sex-twin subgroups which was defined according to the sex of each twin in pairs; SF (Same-sex: Female), SM (Same-sex: Male), LF (LBW: Female) and LM (LBW: Male). Incidence of dissimilar twins in birth weight was 28.4%. The weight of LBW was significantly lower than the NBW cohort in SF and LF subgroups up to 24 months. The he...
Background: In previous studies, the diagnostic value of Focused Assessment with Sonography for T... more Background: In previous studies, the diagnostic value of Focused Assessment with Sonography for Trauma (FAST) has been evaluated but few studies have been performed on the relationship between the amount of free intra-abdominal fluid and organ injury in blunt abdominal trauma. To select patients with a higher probability of intra-abdominal injuries, several scoring systems have been proposed based on the results of FAST. Objectives: The aim of this study was to determine the prognostic value of FAST according to the Huang scoring system and to propose a cutoff point for predicting the presence of intra-abdominal injuries on the Computed Tomography (CT) scan. The correlation between age and Glasgow Coma Scale (GCS) and the presence of intra-abdominal injuries on the CT scan was also assessed. Patients and Methods: This study was performed on 200 patients with severe blunt abdominal trauma who had stable vital signs. For all patients, FAST-ultrasound was performed by a radiologist and the free fluid score in the abdomen was calculated according to the Huang score. Immediately, an intravenous contrast-enhanced abdominal CT scan was performed in all patients and abdominal solid organ injuries were assessed. Results were analyzed using Kruskal-Wallis test, Mann-Whitney test and ROC curves. The correlation between age and GCS and the presence of intra-abdominal injuries on CT-scan was also evaluated. Results: The mean age of the patients was 29.6 ± 18.3 years and FAST was positive in 67% of the subjects. A significant correlation was seen between the FAST score and the presence of organ injury on CT scan (P < 0.001). Considering the cutoff point of 3 for the free fluid score (with a range of 0-8), sensitivity, specificity, positive predictive value and negative predictive value were calculated to be 0.83, 0.98, 0.93, and 0.95, respectively. Age and GCS showed no significant correlation with intra-abdominal injuries. Conclusions: It seems that FAST examination for intra-abdominal fluid in blunt trauma patients can predict intra-abdominal injuries with very high sensitivity and specificity. Using the scoring system can more accurately determine the probability of the presence of abdominal injuries with a cutoff point of three.
Background: In the recent decades, healthcare providers had a perspective of benevolent paternali... more Background: In the recent decades, healthcare providers had a perspective of benevolent paternalism. Nowadays, the patients' role has changed and they have a significant obligation to participate in their caring decisions. Objectives: The current study aimed to investigate the involvement of patients and public in the patient safety and treatment process in hospitals affiliated to
Background: Computerized Tomography (CT) scan is gaining more importance in the initial evaluatio... more Background: Computerized Tomography (CT) scan is gaining more importance in the initial evaluation of patients with multiple trauma, but its effect on the outcome is still unclear. Until now, no prospective randomized trial has been performed to define the role of routine chest CT in patients with blunt trauma. Objectives: In view of the considerable radiation exposure and the high costs of CT scan, the aim of this study was to assess the effects of performing the routine chest CT on the outcome as well as complications in patients with blunt trauma. Patients and Methods: After approval by the ethics board committee, 100 hemodynamically stable patients with high-energy blunt trauma were randomly divided into two groups. For group one (control group), only chest X-ray was requested and further diagnostic work-up was performed by the decision of the trauma team. For group two, a chest X-ray was ordered followed by a chest CT, even if the chest X-ray was normal. Injury severity, total hospitalization time, Intensive Care Unit (ICU) admission time, duration of mechanical ventilation and complications were recorded. Data were evaluated using t-test, Man-Whitney and chi-squared test. Results: No significant differences were found regarding the demographic data such as age, injury severity and Glasgow Coma Scale (GCS). Thirty-eight percent additional findings were seen in chest CT in 26% of the patients of the group undergoing routine chest CT, leading to 8% change in management. The mean of in-hospital stay showed no significant difference in both groups with a P value of 0.098. In addition, the mean ICU stay and ventilation time revealed no significant differences (P values = 0.102 and 0.576, respectively). Mortality rate and complications were similar in both groups. Conclusions: Performing the routine chest CT in high-energy blunt trauma patients (with a mean injury severity of 9), although leading to the diagnosis of some occult injuries, has no impact on the outcome and does not decrease the in-hospital stay and ICU admission time. It seems that performing the routine chest CT in these patients may lead to overtreatment of nonsignificant injuries. The decision about performing routine CT scan in a trauma center should be made cautiously, considering the detriments and benefits.
Background: The aim of family planning is to prevent unwanted pregnancy. Using safe and effective... more Background: The aim of family planning is to prevent unwanted pregnancy. Using safe and effective contraceptive methods is necessary to achieve this goal. This study was conducted to determine the most causes of high application of unsafe contraception methods in Kashan city using a regression model. Materials and Methods: In a case control study 261 married women referring to health centers and using unsafe contraceptive methods (condom and withdrawal) were selected randomly. Also 261 women using safe methods (hormonal, ligation and intrauterine device) were selected as control group. Using multistage (cluster and simple random) sampling we collected data including age, job, educational level of women and their spouse, marriage duration, number of children, age of the last child and satisfaction about gender of children. The data were analyzed using Chi square and t-Student test in univariate step and then binary logistic regression at multivariate model. Results: women's job a...
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Papers by Fatemeh Atoof