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Heydari F, Karimpour-razkenari E, Azadtarigheh P, Vahdatinia A, Salahshoor A, Alipour A, Moosazadeh M, Gholipour Baradari A, Monajati M, Naderi-Behdani F. Evaluating the factors affecting clinical outcomes in critically ill COVID-19 unvaccinated patients admitted to the intensive care unit in a lower-middle-income country. Ann Med Surg (Lond) 2024; 86:42-49. [PMID: 38222708 PMCID: PMC10783397 DOI: 10.1097/ms9.0000000000001379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/25/2023] [Indexed: 01/16/2024] Open
Abstract
Background COVID-19, the most destructive pandemic of this century, caused the highest mortality rate among ICU patients. The evaluation of these patients is insufficient in lower-middle-income countries with limited resources during pandemics. As a result, our primary goal was to examine the characteristics of patients at baseline as well as their survival outcomes, and propose mortality predictors for identifying and managing the most vulnerable patients more effectively and quickly. Methods A prospective analysis of COVID-19 ICU-admitted patients was conducted in our healthcare centre in Iran, from 1 April until 20 May 2020. Ninety-three patients were included in the study, and all were unvaccinated. A multi-variate logistic regression was conducted to evaluate mortality-associated factors. Results There were 53 non-survivors among our ICU-admitted patients. The mean duration from symptoms' onset to hospitalization was 6.92 ± 4.27 days, and from hospitalization to ICU admission was 2.52 ± 3.61 days. The average hospital stay for patients was 13.23 ± 10.43 days, with 8.84 ± 7.53 days in the ICU. Non-survivors were significantly older, had significantly lower haemoglobin levels and higher creatine phosphokinase levels compared to survivors. They had marginally lower SpO2 levels at admission, higher vasopressor administrations, and were intubated more significantly during their ICU stay. The use of immunosuppressive drugs was also significantly higher in non-survivors. Logistic regression revealed that a one-point increase in APACHE II score at ICU admission increased mortality by 6%, and the presence of underlying diseases increased mortality by 4.27 times. Conclusion The authors presented clinical mortality prediction factors for critically ill patients infected with COVID-19. Additional studies are necessary to identify more generalized mortality indicators for these patients in lower-middle-income countries.
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Affiliation(s)
- Fatemeh Heydari
- Department of Anesthesiology and Critical Care Medicine, Imam Khomeini Hospital
| | | | | | | | - Ali Salahshoor
- Department of Anesthesiology and Critical Care Medicine, Imam Khomeini Hospital
- Department of Internal Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Mahmood Moosazadeh
- Gastrointestitional Cancer Research Center, Non-communicable Disease Institute, Mazandaran University of Medical Sciences, Sari
| | | | - Mahila Monajati
- Department of Internal Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fahimeh Naderi-Behdani
- Department of Clinical Pharmacy, Faculty of Pharmacy, Ramsar Campus, Mazandaran University of Medical Sciences, Ramsar, Mazandaran Province
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Zarghami M, Kharazmi O, Alipour A, Babakhanian M, Khosravi A, Mirtorabi SD. Time Series Modeling and Forecasting of Drug-Related Deaths in Iran (2014-2016). Addict Health 2023; 15:149-155. [PMID: 38026723 PMCID: PMC10658097 DOI: 10.34172/ahj.2023.1277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 09/08/2021] [Indexed: 12/01/2023]
Abstract
Background Investigating the temporal variations and forecasting the trends in drug-related deaths can help prevent health problems and develop intervention programs. The recent policy in Iran is strongly focused on deterring drug use and replacing illicit drugs with legal ones. This study aimed to investigate drug-related deaths in Iran in 2014-2016 and forecast the death toll by 2019. Methods In this longitudinal study, Box-Jenkins time series analysis was used to forecast drug-related deaths. To this end, monthly counts of drug-related deaths were obtained from March 2014 to March 2017. After data processing, to obtain stationary time series and examine the stability assumption with the Dickey-Fuller test, the parameters of the Autoregressive Integrated Moving Averages (ARIMA) model were determined using autocorrelation function (ACF) and partial autocorrelation function (PACF) graphs. Based on Akaike statistics, ARIMA (0, 1, 1) was selected as the best-fit model. Moreover, the Dickey-Fuller test was used to confirm the stationarity of the time series of transformed observations. The forecasts were made for the next 36 months using the ARIMA (0,1,2) model and the same confidence intervals were applied to all months. The final extracted data were analyzed using R software, Minitab, and SPSS-23. Findings According to the Iranian Ministry of Health and the Legal Medicine Organization, there were 8883 drug-related deaths in Iran from March 2014 to March 2017. According to the time series findings, this count had an upward trend and did not show any seasonal pattern. It was forecasted that the mean drug-related mortality rate in Iran would be 245.8 cases per month until 2019. Conclusion This study showed a rising trend in drug-related mortality rates during the study period, and the modeling process for forecasting suggested this trend would continue until 2019 if proper interventions were not instituted.
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Affiliation(s)
- Mehran Zarghami
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Psychiatry, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Omid Kharazmi
- Department of Statistics, Faculty of Mathematical Sciences, Vali-e-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Abbas Alipour
- Community Medicine Department, Medical Faculty, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoudeh Babakhanian
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Ardeshr Khosravi
- Deputy for Public Health, Ministry of Health and Medical Education, Tehran, Iran
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Bagheri B, Alipour A, Yousefi M, Jalalian R, Moghimi M, Mohammadi M, Hassanpour N, Iranian M. Prevalence of Thromboembolic Events, Including Venous Thromboembolism and Arterial Thrombosis, in Patients with COVID-19: A Systematic Review with Meta-Analysis. J Tehran Heart Cent 2023; 18:154-169. [PMID: 38146412 PMCID: PMC10748660 DOI: 10.18502/jthc.v18i3.14110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/23/2023] [Indexed: 12/27/2023] Open
Abstract
Background Many studies have evaluated thromboembolic events in COVID-19 patients, and most of them have reported a high estimation of the prevalence of such events. The present study sought to evaluate the prevalence of thromboembolic events in patients with COVID-19. Methods This study is a systematic review with meta-analysis that investigated thromboembolic events in patients with COVID-19 from the start of the pandemic to August 31, 2021. The 4 main databases for collecting articles were Medline, Scopus, Google Scholar, and Web of Science. Deep vein thrombosis, pulmonary embolism, arterial thrombosis, and the overall rate of thromboembolic events were considered primary outcomes. Results In a total of 63 studies (104 920 patients with COVID-19), the overall thrombosis rate was 21% (95% CI, 18% to 25%), the rate of deep vein thrombosis was 20% (95% Cl, 16% to 25%), the rate of pulmonary embolism was 8% (95% Cl, 6% to 10%), and the rate of arterial thrombosis was 5% (95% Cl, 3% to 7%). The prevalence of all primary outcomes in critically ill patients admitted to the intensive care unit (ICU) was significantly higher (P<0.05). In older patients, the prevalence of overall thrombosis, pulmonary embolism, or deep vein thrombosis was significantly higher (P<0.05). Conclusion This study showed that COVID-19 increases the risk of thromboembolic events, especially in elderly and critically ill patients admitted to the ICU. Therefore, more strategies are needed to prevent thromboembolic events in patients with COVID-19, especially in ICU-admitted and elderly patients.
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Affiliation(s)
- Babak Bagheri
- Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abbas Alipour
- Community Medicine Department, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mojtaba Yousefi
- Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Rozita Jalalian
- Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Minoo Moghimi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahsa Mohammadi
- Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Negar Hassanpour
- Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Iranian
- Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Dadipoor S, Akbarizadeh F, Ghaffari M, Alipour A, Safari-Moradabadi A. Educational Intervention of Improve Student's Oral Health: A Systematic Review and Meta-Analysis School-Based. ijph 2023; 52:500-514. [PMID: 37124899 PMCID: PMC10135520 DOI: 10.18502/ijph.v52i3.12133] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/16/2022] [Indexed: 03/14/2023]
Abstract
Background: The present research aimed to assess the effects of oral health intervention programs at school level on students’ oral hygiene in developing countries. To this aim, a systematic review and meta-analysis approach was employed.
Methods: The present research was done by surfing electronic databases with MEDLINE Ovid (Embase Ovid, Scopus), Web of Science from 2000 to Mar 2020. The data were collected using a standard type of data collection including specific studies to observational ones, and the data entered RevMan 2014. The eligibility criteria were individually randomized controlled trials (RCTs) or cluster-RCTs including quasi- experimental papers with oral health interventions. The RevMan 2014 package was used for a meta-analysis done through random-effects models.
Results: Meta-analyses revealed statistically significant divergences in terms of knowledge (SMD 3.31, 95% CI 2.52 to 4.11; I2 = 98; P<0.001), attitude (SMD 1.99, 95% CI 0. 43 to 3.54; I2 = 99; P<0.001), behavior (SMD 4.74, 95% CI 3.70 to 5.77; I2 = 99; P<0.001), plaque index (SMD -1.01, 95% CI -1.50 to -0. 51; I2 = 97; P<0.001) and Gingival index (SMD 0. 33, 95% CI -0. 36 to 1. 02; I2 = 98; P=0.34) in the case of students who received educational interventions versus those with ordinary care.
Conclusion: The present findings attested to the effectiveness of the educational interventions in improving oral health knowledge, attitudes, behaviors, and so on which can presumably contribute to a better oral hygiene, lower incidence of oral diseases, and lower costs of the treatments imposed by oral diseases.
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Affiliation(s)
- Sara Dadipoor
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Fatemeh Akbarizadeh
- Department of Oral & Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohtasham Ghaffari
- Department of Health Education & Health Promotion, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Alipour
- Epidemiology Thalassemia Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Safari-Moradabadi
- Department of Health Promotion and Education, Social Determinants of Health Research Center, School of Health, Alborz University of Medical Sciences, Karaj, Iran
- Corresponding Author:
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Nabati M, Golshani S, Taghavi M, Alipour A, Parsaee H. The association between tissue doppler-derived E/(e's') ratio and coronary atherosclerosis severity measured by the SYNTAX score in patients with non-ST elevation-acute coronary syndrome. BMC Cardiovasc Disord 2023; 23:98. [PMID: 36809994 PMCID: PMC9945393 DOI: 10.1186/s12872-023-03128-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/17/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND The prognosis of patients hospitalized with non-ST elevation-acute coronary syndrome (NSTE-ACS) is typically determined by the existence and severity of myocardial necrosis and left ventricular (LV) remodeling. AIM The present study was to assess the association between the E/(e's') ratio and the coronary atherosclerosis severity, measured by the SYNTAX score, in patients with NSTE-ACS. METHODS Utilizing a descriptive correlational research design, this study was prospectively conducted on 252 patients with NSTE-ACS, undergoing an echocardiography to determine the left ventricular ejection fraction (LVEF), the left atrial (LA) volume, the pulsed-wave (PW) Doppler-derived transmitral early (E) and late (A) diastolic velocities, and the tissue Doppler (TD)-derived mitral annular early diastolic (e') and peak systolic (s') velocities. After that, a coronary angiography (CAG) was performed, and the SYNTAX score was calculated. RESULTS The patients were divided into two groups, viz., those with the E/(e's') ratio < 1.63 and the cases with the ratio ≥ 1.63. The results revealed that the patients with a high ratio were older, had a higher prevalence of females, a SYNTAX score ≥ 22, and a lower glomerular filtration rate than those with a low ratio (p-value < 0.001). Besides, these patients had larger indexed LA volume and lower LVEF than others (p-value: 0.028 and 0.023, respectively). Furthermore, the multiple linear regression outcomes established a positive independent association between the E/(e's') ratio ≥ 1.63 (B = 5.609, 95% CI 2.324-8.894, p-value = 0.001) and the SYNTAX score. CONCLUSION The study results demonstrated that the patients hospitalized with NSTE-ACS and the E/(e's') ratio ≥ 1.63 had worse demographic, echocardiographic, and laboratory profiles and a higher prevalence of a SYNTAX score ≥ 22 than those with a lower ratio.
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Affiliation(s)
- Maryam Nabati
- Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Samad Golshani
- Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Morteza Taghavi
- Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abbas Alipour
- Community Medicine Department, Medical Faculty, Mazandaran University of Medical Sciences, Sari, Iran
| | - Homa Parsaee
- Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Roohi B, Nemati S, Alipour A, Faeli L, Mayahi S, Haghani I, Shalchizadeh M, Darini A, Al-Hatmi AMS, Abastabar M, Shokohi T. Otomycosis: The foremost aetiological agent causing otitis externa and the antifungal susceptibility pattern in North-Western Iran. Mycoses 2023; 66:87-97. [PMID: 36134511 DOI: 10.1111/myc.13532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/01/2022] [Accepted: 09/15/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Otomycosis is considered a recurring fungal ear infection. The external auditory canal provides an appropriate and optimal situation for fungal growth. OBJECTIVES The study aimed to identify the causative agents of otomycosis and determine corresponding antifungal drug susceptibility patterns in north-western Iran. METHODS From October 2020 until November 2021, 200 patients attended an otolaryngology referral centre with otitis externa, and their ear discharge and debris were examined and cultured. The identification of the fungal agents was implemented by polymerase chain reaction-restriction fragment length polymorphism and sequencing. In vitro antifungal susceptibility testing of the isolates was conducted in accordance with the CLSI broth microdilution protocols. RESULTS The prevalence of otomycosis was measured 50.5% (n = 101/200). The majority of patients were in their forties (n = 35, 34.6%) and female (n = 57, 56.4%), and the most prevalent symptom was otalgia (56.4%). The most underlying factor was remarked manipulation employing a cotton swab (65.3%). Regarding fungus, Aspergillus section Nigri (58.57%) was the foremost isolate, followed by Aspergillus section Flavi (19.23%) and Candida parapsilosis (14.96%). The predominance of Aspergillus isolates had minimal in vitro sensitivity to tioconazole and nystatin. Candida species represented higher geometric mean minimum inhibitory concentrations (MIC) against nystatin. The MIC of three Aspergillus species isolates shown above the epidemiologic cut-off values (ECV) against itraconazole. CONCLUSIONS Otomycosis incidence surpassed in comparison with the previous study as the most common cause of otitis externa. The MIC distribution of Aspergillus species isolates against triazole antifungals is close to the defined ECVs and likely outrun it over time.
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Affiliation(s)
- Behrad Roohi
- Communicable Diseases Institute, Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shadman Nemati
- Department of Otolaryngology and Head and Neck Surgery, Otorhinolaryngology Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Abbas Alipour
- Department of Community Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Leila Faeli
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sabah Mayahi
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iman Haghani
- Communicable Diseases Institute, Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Makan Shalchizadeh
- Department of Otolaryngology and Head and Neck Surgery, Otorhinolaryngology Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Darini
- Department of Otolaryngology and Head and Neck Surgery, Otorhinolaryngology Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Abdullah M S Al-Hatmi
- Natural & Medical Science Research Center, University of Nizwa, Nizwa, Oman.,Center of Expertise in Mycology of Radboud University Medical Center/Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Mahdi Abastabar
- Communicable Diseases Institute, Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Tahereh Shokohi
- Communicable Diseases Institute, Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Alipour A, Hantoushzadeh S, Hessami K, Saleh M, Shariat M, Yazdizadeh B, Babaniamansour S, Ghamari A, Aghajanian S, Moradi K, Abdolmaleki AS, Emami Z. A global study of the association of cesarean rate and the role of socioeconomic status in neonatal mortality rate in the current century. BMC Pregnancy Childbirth 2022; 22:821. [PMID: 36336679 PMCID: PMC9639272 DOI: 10.1186/s12884-022-05133-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022] Open
Abstract
Introduction Caesarean section (C/S) rates have significantly increased across the world over the past decades. In the present population-based study, we sought to evaluate the association between C/S and neonatal mortality rates. Material and methods This retrospective ecological study included longitudinal data of 166 countries from 2000 to 2015. We evaluated the association between C/S rates and neonatal mortality rate (NMR), adjusting for total fertility rate, human development index (HDI), gross domestic product (GDP) percentage, and maternal age at first childbearing. The examinations were also performed considering different geographical regions as well as regions with different income levels. Results The C/S rate and NMR in the 166 included countries were 19.97% ± 10.56% and 10 ± 10.27 per 1000 live birth, respectively. After adjustment for confounding variables, C/S rate and NMR were found correlated (r = -1.1, p < 0.001). Examination of the relationship between C/S rate and NMR in each WHO region resulted in an inverse correlation in Africa (r = -0.75, p = 0.005), Europe (r = -0.12, p < 0.001), South-East Asia (r = -0.41, p = 0.01), and Western Pacific (r = -0.13, p = 0.02), a direct correlation in America (r = 0.06, p = 0.04), and no correlation in Eastern Mediterranean (r = 0.01, p = 0.88). Meanwhile, C/S rate and NMR were inversely associated in regions with upper-middle (r = -0.15, p < 0.001) and lower-middle (r = -0.24, p < 0.001) income levels, directly associated in high-income regions (r = 0.02, p = 0.001), and not associated in low-income regions (p = 0.13). In countries with HDI below the centralized value of 1 (the real value of 0.9), the correlation between C/S rate and NMR was negative while it was found positive in countries with HDI higher than the mentioned cut-off. Conclusions This study indicated that NMR associated with C/S is dependent on various socioeconomic factors such as total fertility rate, HDI, GDP percentage, and maternal age at first childbearing. Further attentions to the socioeconomic status are warranted to minimize the NMR by modifying the C/S rate to the optimum cut-off.
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Alipour A, Zarghami M, Pordanjani SR, Khosravi A, Saberi M, Babakhanian M. Spatial distribution and temporal trend of drug-related deaths in the Islamic Republic of Iran during 2014–2017. East Mediterr Health J 2022; 28:758-767. [DOI: 10.26719/emhj.22.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 06/29/2022] [Indexed: 11/09/2022]
Abstract
Background: Research suggests that there is an increasing trend in drug-related deaths worldwide: an estimated 69 000 individuals lose their lives due to substance abuse annually. Aims: To determine the geographical pathology of drug-related deaths in the Islamic Republic of Iran and to evaluate incidence trends, with a focus on identifying high- and low-risk regions. Methods: For this ecological study, we collected data from the 2 main sources (the Legal Medicine Organization and the Ministry of Health and Medical Education) responsible for registering substance-related deaths during 2014–2017. Data analysis was conducted using Joinpoint regression analysis, Global Moran’s I and Anselin Local Moran’s I. Results: Of the 12 386 drug-related deaths in 2014–2017, most occurred during the summer months; 7162 of these were among middle-aged individuals. The mean age of children and adolescents who died of substance abuse was 5.2 [standard deviation (SD) 4.6] years. In the young adult group, mean age at death was 20.7 (SD 2.5) years; it was 34.2 (SD 5.4) years for adults and 55.6 (SD 9.8) years for older adults. Changes in mortality rate peaked in 2017 (annual percentage change = 0.52); in the last months of the study period there was a nonsignificant decrease (annual percentage change = –6.99) in the incidence (average annual percentage change = –0.5; 95% confidence interval: –3.2, 2.3). Conclusion: Deaths due to substance abuse will remain a huge public health problem unless policy- and decision-makers determine why this problem continues to increase despite the extensive efforts on regulation and find ways to mitigate it.
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Razavi-Amoli SK, Alipour A. HCV co-infection in people with HIV in Iran; A systematic review and meta-analysis. Open Forum Infect Dis 2022; 9:ofac477. [PMID: 36267256 PMCID: PMC9578574 DOI: 10.1093/ofid/ofac477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Hepatitis C virus (HCV) coinfection is associated with higher mortality and morbidity in people with human immunodeficiency virus (PWH). Methods We aimed to characterize the epidemiology and factors associated with HCV coinfection among PWH in Iran. In this systematic review, we searched 3 English databases (MEDLINE, SCOPUS, Embase) and 2 Farsi databases (Scientific Information Database and Magiran) for studies that measured the prevalence of HCV coinfection among PWH, published between 2000 and January 1, 2021. We included studies with a minimum sample size of 5 PWH. Reviews, editorials, conference abstracts, theses, studies with no relevant data, and unclear serological assays were excluded. Results We summarized the HCV coinfection prevalence by random-effect meta-analysis and assessed the sources of heterogeneity by a meta-regression model. Of the 858 records identified, 69 eligible studies with 12 996 PWH were included. Overall, HCV coinfection prevalence was 64% (95% confidence interval [CI], 58–69). The prevalence was higher among older (mean age ≥35 years) PWH (69%; 95% CI, 64–74) and PWH who inject drugs (77%; 95% CI, 71–82). Furthermore, we found that coinfection was higher among studies conducted between 2000 and 2014 (67%; 95% CI, 59–75) versus 2015–2020 (57%; 95% CI, 50–64). Conclusions The prevalence of HCV coinfection is high in Iranian PWH, with significant geographical variations. Hepatitis C virus screening and treatment among PWH are warranted to avoid the future burden of HCV-related liver damage, cancer, and mortality.
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Affiliation(s)
- Seyedeh Kiana Razavi-Amoli
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences , Sari , Iran
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN) , Tehran , Iran
| | - Abbas Alipour
- Department of community medicine, School of Medicine, Mazandaran University of Medical Sciences. Mazandaran , Sari , Iran
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Roohi B, Nemati S, Alipour A, Faeli L, Mayahi S, Haghani I, Shokohi T. P270 Otomycosis: Main challenging microbial agent causing otitis externa in northern Iran. Med Mycol 2022. [PMCID: PMC9509852 DOI: 10.1093/mmy/myac072.p270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objectives Otitis externa is one of the most common ear diseases, caused by bacterial and fungal agents. Accumulation of epithelial cells, cellular detritus, waxy substances, and microorganisms in the ear canal provide a proper environment for fungal growth, leading to annoying congestion. In this study, we aimed to identify the fungal causative agents and determine their susceptibility to the antifungal drugs were examined. Methods All patients with suspected otitis externa, referred to Amir-al Momenin Referral Centre from October 2020 to November 2021 entered to study. A total of 200 patients’ ear discharge and debris collected samples were examined by direct examination and cultured on SDA supplemented with chloramphenicol. Definitive identification of grown fungi was made by PCR-RFLP and sequencing of ribosomal DNA. In vitro susceptibility testing of the fungal isolates against eleven different antifungal agents was analyzed using the CLSI broth microdilution methods. Results A total of 101 (50.5%) cases were confirmed with otomycosis. Most patients were in their fifth decade of life (n = 35, 34.6%), female (n = 57, 56.4%), and had unilateral ear involvement (n = 78, 77.2%). The most common symptoms were earache (56.4%) and itching (51.4%). Most underlying predisposing factors are overaggressive using cotton swabs (65.3%) and history of topical antibiotics (48.5%). Among the 117 fungal isolates, Aspergillus section Nigri was the most common agent 58 (49.57%), followed by Aspergillus section Flavi 19 (16.23%), C. parapsilosis 14(11.96%), Aspergillus section Fumigati 12 (10.25%), C. orthopsilosis 6 (5.12%), C. albicans complex 5 (4.27%), Mucor spp. 2 (1.71%), and Syncephalastrum spp. 1 (0.85%). Mainly, all tested antifungals were active against the most isolates of Aspergillus, aside from tioconazole, nystatin, and terbinafine, which showed low in vitro effects. Also, nystatin and itraconazole showed higher GM MICs in against all Candida species isolates. Conversely, amphotericin B (GM = 0.07129) in Aspergillus and voriconazole (GM = 0.03686) in Candida showed the highest antifungal activity. Regarding ECV values represented by ECOFFs, one of each A. niger (MIC 8 μg/mL), A. flavus (MIC 2 μg/ml), and A. fumigatus (MIC 2 μg/ml) isolates were resistant to itraconazole. Conclusion In this study, inconsistent with previous ones, fungal agents have overcome bacterial ones as the etiology of otitis externa. This result may relate to misuse or improper use of topical steroids, antibiotics, and inappropriate control of infection. In addition, our sample collection site was an ENT referral center and many patients have been admitted to this center due to treatment failure and suffered from recurrence. Aspergillus section Nigri isolation domination was seen, in agreement with other results. The MICs distribution of Aspergillus species isolates against triazole antifungals are close to ECVs defined by the CLSI and likely outrun it over time. We recommend that physicians request drug susceptibility testing before antibiotic therapy, to prevent the development of resistance.
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Affiliation(s)
- Behrad Roohi
- Invasive Fungi Research Center , Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari , Iran
| | - Shadman Nemati
- Department of Otolaryngology and Head and Neck Surgery , Otorhinolaryngology Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht , Iran
| | - Abbas Alipour
- Department of Community Medicine , Faculty of Medicine, Mazandaran University of Medical Sciences, Sari , Iran
| | - Leila Faeli
- Invasive Fungi Research Center , Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari , Iran
| | - Sabah Mayahi
- Department of Medical Mycology , School of Medicine, Mazandaran University of Medical Sciences, Sari , Iran
| | - Iman Haghani
- Invasive Fungi Research Center , Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari , Iran
| | - Tahereh Shokohi
- Invasive Fungi Research Center , Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari , Iran
- Department of Medical Mycology , School of Medicine, Mazandaran University of Medical Sciences, Sari , Iran
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Shokohi T, Roohi B, Nemati S, Alipour A, Faeli L, Mayahi S, Haghani I. P083 Susceptibility pattern of fungal isolated from patients with otomycosis. Med Mycol 2022. [PMCID: PMC9509965 DOI: 10.1093/mmy/myac072.p083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Objectives Antifungal resistance is posing several new concerns to clinicians. Increased rates of azole and echinocandin resistance in various non-albicans Candida species and azole resistance in A. fumigatus may arise due to clinical or environmental exposure to these drugs. The study evaluated the antifungal susceptibility for clinical fungal isolates causing otomycosis. Methods A total of 89 Aspergillus isolates containing A. niger (58 isolates), A. flavus (19 isolates), A. fumigatus (12 isolates), and 25 Candida isolates containing C. parapsilosis (14 isolates), C. orthopsilosis (6 isolates), and C. albicans (5 isolates) collected from individuals with confirmed otomycosis during October 2020-November 2021 were tested for antifungal susceptibility testing (AFST). AFST of ketoconazole, voriconazole, tioconazole, amphotericin B, miconazole, fluconazole, nystatin, and itraconazole was conducted using the broth microdilution method based on CLSI (M38-A2, M27-A3) protocols. Conidia of molds and colonies of yeasts were harvested from fungal cultures on SDA incubated at 35°C; the turbidity of the suspension was then adjusted to OD630 nm = 80%-82%T for molds and 75%-77%T for yeasts. Results Mainly, all antifungals examined were effective against most Aspergillus isolates, aside from tioconazole (GM = 5.54767 μg/ml) and nystatin (GM = 2.10151 μg/ml). Terbinafine (GM = 1.69824 μg/ml) had minimal in vitro effects (Table 1). Nystatin (GM = 2.94853 μg/ml) and itraconazole (GM = 1.08673 μg/ml) showed higher GM MICs against all Candida species isolates. Conversely, amphotericin B (GM = 0.07129 μg/ml) in Aspergillus, ketoconazole (GM = 0.02570), and voriconazole (GM = 0.03686 μg/ml) in Candida showed the highest antifungal activity (Table 2). Regarding the CLSI-M59 document for ECV, one A. niger (MIC 8 μg/ml), A. flavus (MIC 2 μg/ml), and A. fumigatus (MIC 2 μg/ml) isolates were non-wild type against itraconazole. A total of 3 A. niger non-wild type isolates with MIC 4 μg/ml against voriconazole were inspected (Table 1). Three C. albicans isolates with high itraconazole MICs (two 8 μg/ml and one 16 μg/ml) were observed (Table 2). Even though the MIC50 of Aspergillus niger for tolnaftate was 0.37 μg/ml, 9 isolates with high MICs (16 μg/ml) were found. Conclusion The foremost commonest yeast isolates in this study, C. parapsilosis, exhibit significant sensitivity to various antifungals, including ketoconazole, voriconazole, tioconazole, amphotericin B, miconazole, fluconazole, and itraconazole. However, contrary to other studies, nystatin had high MICs and is not recommended as an effective drug. Since the pattern of antifungal susceptibility is varied among the cryptic species of Aspergillus sections, we recommend that physicians request a drug susceptibility testing before antibiotic therapy to prevent the development of resistance.
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Affiliation(s)
- Tahereh Shokohi
- Invasive Fungi Research Center , Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari , Iran
| | - Behrad Roohi
- Student Research Committee , Mazandaran University of Medical Sciences, Sari, Iran, Sari , Iran
| | - Shadman Nemati
- Department of Otolaryngology and Head and Neck Surgery , Otorhinolaryngology Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht , Iran
| | - Abbas Alipour
- Department of Community Medicine , Faculty of Medicine, Mazandaran University of Medical Sciences, Sari , Iran
| | - Leila Faeli
- Student Research Committee , Mazandaran University of Medical Sciences, Sari, Iran, Sari , Iran
| | - Sabah Mayahi
- Department of Medical Mycology , School of Medicine, Mazandaran University of Medical Sciences, Sari , Iran
| | - Iman Haghani
- Invasive Fungi Research Center , Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari , Iran
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Beigmohammadi MT, Amoozadeh L, Alipour A. Gargle test for successful extubation in critically ill patients underwent head and neck surgeries: A new test. Ann Med Surg (Lond) 2022; 82:104759. [PMID: 36268449 PMCID: PMC9577857 DOI: 10.1016/j.amsu.2022.104759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 09/13/2022] [Accepted: 09/19/2022] [Indexed: 11/06/2022] Open
Abstract
Background Improvement of predictive tools for recognition of airway edema is crucial for safe extubation and patient safety. This study aimed to evaluate the diagnostic accuracy of the Gargle test (GT) as a new test for assessing airway edema and predicting successful extubation in patients admitted to the intensive care unit (ICU). Method In this prospective observational study, patients underwent head and neck surgeries and admitted to ICU included. All the patients were weaned based on the same protocol.Quantitative Cuff Leak Test (CLT) and qualitative CLTwere first applied followed by GT with normal saline 0.9%. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. Results One hundred and eighteen (male 67, female 51) participated in this study. The agreement between GT and CLT was low (Kappa: quantitative CLT 0.07, qualitative CLT 0.21). The GT compared to CLT had higher sensitivity (33.3% vs 16.6%), specificity (96.3% vs qualitative CLT 92.8%, quantitative CLT 79.4%), PPV (33.3% vs qualitative CLT 11.11%, quantitative CLT 4.0%), NPV (96.3% vs qualitative CLT 95.4%, quantitative CLT 94.6%), and accuracy (92.92% vs qualitative CLT 88.98%, quantitative CLT 76.27%. The cut-off value for GT was estimated 16.5% (sensitivity 74.1% and specificity 60%). Conclusion The GT is a simple accurate test and can be used as a new test in the ICU for recognition of airway edema and prediction of safe extubation in patients with head and neck surgeries. This study aimed to introduce the new gargle test for predicting successful extubation in patients admitted to the ICU. The gargle test is simple, easy to apply and interpret test with sound diagnostic accuracy. The gargle test is a useful test for predicting extubation failure in patients with head and neck surgery.
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Alipour A, Babakhanian M, Zarghami M, Khosravi A, Saberi M. Years of Life Lost (YLLs) due to drug-related deaths in the Islamic Republic Of Iran (2014-2017): a temporal and geographic pattern. Cien Saude Colet 2022; 27:2843-2854. [PMID: 35730851 DOI: 10.1590/1413-81232022277.23252021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 03/14/2022] [Indexed: 11/22/2022] Open
Abstract
The present study aimed to measure the mortality burden caused by premature death due to substance abuse in different geographical regions of Iran from 2014-17. In this serial cross-sectional study, the data related to individuals who had died of drug abuse were first collected from two sources (Iranian Ministry of Health and Medical Education and the Iranian Legal Medicine Organization). Then, using the capture-recapture method, the number of drug-related deaths was estimated. The years of life lost (YLLs) for all provinces of Iran was calculated based on age, sex, and year. During these four years, the total number of deaths was 12029. The mean age of the individuals was 37.3±14.1. The mean age of dead people was constant in women and men over this period; however, the mean age of dead women due to substance abuse was lower than that of men. The mean YLLs per dead person was 70131.3329 years for men and 9321.1125 years for women. The potential years of life lost (YLLs) showed an upward trend, which was stronger in women than men. It is necessary to perform more regional overviews for finding differences in the number of YLLs due to substance abuse so that specific regional policies can be adopted.
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Affiliation(s)
- Abbas Alipour
- Mazandaran University of Medical Sciences. Mazandaran Province Iran
| | - Masoudeh Babakhanian
- Social Determinants of Health Research Center, Semnan University of Medical Sciences. University Education and Research Campus, 5 km of Damghan road, JF62+4W5. Semnan Iran.
| | - Mehran Zarghami
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences. Mazandaran Province Iran
| | - Ardeshir Khosravi
- Vice Chancellery for Health, Iranian Ministry of Health and Medical Education. Tehran Iran
| | - Mehdi Saberi
- Legal Medicine Research Center, Legal Medicine Organization, Tehran Iran
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vismoradi ‑Aineh H, Alipour A, Ramezankhani A, Shakeri J, Yarmohammadi S, Marashi T. Investigating the relationship between satisfaction of basic psychological needs, general health, and some background variables in the Iranian older adults: a cross-sectional study. BMC Psychiatry 2022; 22:372. [PMID: 35650584 PMCID: PMC9158081 DOI: 10.1186/s12888-022-03979-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Promoting the health and mental health (MH) of the older adults making up a large part of the world's population in the coming years can provide the necessary conditions for their health and well-being of them. This study aimed to investigate the relationship between the satisfaction of basic psychological needs (BPNs), general health (GH), and some variables in Iranian older adults. METHODS The present descriptive-correlational study was conducted on 780 older adults from Sarpol-e Zahab (Kermanshah) in 2019 including the study by multi-stage cluster random sampling. The data collection tool was BPNs satisfaction and GH questionnaire and a researcher-made questionnaire of individual and background information. Was used for data analysis using the SPSS version 16 program and descriptive statistics and tests Pearson correlation coefficient, chi-square test, independent-sample T-test, and multivariate linear regression. RESULTS In the present study, participating a total of 780 older adult men aged 73.0 ± 29.32 years. There was a significant relationship between the satisfaction of BPNs and GH (p < 0.001). Also, 41% of the older adults were in poor GH and 30% were high in BPNs. Multiple logistic regression showed that the BPNs, age, income satisfaction, weather, and war zone were strong predictors of GH. the adjusted R2 value of 0.55 shows that the model described 55% of changes in the GH score. CONCLUSION According to the findings of the study on the relationship between the satisfaction of BPNs and GH, providing insurance, social and economic support by developing health policies, creating supportive health environments, strengthening community action, and developing individual skills in the older adults can help improve their MH and that of the community.
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Affiliation(s)
- Hassan vismoradi ‑Aineh
- grid.411600.2School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Alipour
- grid.411623.30000 0001 2227 0923Community Medicine Department, Medical Faculty, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Ramezankhani
- grid.411600.2Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jalal Shakeri
- grid.412112.50000 0001 2012 5829Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Soudabeh Yarmohammadi
- grid.411600.2Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tayebeh Marashi
- School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Karimpour-razkenari E, Naderi-Behdani F, Salahshoor A, Heydari F, Alipour A, Baradari AG. Melatonin as adjunctive therapy in patients admitted to the Covid-19. Ann Med Surg (Lond) 2022; 76:103492. [PMID: 35287296 PMCID: PMC8908573 DOI: 10.1016/j.amsu.2022.103492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/03/2022] [Accepted: 03/06/2022] [Indexed: 11/24/2022] Open
Abstract
Objective Coronavirus has disrupted the natural order of the world since September 2019 with no specific medication. The beneficial effects of melatonin on sepsis and viral influenza were demonstrated previously, but its effects on covid-19, especially COVID -19 ICU, is unclear. Therefore, our aim was to determine the effects of melatonin in COVID-19 ICU patients. Methods This is a retrospective cohort study in which the records of patients admitted to COVID -19 ICU of (XXX) during March to June 2020 were reviewed. According to inclusion criteria, patients who received 15 mg of melatonin daily were called MRG and the rest were called NMRG. Results Thirty-one patients were included and analyzed, of which twelve patients were in MRG. Demographic and clinical characteristics, and laboratory data were similar between two groups at ICU admission. Melatonin had no significant effect on ICU duration, CRP and ESR, also the trend of changes was in favor of melatonin. Nevertheless, melatonin significantly reduced the NLR (OR = −9.81, p = 0.003), and also declined mortality marginally (p = 0.09). Melatonin was well tolerated with no major adverse effects, moreover the thrombocytopenia occurrence was significantly lower in MRG (p = 0.005). In MRG, survival increased and mortality risk decreased, although the difference between groups wasn't significant (p = 0.37), which might be related to the small sample-size. Conclusion Our study showed that melatonin is unlikely to reduce mortality among COVID19 patients and with no significant effect on disease-specific biochemical parameters. Coronavirus has disrupted the natural order of the world since September 2019 with no specific medication. The beneficial effects of melatonin on sepsis and viral influenza were demonstrated previously. Our survey showed melatonin had a beneficial effect on survival and mortality risk. As well as platelets and lymphocytes without life-threatening complications. Melatonin was an essential adjuvant therapy in patients admitted to covid-19 ICU.
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Zarghami M, Babakhanian M, Khavari A, Alipour A, Khosravi A, Saberi M. Drug-related Death low Registration in Iran: A Mixed Method Approach for Causes, Recommendations to Solve This Problem and Geographical Evaluation of an Intervention. Addict Health 2022; 14:138-151. [PMID: 36544515 PMCID: PMC9743819 DOI: 10.22122/ahj.2022.196156.1266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/07/2021] [Indexed: 12/24/2022]
Abstract
Background The death registration is conducted by different systems in Iran. The drug-related death registration is exclusively conducted by Ministry of Health and Medical Education (MOHME) and Legal Medicine Organization (LMO). This study investigates the causes of undercounting drug-related deaths (DRDs) in Iran, provides recommendations for addressing this issue, and provides a geographical evaluation of the integrity and quality of drug-related mortality registration (2014-2017). Methods This is a mix-method study. In part1, individual targeted interviews were conducted with 12 experts in death registration in MOHME and LMO to collect data on the causes of low registration in Iran and provide recommendations for resolving the issue. Part2 of the study involved an intervention in the form of a memorandum of understanding on reduction of low-registrations. This memorandum was signed to transfer information about the corpses between the MOHME and LMO. First, the number of DRDs (2014- 2017) was examined using capture-recapture method and, then, we calculated and compared the rate of pre-intervention (2014-2016) and post-intervention (2017) under-registration to assess whether this memorandum of understanding had been effective in reduction of under-registrations. Findings In part1, according to the participants, the causes of undercounting DRDs in LMO and MOHME were arranged and categorized into 4 categories: weak administration system, physician and personnel training problems, system constraints, and client-related problems. Also, some suggestions were presented to help resolving the problem of undercounting; these suggestions concern the administrative system, technology, and educational domains. In part 2, about half of the provinces in Iran had a positive performance in reducing the undercount. Conclusion At the macro level, the memorandum of understanding between the two organizations responsible for registering deaths was effective. However, increasing the quality of data registrations requires monitoring at the micro and organizational levels to lead to a positive performance in reducing death under-registration in all provinces.
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Affiliation(s)
- Mehran Zarghami
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Department of Psychiatry, Mazandaran University of Medical Sciences, Sari, Iran,Department of Psychiatry, School of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Sari, Iran
| | - Masoudeh Babakhanian
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Department of Psychiatry, Mazandaran University of Medical Sciences, Sari, Iran,Correspondence to: Masoudeh Babakhanian; Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Mazandaran, Sari, Iran;
| | | | - Abbas Alipour
- Department of Social Medicine, School of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Sari, Iran
| | - Ardeshir Khosravi
- Vice Chancellery for Health, Iranian Ministry of Health and Medical Education, Tehran, Iran
| | - Mehdi Saberi
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
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Triolo E, Khegai O, Ozkaya E, Rossi N, Alipour A, Fleysher L, Balchandani P, Kurt M. Design, Construction, and Implementation of a Magnetic Resonance Elastography Actuator for Research Purposes. Curr Protoc 2022; 2:e379. [PMID: 35286023 PMCID: PMC9517172 DOI: 10.1002/cpz1.379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Magnetic resonance elastography (MRE) is a technique for determining the mechanical response of soft materials using applied harmonic deformation of the material and a motion-sensitive magnetic resonance imaging sequence. This technique can elucidate significant information about the health and development of human tissue such as liver and brain, and has been used on phantom models (e.g., agar, silicone) to determine their suitability for use as a mechanical surrogate for human tissues in experimental models. The applied harmonic deformation used in MRE is generated by an actuator, transmitted in bursts of a specified duration, and synchronized with the magnetic resonance signal excitation. These actuators are most often a pneumatic design (common for human tissues or phantoms) or a piezoelectric design (common for small animal tissues or phantoms). Here, we describe how to design and assemble both a pneumatic and a piezoelectric MRE actuator for research purposes. For each of these actuator types, we discuss displacement requirements, end-effector options and challenges, electronics and electronic-driving requirements and considerations, and full MRE implementation. We also discuss how to choose the actuator type, size, and power based on the intended material and use. © 2022 Wiley Periodicals LLC. Basic Protocol 1: Design, construction, and implementation of a convertible pneumatic MRE actuator for use with tissues and phantom models Basic Protocol 2: Design, construction, and implementation of a piezoelectric MRE actuator for localized excitation in phantom models.
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Affiliation(s)
- E.R. Triolo
- University of Washington, Dept. of Mechanical Engineering (3900 E Stevens Way NE Seattle, WA 98195)
| | - O. Khegai
- Icahn School of Medicine at Mount Sinai, BioMedical Engineering and Imaging Institute (1470 Madison Ave, New York City, NY 10029)
| | - E. Ozkaya
- Icahn School of Medicine at Mount Sinai, BioMedical Engineering and Imaging Institute (1470 Madison Ave, New York City, NY 10029)
| | - N. Rossi
- Stevens Institute of Technology, Dept. of Mechanical Engineering (1 Castle Point Terrace, Hoboken, NJ 07030)
| | - A. Alipour
- Icahn School of Medicine at Mount Sinai, BioMedical Engineering and Imaging Institute (1470 Madison Ave, New York City, NY 10029)
| | - L. Fleysher
- Icahn School of Medicine at Mount Sinai, BioMedical Engineering and Imaging Institute (1470 Madison Ave, New York City, NY 10029)
| | - P. Balchandani
- Icahn School of Medicine at Mount Sinai, BioMedical Engineering and Imaging Institute (1470 Madison Ave, New York City, NY 10029)
| | - M. Kurt
- University of Washington, Dept. of Mechanical Engineering (3900 E Stevens Way NE Seattle, WA 98195)
- Icahn School of Medicine at Mount Sinai, BioMedical Engineering and Imaging Institute (1470 Madison Ave, New York City, NY 10029)
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Aletaha N, Hamid H, Alipour A, Ketabi Moghadam P. Magnesium Sulfate for Prevention of Post-ERCP-Pancreatitis: A Randomized Controlled Trial. Arch Iran Med 2022; 25:148-154. [PMID: 35429955 DOI: 10.34172/aim.2022.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 02/20/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Acute pancreatitis is one of the most common complications of endoscopic retrograde cholangiopancreatography (ERCP). Studies suggest that intrapancreatic calcium has an important role in activating pancreatic enzymes; in addition, elevated intraductal pressure is required for development of pancreatitis. Magnesium sulfate (MS), as a calcium antagonist and a muscle relaxant of the Oddi sphincter, is suggested to reduce the incidence and severity of post-ERCP-pancreatitis (PEP) in this article. METHODS We included 270 patients who referred for ERCP between March 2017 and March 2018. They were enrolled into MS (2 g) and placebo (normal saline) groups, administered 1 hour before and 6 hours after the procedure. The ERCPs were done by fellows of gastroenterology under supervision of expert physicians. The incidence and severity of PEP were followed. RESULTS PEP was seen in 12 (8.9%) patients in the MS group and 17 (12.6%) in the placebo group (P value=0.33). The incidence of PEP in high risk patients group (P value=0.017). CONCLUSION Although the usage of MS was not able to prevent PEP in all patients enrolled in this study, but it could significantly reduce the incidence of PEP in high risk patients of intervention group in comparison with placebo group. The median length of hospital stay was also significantly lower in new drug group in contrast to placebo.
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Affiliation(s)
- Najmeh Aletaha
- Gastroenterology Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Hoda Hamid
- Gastroenterology Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Alipour
- Thalassemia Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Pardis Ketabi Moghadam
- Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti Medical University, Tehran, Iran
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Kiasari AZ, Aghaei N, Aezzi G, Alipour A, Ghavibonyeh K. Effects of intrathecal and intravenous dexamethasone on complications associated with intrathecal morphine after cesarean section: A comparative study. J Educ Health Promot 2022; 11:28. [PMID: 35281410 PMCID: PMC8893078 DOI: 10.4103/jehp.jehp_9_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 05/11/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Pain and nausea and vomiting are of serious complications following the use of opiates after surgery, especially cesarean section. Control of postoperative complications is one of the necessities of quality promotion of health-care system. Medications with few side effects such as corticosteroids including dexamethasone can be an appropriate option. In addition, the route of administration can have a significant effect on the effectiveness of the drug. The aim of the present study was to compare the effects of intrathecal with intravenous dexamethasone in reducing the complications associated with intrathecal morphine after cesarean section. MATERIALS AND METHODS The study was a double-blind randomized controlled clinical trial and determined the effect of intrathecal and intravenous dexamethasone on the incidence and severity of complications of intrathecal morphine after cesarean section on 120 patients and its relationship with serious complications after surgery. Descriptive and analytical statistics were used to examine the characteristics of the case and control groups, and STATA SPSS software was used to compare the two groups. RESULTS There was no significant association between the two groups in terms of baseline characteristics. Pain score in the intrathecal injection group was lower than the intravenous injection group, with a statistically significant difference (P = 0.02). In addition, there was a significant association regarding to the incidence of nausea, vomiting, and itching between intrathecal and intravenous injection groups (P = 0.008). CONCLUSION Dexamethasone was effective to reduce opiate complications after cesarean section. Establishing a suitable association between dexamethasone half-life, efficacy, type of use, and time of use can result the best outcomes and promote patients' satisfaction in cesarean section.
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Affiliation(s)
- Alieh Zamani Kiasari
- Department of Anesthesiology, Intensive Care Medicine and Pain Management, School of Medicine, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran
| | - Nahid Aghaei
- Department of Medical-Surgical Nursing, School of Nasibeh Nursing and Midwifery, Mazandaran University of Medical Sciences, Educational Instructor of Nasibeh Nursing and Midwifery School, Sari, Mazandaran, Iran
| | - Goli Aezzi
- Department of Anesthesiology, Intensive Care Medicine and Pain Management, School of Medicine, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran
| | - Abbas Alipour
- Department of Community Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran
| | - Khadijeh Ghavibonyeh
- Department of Anesthesiology, Intensive Care Medicine and Pain Management, School of Medicine, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran
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20
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Alipour A, Rostamian H, Javandoost E, Mohammadian M. Prevalence and specificity of red blood cell alloantibodies and autoantibodies in transfused Iranian β-thalassemia patients: A systematic review and meta-analysis. Asian J Transfus Sci 2022; 16:111-120. [PMID: 36199396 PMCID: PMC9528548 DOI: 10.4103/ajts.ajts_39_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 10/18/2020] [Accepted: 03/29/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND: Repeated allogeneic blood transfusions in thalassemia major patients stimulate the patient's immune system to generate antibodies against foreign erythrocyte antigens. This study was carried out to systematically review the findings of available studies about the prevalence of alloantibodies and autoantibodies, as well as the type of causative antigens among transfusion-dependent thalassemia patients in Iran. METHODS: Electronic search was conducted on Medline, PubMed, Cochrane, EMBASE, ScienceDirect, and Persians databases. All relevant articles published from January 1990 to July 2018 were included. Abstracts of conference booklets which that been published in the last 5 years were also included in the meta-analysis. The search language was restricted to English and Persian. The quality of studies was evaluated according to a checklist developed by authors, and Cochrane Risk of Bias Assessment Tool was used to evaluate the risk of bias. RESULTS: Twenty-three relevant articles met all the inclusion criteria. The prevalence of alloimmunization was 13%. Our study showed that anti-D (25%) and anti-K (25%) were most prevalent among Iranian β-thalassemia patients. Data analysis shows the autoantibody prevalence to be 1% among 3787 patients. Meta-regression revealed that the prevalence of alloantibodies increases with each year as the average age of the study population increases. CONCLUSION: The prevalence of red blood cell (RBC) alloantibodies in transfused Iranian β-thalassemia patients was high. Appropriate preventive strategies such as RBC phenotyping for patients before beginning transfusion and using extended RBC donor–recipient matching, specifically for Rh and Kell system, could be implemented to avoid complications in thalassemia patients.
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21
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Chaichi-Raghimi M, Ilkhani R, Parsa E, Khodadoost M, Choopani R, Mokaberinejad R, Tansaz M, Movahhed M, Namdar H, Emaratkar E, Alizadeh Vaghasloo M, Hashemi M, Tabarrai M, Moeini R, Gorji N, Alipour A, Jafari P, Hakimi F, Yaghmaei F, Zareiyan A, Montazeri A, Mojahedi M. Major and minor criteria for gastric dystemperaments in Persian Medicine: Sari gastric dystemperament criteria-I (SGDC-I). Caspian J Intern Med 2022; 13:681-688. [PMID: 36420335 PMCID: PMC9659836 DOI: 10.22088/cjim.13.4.681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 06/22/2021] [Accepted: 08/08/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Gastric disorders are one of the most common human ailments, which impose a huge economic burden on countries. In Persian Medicine (PM), it is possible to predict the susceptibility to gastric diseases with diagnosis of gastric Mizajes (temperaments) and dystemperaments. The semiology of gastric dystemperaments has been investigated in PM textbooks, although the value of each sign and symptom is not mentioned. Consequently, this research is designed to determine the major and minor criteria for classifying gastric dystemperaments on the basis of valid manuscripts and with the help of PM specialists in the present era. METHODS This was a consensus-based study consisting of four phases. In the first phase, reference PM textbooks were studied. Symptoms and signs of gastric dystemperaments were collected and listed in four groups. In the second phase, semi-structured interviews with a sample of PM experts were carried out. Phase three included a focused group discussion with experts. Eventually, findings were integrated from the three study phases in a two-day meeting in Sari City. RESULTS Selected criteria included eight major and eight minor criteria for hot-cold dystemperament, as well as six major and eight minor criteria for wet-dry gastric dystemperament. CONCLUSION Modern lifestyles and the interfering factors are responsible for some changes in diagnostic signs and symptoms according to PM. This was the first step to coordinate PM diagnostic criteria for gastric dystemperaments. Further studies are recommended to reach a unique protocol in the field of PM diagnostics. The next step includes design and validation of national diagnostic tools.
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Affiliation(s)
- Mahshid Chaichi-Raghimi
- Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Student Research Committee, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Ilkhani
- Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Parsa
- Department of Iranian Traditional Medicine (Persian Medicine), Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mahmood Khodadoost
- Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rasool Choopani
- Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roshanak Mokaberinejad
- Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mojgan Tansaz
- Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mina Movahhed
- Traditional Medicine and Materia Medica Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hasan Namdar
- Traditional Medicine Clinical Trial Research Center, Shahed University, Tehran, Iran
- Department of Traditional Medicine, School of Medicine, Shahed University, Tehran, IR Iran
| | - Elham Emaratkar
- Traditional Medicine Clinical Trial Research Center, Shahed University, Tehran, Iran
- Department of Traditional Medicine, School of Medicine, Shahed University, Tehran, IR Iran
| | - Mahdi Alizadeh Vaghasloo
- Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Persian Medicine Network (PMN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mamak Hashemi
- Department of Persian Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Malihe Tabarrai
- Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reihaneh Moeini
- Department of History of Medical Sciences, School of Persian Medicine, Babol University of Medical Sciences, Babol, Iran
- Traditional Medicine and History of Medical Sciences Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Narjes Gorji
- Department of History of Medical Sciences, School of Persian Medicine, Babol University of Medical Sciences, Babol, Iran
- Traditional Medicine and History of Medical Sciences Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Abbas Alipour
- Community Medicine Department, Medical Faculty, Mazandaran University of Medical Sciences, Sari, Iran
| | - Parisa Jafari
- Department of Persian Medicine, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Fatemeh Hakimi
- Clinical Research Development Unit, Moradi Hospital in Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Farideh Yaghmaei
- Department of Nursing, Zanjan Branch, Islamic Azad University, Zanjan, Iran
| | - Armin Zareiyan
- Community Health Department, School of Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Ali Montazeri
- Institute for Health Sciences Research, Academic Center for Education, Culture and Research, ACECR, Tehran, Iran
| | - Morteza Mojahedi
- Department of History of Medical Sciences, School of Persian Medicine, Babol University of Medical Sciences, Babol, Iran
- Traditional Medicine and History of Medical Sciences Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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22
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Meybodi MME, Foroushani AR, Zolfaghari M, Abdollahi A, Alipour A, Mohammadnejad E, Mehrjardi EZ, Seifi A. Antimicrobial resistance pattern in healthcare-associated infections: investigation of in-hospital risk factors. Iran J Microbiol 2021; 13:178-182. [PMID: 34540152 PMCID: PMC8408023 DOI: 10.18502/ijm.v13i2.5978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background and Objectives: Antimicrobial resistance (AMR) is an increasing threat for efficient treatment of infections. Determining the epidemiology of healthcare-associated infections and causative agents in various hospital wards helps appropriate selection of antimicrobial agents. Materials and Methods: This retrospective study was performed by analyzing antibiograms from March 2017 to March 2018 among patients admitted to the different wards of Imam Khomeini Hospital Complex in Tehran, Iran. Results: Among 2440 hospital acquired infections, 59.3% were Gram-negative bacilli: E. coli (n = 469, 22.2%), K. pneumoniae (n = 457, 21.7%), Acinetobacter spp. (n = 282, 13.4%), P. aeruginosa (n = 139, 6.6%) and important Gram-positive bacteria were Enterococcus spp. (n = 216, 10.2%), S. aureus (n = 148, 7%), S. epidermidis (n = 118, 5.6). Generally, there was a high antimicrobial resistance in bacterial isolates in this study. Methicillin resistant Staphylococcus aureus (MRSA) was 56.3 % and MRSE 62.9 %. Vancomycin resistant enterococci (VRE) was 60.7%. K. pneumoniae-ESBL was 79.6% and its resistance to carbapenem was 38.4%. E. coli-ESBL was 42% and its resistance to carbapenems was 2.3%. P. aeruginosa resistance to ceftazidime was 74.4%, to fluroquinolones 63.3%, to aminoglycosides 64.8%, to piperacillin tazobactam 47.6% and to carbapenems 62.1%. Acinetobacter baumannii resistance to ceftazidime was 98.7%, to fluroquinolones 97%, to aminoglycosides 95.9%, to ampicillin sulbactam 84%, to carbapenems 96.4% and to colistin 4%. Conclusion: The study revealed an alarming rate of resistance to the commonly used antimicrobial agents used in treating HAIs. Also the relationship between AMR and some risk factors and thus taking steps towards controlling them have been shown.
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Affiliation(s)
| | - Abbas Rahimi Foroushani
- Department of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoome Zolfaghari
- Department of Infectious Diseases, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Abdollahi
- Department of Pathology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Alipour
- Department of Community Medicine, Thalassemia Research Center, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Esmaeil Mohammadnejad
- Department of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Ehsan Zare Mehrjardi
- Department of Industrial and Environmental Biotechnology, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Arash Seifi
- Department of Infectious Diseases, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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23
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Mousavi A, Modarres Gilani M, Akhavan S, Sheikh Hasani S, Alipour A, Gholami H. The Outcome of Locally Advanced Cervical Cancer in Patients Treated with Neoadjuvant Chemotherapy Followed by Radical Hysterectomy and Primary Surgery. Iran J Med Sci 2021; 46:355-363. [PMID: 34539010 PMCID: PMC8438343 DOI: 10.30476/ijms.2020.81973.0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 07/26/2019] [Accepted: 09/01/2019] [Indexed: 12/04/2022]
Abstract
Background: In recent years, before radical hysterectomy, neoadjuvant chemotherapy (NACT) has been administered to patients with locally advanced cervical cancer to shrink large tumors.
It has been reported that this treatment significantly reduces the need for radiotherapy after surgery. The current study aimed to assess the outcome
(survival, recurrence, and the need for adjuvant radiotherapy) of locally advanced cervical cancer in patients treated with NACT followed by radical hysterectomy and primary surgery. Methods: In a retrospective cohort study, the records of 258 patients with cervical cancer (stage IB2, IIA, or IIB), who referred to Imam Khomeini Hospital (Tehran, Iran)
from 2007 to 2017 were evaluated. The patients were assigned into two groups; group A (n=58) included patients, who underwent radical hysterectomy and group B (n=44)
included those, who underwent a radical hysterectomy after NACT. The outcome measures were the recurrence rate, five-year survival rate, and the need for adjuvant radiotherapy. Results: The median for overall survival time in group A and B was 113.65 and 112.88 months, respectively (P=0.970). There was no recurrence among patients with stage
IB2 cervical cancer in group B, while the recurrence rate in group A was 19.5% with a median recurrence time of 59.13 months. Lymph node involvement was the
only factor that affected patients’ survival. The need for postoperative adjuvant radiotherapy in group B was lower than in group A (P=0.002). Conclusion: NACT before the hysterectomy was found to reduce the need for postoperative radiotherapy in patients with locally advanced cervical cancer according to disease stages.
As a direct result, adverse side effects and the recurrence rate were reduced, and the overall survival rate of patients with stage IIB cervical cancer was increased.
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Affiliation(s)
- Azamsadat Mousavi
- Department of Oncology, Emam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modarres Gilani
- Department of Oncology, Emam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Setareh Akhavan
- Department of Oncology, Emam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrzad Sheikh Hasani
- Department of Oncology, Emam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Alipour
- Thalassemia Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamideh Gholami
- Department of Oncology, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
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24
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Ozkaya E, Triolo ER, Rezayaraghi F, Abderezaei J, Meinhold W, Hong K, Alipour A, Kennedy P, Fleysher L, Ueda J, Balchandani P, Eriten M, Johnson CL, Yang Y, Kurt M. Brain-mimicking phantom for biomechanical validation of motion sensitive MR imaging techniques. J Mech Behav Biomed Mater 2021; 122:104680. [PMID: 34271404 DOI: 10.1016/j.jmbbm.2021.104680] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/07/2021] [Accepted: 06/30/2021] [Indexed: 10/20/2022]
Abstract
Motion sensitive MR imaging techniques allow for the non-invasive evaluation of biological tissues by using different excitation schemes, including physiological/intrinsic motions caused by cardiac pulsation or respiration, and vibrations caused by an external actuator. The mechanical biomarkers extracted through these imaging techniques have been shown to hold diagnostic value for various neurological disorders and conditions. Amplified MRI (aMRI), a cardiac gated imaging technique, can help track and quantify low frequency intrinsic motion of the brain. As for high frequency actuation, the mechanical response of brain tissue can be measured by applying external high frequency actuation in combination with a motion sensitive MR imaging sequence called Magnetic Resonance Elastography (MRE). Due to the frequency-dependent behavior of brain mechanics, there is a need to develop brain phantom models that can mimic the broadband mechanical response of the brain in order to validate motion-sensitive MR imaging techniques. Here, we have designed a novel phantom test setup that enables both the low and high frequency responses of a brain-mimicking phantom to be captured, allowing for both aMRI and MRE imaging techniques to be applied on the same phantom model. This setup combines two different vibration sources: a pneumatic actuator, for low frequency/intrinsic motion (1 Hz) for use in aMRI, and a piezoelectric actuator for high frequency actuation (30-60 Hz) for use in MRE. Our results show that in MRE experiments performed from 30 Hz through 60 Hz, propagating shear waves attenuate faster at higher driving frequencies, consistent with results in the literature. Furthermore, actuator coupling has a substantial effect on wave amplitude, with weaker coupling causing lower amplitude wave field images, specifically shown in the top-surface shear loading configuration. For intrinsic actuation, our results indicate that aMRI linearly amplifies motion up to at least an amplification factor of 9 for instances of both visible and sub-voxel motion, validated by varying power levels of pneumatic actuation (40%-80% power) under MR, and through video analysis outside the MRI scanner room. While this investigation used a homogeneous brain-mimicking phantom, our setup can be used to study the mechanics of non-homogeneous phantom configurations with bio-interfaces in the future.
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Affiliation(s)
- E Ozkaya
- Department of Mechanical Engineering, Stevens Institute of Technology, Hoboken, NJ, 07030, USA.
| | - E R Triolo
- Department of Mechanical Engineering, Stevens Institute of Technology, Hoboken, NJ, 07030, USA
| | - F Rezayaraghi
- Department of Mechanical Engineering, Stevens Institute of Technology, Hoboken, NJ, 07030, USA
| | - J Abderezaei
- Department of Mechanical Engineering, Stevens Institute of Technology, Hoboken, NJ, 07030, USA
| | - W Meinhold
- The George W. Woodruff of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - K Hong
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - A Alipour
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - P Kennedy
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - L Fleysher
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - J Ueda
- The George W. Woodruff of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - P Balchandani
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - M Eriten
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - C L Johnson
- Department of Biomedical Engineering, University of Deleware, Newark, DE, 19716, USA
| | - Y Yang
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - M Kurt
- Department of Mechanical Engineering, Stevens Institute of Technology, Hoboken, NJ, 07030, USA; BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
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25
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Akhavan S, Alibakhshi A, Parsapoor M, Alipour A, Rezayof E. Comparison of therapeutic effects of chemo-radiotherapy with neoadjuvant chemotherapy before radical surgery in patients with bulky cervical carcinoma (stage IB3 & IIA2). BMC Cancer 2021; 21:667. [PMID: 34088300 PMCID: PMC8178912 DOI: 10.1186/s12885-021-08416-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 05/25/2021] [Indexed: 11/25/2022] Open
Abstract
Background Cervical cancer is one of the most common malignancies among women. Appropriate and timely treatment of these patients can reduce the complications and increase their survival. The objective of this study was to compare neoadjuvant chemotherapy plus radical hysterectomy (NACTRH) and chemo-radiotherapy (CRT) in patients with bulky cervical cancer (stage IB3 & IIA2). Material and methods The medical records of patients with bulky cervical cancer (stage IB3 & IIA2) that received NACTRH or CRT between 2007 and 2017 were evaluated for therapeutic effects. Demographic characteristics, complications of chemo-radiotherapy and neoadjuvant chemotherapy, were collected in a researcher-made questionnaire. Our primary outcome was comparison of overall survival (OS), and disease-free survival (DFS) between two groups receiving NACTRH and CRT modalities. Results One-hundred and twenty three patients were enrolled in the study. The median age and the proportion of patients with stage IIA2 were higher in the CRT group compared to the NACTRH group (p < 0.05). The medians (95% CI) OS were 3.64 (3.95–6.45) and 3.9 (3.53–4.27) years in the NACTRH and CRT groups, respectively (P = 0.003). There were 16 (34.8%) and 22 (43.1%) recurrences in the NACTRH and CRT group, respectively (P = 0.4). The median (95% CI) DFS was 4.5 (3.88–5.12) years in the NACTRH group and 3.6 (2.85–4.35) years in the CRT group (P = 0.004). The 3-year OS rate in NACTRH and CRT groups were 97 and 90% respectively. The 3-year DFS rate in NACTRH and CRT groups were 88 and 66% respectively. Conclusions NACTRH is associated with a higher OS and DFS compared to CRT.
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Affiliation(s)
- Setareh Akhavan
- Gynecology Oncology Ward, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, Tohid Square, Tehran, 1419733141, Iran.
| | - Abbas Alibakhshi
- General Surgery Ward, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdieh Parsapoor
- Gynecology Oncology Ward, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, Tohid Square, Tehran, 1419733141, Iran
| | - Abbas Alipour
- Community Medicine Department, Medical Faculty, Thalassemia Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Elahe Rezayof
- Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
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26
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Saei S, Sahebnasagh A, Ghasemi A, Akbari J, Alipour A, Lashkardoost H, Yaghobi Joybari A, Nejad Dadgar F, Ala S, Salehifar E. Efficacy of sucralfate ointment in the prevention of acute proctitis in cancer patients: A randomized controlled clinical trial. Caspian J Intern Med 2021; 11:410-418. [PMID: 33680383 PMCID: PMC7911762 DOI: 10.22088/cjim.11.4.410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Acute radiation proctitis (ARP) is a usual adverse effect in patients undergoing pelvic radiotherapy. The symptoms include diarrhea, rectal blood or mucus discharge, fecal urgency and tenesmus with pain. Sucralfate, an aluminum-based salt of sucrose octasulfate, is a cytoprotective agent that forms a coating barrier at injured sites by adhering to mucoproteins. It has been used in topical management of a wide variety of local lesion. This study was designed to evaluate the preventive effect of rectal sucralfate on acute radiotherapy induced proctitis. Methods: Seven percent sucralfate ointment was prepared for topical use. Drug quantification, chemical stability and microbial limit tests were performed carefully. In this randomized double blind placebo controlled trial, fifty-seven patients with pelvic malignancies undergoing radiotherapy were allocated to receive either 1 g of sucralfate or 1 g of placebo, given as a twice daily ointment, one day before and during radiotherapy for six weeks. The eligible patients were evaluated based on RTOG acute toxicity criteria and the following ARP symptoms weekly: rectal hemorrhage, diarrhea, rectal pain, and fecal urgency. The influence of symptoms on lifestyle was also recorded weekly. Results: Acute proctitis was significantly less prevalent in patients in the sucralfate group. The incidence of rectal bleeding (P=0.003), diarrhea (P=0.002), rectal pain (P=<0.001) and fecal urgency (P=0.002) was significantly less common in the sucralfate group. No statistical significant difference was observed for radiotherapy induced cystitis in the placebo and sucralfate groups (P=0.27). Conclusion: This study suggests that sucralfate7% ointment reduces the incidence of symptoms associated with acute radiation proctitis.
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Affiliation(s)
- Sara Saei
- Student Research Committee, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Adeleh Sahebnasagh
- Clinical Research Center, Department of Internal Medicine, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Arash Ghasemi
- Emam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jafar Akbari
- Pharmaceutical Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abbas Alipour
- Department of Epidemiology, Faculty of Medicine, Community Medicine Department, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Lashkardoost
- School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Ali Yaghobi Joybari
- Pharmaceutical Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farid Nejad Dadgar
- Pharmaceutical Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shahram Ala
- Pharmaceutical Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ebrahim Salehifar
- Gastrointestinal Cancer Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
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27
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Sahebnasagh A, Saghafi F, Ghasemi A, Akbari J, Alipour A, Habtemariam S, Safdari M, Ghaleno HR, Salehifar E. Aloe vera for Prevention of Acute Radiation Proctitis in Colorectal Cancer a Preliminary Randomized, Placebo-Controlled Clinical Trial. J Gastrointest Cancer 2021; 53:318-325. [PMID: 33616843 DOI: 10.1007/s12029-021-00597-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To examine the preventive effects of Aloe vera in colorectal cancer patients undergoing radiotherapy. MATERIAL AND METHOD Twenty colorectal cancer patients, who received radiation, were randomized to receive Aloe vera 3% or placebo ointment, 1 g twice daily for 6 weeks. At weekly visits, acute radiation proctitis (ARP) was evaluated by Radiation Therapy Oncology Group and clinical presentation criteria as the primary endpoint. We also evaluated secondary endpoints of quality of life, psychosocial status, by applying Hospital Anxiety-Depression (HAD) Scale and laboratory measures of quantitative measurement of C-reactive protein (CRP) as a marker for systemic inflammation. RESULTS There was a significant improvement in the symptom index (before treatment vs. after treatment with Aloe vera) for diarrhea (p = 0.029, median score: 0.5 vs. 0.001). The overall primary and secondary outcomes favored Aloe group, while the measures of toxicity did not achieve a statistical significant difference. The lifestyle score improved significantly with A. vera (p = 004), and they also had a lower depression score in HAD scale (p = 0.008). Furthermore, quantitative CRP decreased significantly during the course of treatment with Aloe vera. CONCLUSION The use of topical formulation of Aloe vera 3% diminishes the severity of ARP in colorectal cancer patients.
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Affiliation(s)
- Adeleh Sahebnasagh
- Clinical Research Center, Department of Internal Medicine, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Fatemeh Saghafi
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Arash Ghasemi
- Emam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jafar Akbari
- Pharmaceutical Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abbas Alipour
- Faculty of Medicine, Community Medicine Department, Mazandaran University of Medical Sciences, Sari, Iran
| | - Solomon Habtemariam
- Pharmacognosy Research Laboratories and Herbal Analysis Services UK, University of Greenwich, Central Avenue, Chatham-Maritime,, ME4 4TB, Kent, UK
| | - Mohammadreza Safdari
- Department of Orthopedic Surgery, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Hassan Rezai Ghaleno
- Department of Surgery, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ebrahim Salehifar
- Pharmaceutical Sciences Research Center, Faculty of Pharmacy, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran.
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Alipour A, Giffney T, Lin R, Jayaraman K. Effects of matrix viscosity on morphological and rheological properties and the electrical percolation threshold in graphene/epoxy nanocomposites. EXPRESS POLYM LETT 2021. [DOI: 10.3144/expresspolymlett.2021.46] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Haddadi K, Abediankenari S, Alipour A, Ghazvini HRG, Jafarpour H, Asadian L, Ketabchi SE. Association between Serum Levels of Interleukin-6 on Pain and Disability in Lumbar Disc Herniation Surgery. Asian J Neurosurg 2020; 15:494-498. [PMID: 33145197 PMCID: PMC7591175 DOI: 10.4103/ajns.ajns_71_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/18/2020] [Accepted: 05/21/2020] [Indexed: 12/02/2022] Open
Abstract
Context: Many inflammatory cytokines are also elevated in degenerated or herniated intervertebral discs. Among biomarkers, interleukin-6 (IL-6) plays an essential role in the inflammatory process of disc herniation. Some studies have suggested that an increase in serum IL-6 levels occurs in sustained radicular pain. Aims: The aim of this study was to determine the relationship between changes in IL-6 serum level and pain and disability index in patients with radicular pain in acute herniated lumbar disc before and after lumbar disc surgery. Settings and Design: This is a descriptive-analytic prospective study to examine the association between IL-6 serum levels on pain and disability before and after the surgery in patients admitted with acute herniated lumbar intervertebral discs from 2015 to 2018 in Imam Khomeini Hospital, Sari, Mazandaran, Iran. Subjects and Methods: The blood level of IL-6, the severity of pain based on visual analog score, and disability based on the Oswestry disability index were measured before and 3 months after surgery. Statistical Analysis Used: All data were analyzed using SPSS version 24. Results: Thirty-two patients were enrolled in the study. Seventeen patients were male. The mean age was 39.53 ± 8.89 years. IL-6 concentration, 4.36 and 1.16 pg/ml were determined as cutoff before and after the surgery. Conclusions: The acceptable sensitivity and specificity of IL were obtained in this study. Our findings revealed that IL-6 could be used as a biomarker for predicting postoperative pain relief and disability improvement.
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Affiliation(s)
- Kaveh Haddadi
- Spine Fellowship, Department of Neurosurgery, Faculty of Medicine, Diabetes Research Center, Mazandaran University of Medical Science, Sari, Iran
| | - Saeed Abediankenari
- Department of Immunology, Faculty of Medicine, Immunogenetic Research Center, Cancer Research Institute, Mazandaran University of Medical Science, Sari, Iran
| | - Abbas Alipour
- Department of Community Medicine, Faculty of Medicine, Psychiatry and Behavioral Sciences Research Center, Addiction Research Institutes, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Hamed Jafarpour
- Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Science, Sari, Iran
| | - Leila Asadian
- Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Science, Sari, Iran
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Darvishi-Khezri H, Kosaryan M, Karami H, Salehifar E, Mahdavi M, Alipour A, Aliasgharian A. Can Use of Silymarin Improve Inflammatory Status in Patients with β-Thalassemia Major? A Crossover, Randomized Controlled Trial. Complement Med Res 2020; 28:123-130. [PMID: 32971524 DOI: 10.1159/000509829] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 06/29/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND In β-thalassemia major (β-TM) patients, iron overload is one of the main causes of inflammation. This study investigated whether use of silymarin could improve inflammatory status in patients with β-TM and iron overload, through a placebo-controlled, crossover study. METHODS Silymarin (140 mg, 3 times a day) or placebo were prescribed to all patients (n = 82) for 12 weeks, and after a 2-week washout period, patients were crossed over to the other group. The efficacy of silymarin was assessed by measuring serum C-reactive protein (CRP) (mg/dL), interleukin (IL)-6 (pg/mL), and IL-10 (pg/mL). RESULTS Sixty-nine patients completed the study. Data analysis showed that compared to the placebo, silymarin could decrease CRP, IL-6, and raise IL-10 significantly (the p values for all variables were <0.001). Cohen's d for CRP adjusted according to the baseline CRP value was -1.72, the 95% confidence interval (CI) -2.12 to -1.33. The adjusted Cohen's d equal to -1.12, 95% CI -1.48 to -0.76, and 0.78, 95% CI 0.43-1.12, were also estimated for IL-6 and IL-10, respectively. CONCLUSION The results of the current study demonstrate that the combination of iron chelation therapy with silymarin can improve inflammatory status in patients with β-TM in the clinical setting.
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Affiliation(s)
- Hadi Darvishi-Khezri
- Thalassemia Research Center (TRC), Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehrnoush Kosaryan
- Thalassemia Research Center (TRC), Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Karami
- Thalassemia Research Center (TRC), Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ebrahim Salehifar
- Phamaceutical Science Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran,
| | - Mohammadreza Mahdavi
- Thalassemia Research Center (TRC), Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abbas Alipour
- Department of Community Medicine, Thalassemia Research Center (TRC), Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Aily Aliasgharian
- Medical Microbiology, Thalassemia Research Center (TRC), Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran
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Mousavi AS, Pouryasin A, Yarandi F, Pirzadeh L, Alipour A, Khodadad S, Pouryasin M. Assessment of Cervical Cancer Molecular-Based Screening Tools; HPV-DNA Detection versus E6/E7 mRNA Testing; First Report of a Prospective Cohort Study among Iranian Women. Iran J Public Health 2020; 49:1734-1742. [PMID: 33643949 PMCID: PMC7898099 DOI: 10.18502/ijph.v49i9.4093] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Human papillomavirus (HPV) has been found as the most considerable causes of cervical cancer. Recently, several molecular methods have been introduced to increase the accuracy of the screening programs and decrease the mortality rate. Among these methods, mRNA-based methods have more advantages as they assess the expression level of HPV E6 and E7 oncogenic mRNAs. This study aimed to evaluate the results of HPV RNA- and DNA-based methods among Iranian women population with normal cytology results. Methods: Overall, 4640 women were enrolled referred to the Gynecology Oncology Ward of Vali-e-Asr Hospital, private and academic clinics, Tehran, Iran from Jan 2016 to Apr 2018. To assess the HPV-DNA infection INNO-LiPA® HPV Genotyping Extra-II kit was used. For HPV-RNA assessment, Aptima HPV Assay and in house HPV-RNA genotyping methods were applied. Results: The positivity rates of HPV infection according to DNA- and RNA-based methods were 18.0% and 11.2%, respectively (P<0.001). The positive predictive value, negative predictive value, specificity and sensitivity of DNA-based method in contrast with RNA-based method were 59.2% (56.6–61.6), 99.4% (99.0–99.6), 91.7% (90.8–92.6) and 95.2% (93.0–96.9) respectively. Conclusion: At the present study for prognosis of cervical cancer, RNA-based method seemed to be more specific in contrast to DNA-based method. Patient follow up and further studies will be conducted in order to clarify the clinical sensitivity and specificity of the two methods.
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Affiliation(s)
- Azam-Sadat Mousavi
- Department of Gynecology-Oncology, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.,National Association of Iranian Gynecologists and Obstetricians, Tehran, Iran.,Iranian Society for Colposcopy and Cervical Pathology, Tehran, Iran
| | - Ali Pouryasin
- Department of Molecular Diagnosis, Armin Pathobiology Laboratory, Tehran, Iran.,Department of Genetics, Arsanjan Branch, Islamic Azad University, Arsanjan, Iran
| | - Fariba Yarandi
- National Association of Iranian Gynecologists and Obstetricians, Tehran, Iran.,Iranian Society for Colposcopy and Cervical Pathology, Tehran, Iran.,Department of Gynecology-Oncology, Yas Women Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Pirzadeh
- Department of Gynecology-Oncology, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.,National Association of Iranian Gynecologists and Obstetricians, Tehran, Iran.,Iranian Society for Colposcopy and Cervical Pathology, Tehran, Iran
| | - Abbas Alipour
- Thalassemia Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shakiba Khodadad
- National Association of Iranian Gynecologists and Obstetricians, Tehran, Iran.,Department of Gynecology-Oncology, Erfan Hospital, Tehran, Iran
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Babakhanian M, Zarghami M, Alipour A, Khosravi A, Hashemi-Nazari SS, Saberi M, Ghadirzadeh MR. An Estimation of Drug-Related Deaths in Iran, Using the Capture-Recapture Method (2014-2016). Addict Health 2020; 12:87-97. [PMID: 32782731 PMCID: PMC7395932 DOI: 10.22122/ahj.v12i2.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background The Ministry of Health and Medical Education (MOHME) and the Legal Medicine Organization (LMO) are the 2 death registration systems in Iran for registering drug-related deaths. The aim of the present study was to assess the number of undercount and the overlap between the deaths registered by the 2 sources. Methods In this descriptive study, according to the ý10th revision of the International Classification of Diseases ý(ICD-10), the registered data on drug-related deaths in the years 2014-2016, as recorded by the MOHME and the LMO, were collected and the number of deaths was estimated using 2-source capture-recapture method and Excel and SPSS software. Findings The total number of drug-related deaths, as registered by the 2 sources, was 8639 during the 3 years. A major part of the drug-related deaths (75% of the data) had been registered by the LMO and only 25% of deaths had been registered by the MOHME. There was also a small overlap (7.7% of deaths) between the data from the 2 sources. The final estimation from the capture-recapture model and analysis of sensitivity showed that, during the 3 years, the total number of drug-related deaths was 14517 [95% confidence interval (CI):14498-14558]. Based on the complete overlap assumption and 50% of unidentified individuals in the 2 sources, the number of deaths was estimated at 11341 and 12418, respectively. The largest number of drug-related deaths had occurred within the age range of 25-39 years and in men. Kermanshah, Hamedan, and Zanjan Provinces (Iran) had the largest number of cumulative incidences of drug-related deaths. Based on the data provided by the MOHME, the most common cause of death was Methadone poisoning. Conclusion There was a small overlap between the MOHME and the LMO in the registration of drug-related deaths. Failure to enter accurate and correct information has led to miscalculations of these deaths in Iran.
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Affiliation(s)
- Masoudeh Babakhanian
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehran Zarghami
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute AND Department of Psychiatry, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abbas Alipour
- Department of Social Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ardeshir Khosravi
- Deputy for Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Seyed Saeed Hashemi-Nazari
- Promotion and Injury Prevention Research Center AND Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Hasani Moghadam S, Alipour A, Abedian Kenari S, Khani S. Diagnostic Tests and Clinical, Laboratory and Radiological Charactersitics of COVID-19 in Pregnant Women: A Review. J Qazvin Univ Med Sci 2020. [DOI: 10.32598/jqums.24.2.2392.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The emerging Coronavirus (COVID-19) is a new infectious disease and the definitive gold standard for its diagnosis in pregnancy has not yet been established. Therefore, this study was conducted with the aim of reviewing the diagnostic methods and clinical, laboratory and radiological symptoms of COVID-19 disease in pregnant women. The present study is a Narrative review. To do so, the keywords were searched in the Scopus, Google scholar, PubMed, Embase, Science Direct, WHO databases from April 1, 2020 to May 9, 2020. 34 articles were obtained and finally 6 articles were used to write this study. Evidence related to the purpose of this study was identified in three categories. The first category examines clinical findings (fever and cough), the second category examines laboratory findings (leukocytosis and lymphopenia), and a third category examines chest radiographic findings (Pure ground-glass opacity). Since infection is one of the most important causes of death in pregnant women and is one of the preventable and controllable factors, so by identifying the correct diagnostic methods of this infection, at-risk pregnant women will be identified and Prevent the consequences of this infection.
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Sahebnasagh A, Ghasemi A, Akbari J, Alipour A, Lashkardoost H, Ala S, Hosseinimehr SJ, Salehifar E. Prevention of acute radiation-induced Proctitis by Aloe vera: a prospective randomized, double-blind, placebo controlled clinical trial in Pelvic Cancer patients. BMC Complement Med Ther 2020; 20:146. [PMID: 32404169 PMCID: PMC7222341 DOI: 10.1186/s12906-020-02935-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 04/22/2020] [Indexed: 01/28/2023] Open
Abstract
Background Acute radiation-induced proctitis (ARP) is the most common side effect following radiotherapy for malignant pelvic disease. This study evaluated the efficacy of Aloe vera ointment in prevention of ARP. Methods Forty-two patients receiving external-beam radiotherapy (RT) for pelvic malignancies were randomized to receive either Aloe vera 3% or placebo topical ointment during radiotherapy for 6 weeks. These patients were evaluated based on the severity (grade 0–4) of the following symptoms weekly: rectal bleeding, abdominal/rectal pain, diarrhea, or fecal urgency. RTOG acute toxicity criteria and psychosocial status of the patients were also recorded weekly. Lifestyle impact of the symptoms, and quantitative measurement of C-reactive protein (CRP), an indicator of systemic inflammation, were also measured. Results The results of present study demonstrated a significant preventive effect for Aloe vera in occurrence of symptom index for diarrhea (p < 0.001), rectal bleeding (p < 0.001), and fecal urgency (p = 0.001). The median lifestyle score improved significantly with Aloe vera during RT (p < 0.001). Intervention patients had a significant lower burden of systemic inflammation as the values for quantitative CRP decreased significantly over 6 weeks of follow-up (p = 0.009). Conclusion This study showed that Aloe vera topical ointment was effective in prevention of symptoms of ARP in patients undergoing RT for pelvic cancers. Trial registration IRCT201606042027N6. Registration date: 2016-09-04.
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Affiliation(s)
- Adeleh Sahebnasagh
- Clinical Research Center, Department of Internal Medicine, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Arash Ghasemi
- Emam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jafar Akbari
- Pharmaceutical Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abbas Alipour
- Epidemiology, Faculty of Medicine, Community medicine Department, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Lashkardoost
- School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, I.R, Iran
| | - Shahram Ala
- Pharmaceutical Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Jalal Hosseinimehr
- Department of Radiopharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ebrahim Salehifar
- Gastrointestinal Cancer Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran. .,Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, 48471-16548, Km 18 Khazarabad Road, Khazar sq., Sari, Mazandaran Province, Iran.
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35
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Alipour A, Zarinabadi S, Azimi A, Mirzaei M. Adsorptive removal of Pb(II) ions from aqueous solutions by thiourea-functionalized magnetic ZnO/nanocellulose composite: Optimization by response surface methodology (RSM). Int J Biol Macromol 2020; 151:124-135. [DOI: 10.1016/j.ijbiomac.2020.02.109] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 01/30/2020] [Accepted: 02/11/2020] [Indexed: 01/18/2023]
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Klaver MN, Wintgens LIS, Wijffels MCEF, Balt JC, van Dijk VF, Alipour A, Chaldoupi SM, Derksen R, Boersma LVA. Acute success and safety of the second-generation PVAC GOLD phased RF ablation catheter for atrial fibrillation. J Interv Card Electrophysiol 2020; 60:261-270. [PMID: 32253598 PMCID: PMC7925470 DOI: 10.1007/s10840-020-00728-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 03/10/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE The second-generation multi-electrode catheter, pulmonary vein ablation catheter (PVAC) GOLD, was designed to improve the delivery of phased radiofrequency energy and reduce procedure times using a 'single-shot' approach for pulmonary vein isolation (PVI), while retaining efficacy and safety. This large registry presents acute success rates and safety outcomes in a daily practice setting. METHODS A total of 1017 patients undergoing first-time ablation for atrial fibrillation (AF) using PVAC GOLD were included, 644 patients with paroxysmal AF and 373 patients with non-paroxysmal AF, divided into 175 patients receiving PVI only and 198 patients receiving PVI with additional substrate modification. RESULTS High and comparable percentages of successful PVI could be achieved in all groups (98%, 95% and 99%; p = 0.108). The median total procedure time for all groups was 90 min [70-100]. As expected, the total procedure, ablation and fluoroscopy time were significantly longer in the PVI + substrate modification group compared with the PVI-only cases (all p < 0.001), but not between the PVI-only groups (p = 0.306, p = 0.088, p = 0.233, respectively). A total of 44 complications were observed in 43 patients (4.2%). Major complications were seen in 19 patients (1.87%) and non-major procedure-related complications were seen in 25 patients (2.46%). Complications leaving permanent sequelae were rare and occurred in only four patients (0.39%). Complications did not differ between groups (p = 0.199, p = 0.438, p = 0.240 and p = 0.465 respectively). CONCLUSION PVAC GOLD performs successful PVI, while reducing procedure times and retaining safety for paroxysmal, persistent and long-standing persistent AF. Safety was unaffected by additional substrate modification.
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Affiliation(s)
- M N Klaver
- Department of Cardiology, St. Antonius Hospital, Koekoekslaan 1, 3435CM, Nieuwegein, The Netherlands. .,Department of Cardiology, Amsterdam University Medical Centres, location Academic Medical Centre, Amsterdam, The Netherlands.
| | - L I S Wintgens
- Department of Cardiology, St. Antonius Hospital, Koekoekslaan 1, 3435CM, Nieuwegein, The Netherlands
| | - M C E F Wijffels
- Department of Cardiology, St. Antonius Hospital, Koekoekslaan 1, 3435CM, Nieuwegein, The Netherlands
| | - J C Balt
- Department of Cardiology, St. Antonius Hospital, Koekoekslaan 1, 3435CM, Nieuwegein, The Netherlands
| | - V F van Dijk
- Department of Cardiology, St. Antonius Hospital, Koekoekslaan 1, 3435CM, Nieuwegein, The Netherlands
| | - A Alipour
- Department of Cardiology, Rivierenland Hospital, Tiel, The Netherlands
| | - S M Chaldoupi
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - R Derksen
- Department of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands
| | - L V A Boersma
- Department of Cardiology, St. Antonius Hospital, Koekoekslaan 1, 3435CM, Nieuwegein, The Netherlands.,Department of Cardiology, Amsterdam University Medical Centres, location Academic Medical Centre, Amsterdam, The Netherlands
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Alipour A, Khodakarim S, Khosravi A, Ataey A. Estimating population cause-specific mortality fractions in the Islamic Republic of Iran: validation of Murray's method. East Mediterr Health J 2020; 26:290-296. [PMID: 32281638 DOI: 10.26719/emhj.19.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 06/28/2018] [Indexed: 11/09/2022]
Abstract
Background Vital civil information is recorded in only 25% of middle-income countries. Aims To estimate the number and causes of deaths expected in the population, using hospital mortality data and comparing them with data from the Ministry of Health and Medical Education, Tehran, Islamic Republic of Iran. Methods Hospital mortality data for 2011-2015 were extracted and were corrected qualitatively through reference to medical records. Using Murray's proposed method, an estimate of the expected deaths was obtained according to cause of death. Results During 2011-2015, 12 704 deaths were recorded in the hospital and Murray's method estimated 28 768 deaths for the entire population. The most frequent cause of death was ischemic heart disease. The results were compared with data from the Ministry of Health and Medical Education, which had a relative error of 6.9% and -13.5% respectively. The mortality rates registered by the Civil Registration Office were higher than those estimated in the present study. The mortality rates registered by the Ministry of Health and Medical Education were lower than those in the present study. Conclusions Considering the importance of registering deaths, alternative methods, with efficiency and low cost, are needed to estimate the number and causes of death in a population.
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Affiliation(s)
- Abbas Alipour
- Thalassemia Research Center, Mazandaran University of Medical Sciences, Sari, Islamic Republic of Iran
| | - Soheila Khodakarim
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Ardeshir Khosravi
- Deputy for Public Health, Ministry of Health and Medical Education and Medical Education, Tehran, Islamic Republic of Iran
| | - Amin Ataey
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
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Hakimi F, Movahhed M, Yaghmaei F, Alipour A. Explanation of Dry Liver Dystemperament (sue-mizaj) Concept in Iranian Traditional Medicine (Persian Medicine): A Qualitative Study. CTM 2020. [DOI: 10.2174/2215083806666191202145837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Temperament (mizaj), prakruti and zheng are equivalent basic concepts
in different traditional medical schools. In Iranian Traditional Medicine (ITM), Liver
distemperament is one of the liver diseases not yet objectively defined.
Objectives:
The present study aims to explain the concept of dry liver dystemperament in
Iranian Traditional Medicine.
Methods:
This study is a qualitative research based on a hybrid model of concept analysis.
In literature review, 11 major academic textbooks of PhD students of ITM as well as, recent
investigations were reviewed. In addition, 16 ITM experts were interviewed to collect empirical
data. The data were analyzed using MAXQDA10 software and categorized based on
conventional content analysis.
Result:
Here, dry dystemperament of the liver was classified into three main themes of systemic,
local, and Para-clinical symptoms and 10 categories. Phenotypic features, skin color,
dryness or stiffness in mucus, skin and subcutaneous tissue touch, general or gastrointestinal
dysfunction; especially thirst and systemic impressibility speed were the most important
clinical diagnostic criteria.
Conclusion:
In this study, a new definition was presented for dry liver dystemperament.
Based on the results, there were some scattered symptoms in textbooks, which were of the
same importance. However, in empirical phase, the experts of traditional medicine stated
that in clinical diagnosis, some signs or symptoms are more important for them. The concept
of dry liver dystemperament was classified into 10 categories which were the same as dysfunction
in 10 categories that mentioned for general temperament.
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Affiliation(s)
- Fatemeh Hakimi
- Department of Traditional Medicine, School of Traditional Medicine. Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mina Movahhed
- Department of Traditional Medicine, School of Traditional Medicine. Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farideh Yaghmaei
- Department of Nursing Zanjan Branch, Islamic Azad University, Zanjan, Iran
| | - Abbas Alipour
- Department of Health and Social Medicine, Mazandaran University of Medical Sciences, MAZUMS, Mazandaran, Iran
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Salehifar E, Janbabaei G, Alipour A, Tabrizi N, Avan R. Taxane-induced peripheral neuropathy and quality of life in breast cancer patients. J Oncol Pharm Pract 2020; 26:1421-1428. [PMID: 31937190 DOI: 10.1177/1078155219898511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE Taxane-induced peripheral neuropathy (TIPN) is a common and bothersome toxicity. This study aimed to determine the incidence and severity of TIPN in patients with breast cancer and to investigate the relationship between TIPN and quality of life. METHODS A total of 82 breast cancer patients with TIPN symptoms were included in this study. The criteria of National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE v4.03) and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30, version 3.0) were used to evaluate grading of sensory neuropathy and quality of life, respectively. Analysis of the data was done by IBM SPSS statistics version 23. RESULTS A total of 346 patients received taxane-based chemotherapy and 82 patients (23.7%) experience TIPN. The mean (SD) global health status/quality of life, physical functioning, role functioning, and pain subscales were 60.63 (5.26), 80.64 (9.05), 81.77 (10.41), and 43.88 (11.27), respectively. There were significant negative correlations between global health status/quality of life, physical functioning, and role functioning subscales with the grade of neuropathy (r = -0.33, -0.80, and -0.61, respectively) and positive correlation between pain subscale and the grade of neuropathy (r = 0.70). CONCLUSION This study shows a clear association between TIPN and worsened quality of life. These findings emphasize on detecting and management of TIPN in an effort to improve the quality of life of breast cancer patients.
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Affiliation(s)
- Ebrahim Salehifar
- Pharmaceutical Sciences Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ghasem Janbabaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abbas Alipour
- Thalassemia Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Nasim Tabrizi
- Department of Neurology, Mazandaran University of Medical Sciences, Sari, Iran
| | - Razieh Avan
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Faculty of Pharmacy, Birjand University of Medical Sciences, Birjand, Iran
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Kazemian K, Ala S, Mojtahedzadeh M, Abedini M, Alipour A, Abediankenari S, Rafati M, Abaskhanidavanloo A, Mohajerani F. Evaluation of Neuroprtective Effects of L-Carnitine and Fat Emulsion in the CVA Patients: A Prospective, Randomized, Double Blind, Clinical Trial. Iran J Pharm Res 2020; 19:111-119. [PMID: 32922474 PMCID: PMC7462480 DOI: 10.22037/ijpr.2020.1100952] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Cerebral infarction presents with neurological deficits caused by the death of neurons in a focal area of the brain. S100B is a biomarker that increases in brain damage. Neuroprotectives can reduce the brain sequels after neurological insult. The purpose of this study was to evaluate the neuroprotective effects of L-carnitine and Fat emulsion (Lipofundin®) alone and in combination in patients with ischemic stroke. In a prospective, RCT, and double-blind study 100 patients with MCA ischemic cerebrovascular accident who were admitted in the first 24 h of injury entered the study. The patients were randomly assigned into four groups of L-carnitine, fat emulsion, L-carnitine plus fat emulsion and control. Fat emulsion 10%, 500 mL, was infused over 6 to 12 h and 1 gr of L-carnitine (10 mL of solution) was administered orally to patients in addition to common therapies, according to the American Heart Association and American Stroke Association (AHA/ASA) guidelines. The patients in the control group received only the usual treatment according to stroke guidelines. Blood samples before the intervention, then after 24 h, 48 h, and 7 days later were taken and immunoenzymatic colorimetric method was used for quantitative determination of S100B concentration in the patients' serum. In the within group analysis, all of our treatment interventions (except control group) have decreased S100B levels statistically significant (P < 0.05). Moreover, changes in observed levels of S100B before and after intervention were different between the groups and the observed differences were statistically significant (P = 0.01). In the GEE model, it was found that S100B levels in the L-carnitine plus fat emulsion group decreased more than the control group and this decline has been statistically significant [P = 0.02, 20.47 (CI 95%: 6.25-34.41)], but in comparison of L-carnitine and fat emulsion group with control group, did not reached statistical significance (P > 0.05). Based on the results obtained from this study, it seems that L-carnitine with fat emulsion could lead to neuroprotective effects with a significant reduction in the S100B biomarker.
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Affiliation(s)
- Kaveh Kazemian
- Department of Clinical Pharmacy, Pharmaceutical Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Shahram Ala
- Department of Clinical Pharmacy, Pharmaceutical Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Mojtaba Mojtahedzadeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mahmoud Abedini
- Department of Neurology, Bu Ali Sina General Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Abbas Alipour
- Thalassemia Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Saeid Abediankenari
- Immunogenetics Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammadreza Rafati
- Department of Clinical Pharmacy, Pharmaceutical Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Ali Abaskhanidavanloo
- Department of Anesthesiology, Bu Ali Sina General Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Mohajerani
- Department of Neurology, Bu Ali Sina General Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
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Taghizadeh F, Sharifpour A, Zarghami M, Alipour A. The effectiveness of individual interventions on smoking cessation of chronic obstructive pulmonary disease patients. J Nurs Midwifery Sci 2020. [DOI: 10.4103/jnms.jnms_38_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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42
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Zarghami M, Taghizadeh F, Sharifpour A, Alipour A. Efficacy of guided self-change for smoking cessation in chronic obstructive pulmonary disease patients: A randomized controlled clinical trial. Tob Induc Dis 2019; 17:90. [PMID: 31892920 PMCID: PMC6915435 DOI: 10.18332/tid/114227] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/02/2019] [Accepted: 11/14/2019] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION The aim of this study was to examine the efficacy of guided self-change (GSC), nicotine replacement therapy (NRT), and their combination, on smoking cessation among patients with COPD. METHODS A total of 60 participants were randomly assigned to three groups for GSC (n=20), nicotine replacement therapy (NRT) (n=20) or their combination (n=20), from December 2016 to November 2017. The quality of life (QoL) questionnaire, clinical assessment test (CAT) and exhaled carbon monoxide (CO), were measured at baseline and post-treatment. RESULTS At 6, 12, and 29 weeks, the abstinence rate in the NRT group was 5.3%, 15.8% and 21.1%, in the GSC group 21.1%, 31.6% and 47.4%, and in the combined group 36.8%, 36.8% and 47.4%, respectively. The exhaled CO in the NRT group was greater than the GSC group, however this difference was not statistically significant (3.4; 95% CI: -0.24–7.0; p=0.067), CO levels in the combined group were less than the GSC group, while this difference was also not significant (-0.75; 95% CI : -4.2–2.7; p=0.68). CAT and QoL recovery in the GSC and combined groups were higher than in the NRT group (9.2; 95% CI: 5.0–13.4; p=0.001) and (-4.5; 95% C: -8.1– -0.6; p=0.02), respectively. However, differences between combined and GSC groups were not significant (p=0.24 and p=0.41, respectively). There was a statistically significant difference between the abstinence rate in the GSC or combined group and the NRT group (p=0.001). The GEE model showed that GSC reduced the odds of smoking compared with the NRT group (interaction group effect) (OR=0.31, 95% CI: 0.022–0.545; p=0.001). CONCLUSIONS In our context among COPD patients, GSC was more effective in decreasing smoking than NRT alone. Moreover, the recovery of exhaled carbon monoxide, CAT and QoL in GSC was more than in the NRT group. Moreover, since GSC was as effective as GSC plus NRT, the effectiveness of the combination method for smoking cessation in COPD patients may be attributed to GSC. Clinical trial registration details: IRCT201609271457N11; www.irct.ir
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Affiliation(s)
- Mehran Zarghami
- Department of Psychiatry, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Taghizadeh
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Sharifpour
- Pulmonary and Critical Care Division, Iranian National Registry Center for Lophomoniasis, Mazandaran University of Medical Sciences, Sari, Iran.,Toxoplasmosis Research Center, Iranian National Registry Center for Lophomoniasis, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abbas Alipour
- Department of Epidemiology, Mazandaran University of Medical Sciences, Sari, Iran
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Vakili F, Alipour A, Merghati Khoei E, Rasoolinejad M. Vulnérabilité des femmes infectées par le VIH à un dysfonctionnement sexuel : rôle des croyances sexuelles dysfonctionnelles. Sexologies 2019. [DOI: 10.1016/j.sexol.2019.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Bazmi E, Alipour A, Yasamy MT, Kheradmand A, Salehpour S, Khodakarim S, Soori H. Job Burnout and Related Factors among Health Sector Employees. Iran J Psychiatry 2019; 14:309-316. [PMID: 32071605 DOI: 10.18502/ijps.v14i4.1982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Objective: Job burnout can cause physical and psychological damage and reduce job efficiency, especially in difficult jobs such as health care fields. This study aimed to assess the association between the level of job burnout and some contributing factors among health care providers in Iran. Method : This study was performed on the data derived from 1807 participants from the first phase of the employees' health cohort in 2017-2018. The data were collected using as a self-administrated tool utilizing Maslach Burnout Inventory. The questionnaire scores ranged from never to everyday, with 3 levels of burnout as well as burnout itself; then, the scores were categorized as low, moderate, or high. Ordinal logistic regression model was used to adjust ordinal dependent variables. Results: The mean score of the total burnout was 16.5±7.77 and was associated with work experience and age group (p < 0.001). The components of burnout consisted of emotional exhaustion (8.9± 9.0), depersonalization (23± 2.9), and personal accomplishment (34± 8.6). Emotional exhaustion was related to sex (less among males, OR=0.48) and type of job (less among officials compared to health care staff, OR=0.488). Composite burnout was more common among younger staff (OR= 3.85). Depersonalization was associated with duty shift workers (OR=2.42). Conclusion: Job burnout is a major concern, and lack of personal accomplishment, as a component of burnout, was highly prevalent among Iranian health care employees. Being a single woman, health care provider, and having more than 20 years of work experience with a duty shift were contributing factors for burnout experience. Monitoring symptoms of burnout and its associated factors in the workplace and proposing an alternative organizational and behavioral system and sharing it with relevant authorities may help prevent or reduce job burnout and its deleterious effects.
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Affiliation(s)
- Elham Bazmi
- Safety Promotion and Injury Prevention Research Center. (SBMU Employees' Health Cohort center), Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Alipour
- Safety Promotion and Injury Prevention Research Center. (SBMU Employees' Health Cohort center), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohamad Taghi Yasamy
- Department of Psychiatry, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Kheradmand
- Department of Psychiatry, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soosan Salehpour
- Occupational Medicine Specialist, Poursina Occupational Medicine Services Center, Tehran, Iran
| | - Soheila Khodakarim
- Safety Promotion and Injury Prevention Research Center. (SBMU Employees' Health Cohort center), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Soori
- Safety Promotion and Injury Prevention Research Center. (SBMU Employees' Health Cohort center), Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Vakili F, Alipour A, Merghati Khoei E, Rasoolinejad M. HIV infected women vulnerability for presenting sexual dysfunction: The role of sexual dysfunctional beliefs. Sexologies 2019. [DOI: 10.1016/j.sexol.2019.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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46
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Vakili F, Alipour A, Khoei EM, Rasoolinejad M. "Demand what you prefer": the role of sexual assertiveness among HIV-infected women. Cent Eur J Nurs Midw 2019. [DOI: 10.15452/cejnm.2019.10.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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47
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Hakimi F, Yaghmaei F, Alipour A, Asghari M, Namdar H, Jafari P, Movahhed M. Explanation of the Concept of Wet Liver Dystemperament ( sue-mizaj) in Iranian Traditional Medicine (Persian medicine): A Hybrid Concept Analysis. Crescent J Med Biol Sci 2019. [DOI: 10.34172/cjmb.2023.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Objectives: The semiology of liver dystemperament can help in predicting susceptibility to some diseases and improving the treatment process of the liver or general disease such as non-alcoholic fatty liver disease (NAFLD). Therefore, the aim of this study was to explain the wet liver dystemperament concept in Iranian traditional medicine (ITM) based on a hybrid concept analysis. Materials and Methods: The literature review of this qualitative study focused on evaluating 11 major academic textbooks from the 3rd to 19th century and some databases. In-depth, semi-structured, and face-to-face interviews were conducted with 16 ITM experts with a minimum of five years of clinical experience and maximum variations in terms of gender, age, and clinical experiences for empirical data gathering. Data were analyzed with MAXQAD10 and conventional content analysis. Results: In this study, wet liver dystemperament was classified into three main themes of systemic, local, and Para-clinical symptoms and 10 categories. Conclusions: This manuscript explains wet liver dystemperament as a disorder in general temperament and determines more important diagnostic criteria.
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Affiliation(s)
- Fatemeh Hakimi
- Clinical Research Development Unit, Moradi Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Farideh Yaghmaei
- Department of Nursing, Zanjan Branch, Islamic Azad University, Zanjan, Iran
| | - Abbas Alipour
- Department of Health and Social Medicine, Mazandaran University of Medical Sciences (MAZUMS), Mazandaran, Iran
| | - Majid Asghari
- Traditional Medicine Research Center, School of Traditional Medicine, Qom University of Medical Sciences, Qom, Iran
| | - Hasan Namdar
- Department of Traditional Medicine, School of traditional medicine, Shahed University of Medical Sciences, Tehran, Iran
| | - Parisa Jafari
- Department of Persian Medicine, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mina Movahhed
- Traditional Medicine and Materia Medica Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Habibi A, Alipour A, Baradari AG, Gholinataj A, Habibi MR, Peivandi S. The Effect of Adding Lidocaine to Patient Controlled Analgesia with Morphine on Pain Intensity after Caesarean Section with Spinal Anesthesia: A Double-Blind, Randomized, Clinical Trial. Open Access Maced J Med Sci 2019; 7:1946-1950. [PMID: 31406534 PMCID: PMC6684416 DOI: 10.3889/oamjms.2019.545] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/16/2019] [Accepted: 06/17/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND: Caesarean section is one of the commonest gynaecological surgeries. AIM: Given the importance of pain relief after caesarean section surgery as well as contradictions in the studies conducted on intravenous lidocaine analgesic effects, this study aimed to evaluate the effect of adding lidocaine to patient-controlled analgesia (PCA) with morphine on pain intensity after caesarean section surgery. MATERIAL AND METHODS: In a double-blinded, randomised clinical trial, 80 women who were scheduled for caesarean section surgery with spinal anaesthesia at Sari Imam Khomeini Hospital in 2017 were randomly assigned into two intervention and control groups. After surgery, all patients were connected to a morphine PCA pump. The PCA solution (total volume = 100 ml) in intervention group contained 50 ml of 2% lidocaine and 30 mg (3 ml) of morphine in 47 ml normal saline. In the control group, the PCA pump contained 30 mg (3 ml) of morphine, and the rest (97 cc) was normal saline. Patients’ pain intensity was assessed at 2, 4, 6, 12, 18 and 24 hours after surgery using a visual analogue scale (VAS). Additionally, their postoperative nausea and vomiting, duration of hospitalisation, duration of ileus relapse after surgery, and patients’ satisfaction after surgery were evaluated. Data were analysed using SPSS version 22 software. RESULTS: The mean and standard deviation of pain intensity in all patients at the intervals of 2, 4, 6, 12, 18 and 24 hours after surgery were 5.91 ± 1.57, 4.97 ± 1.55, 3.84 ± 1.60, 3.54 ± 1.45, 2.56 ± 1.70 and 0.94 ± 1.70, respectively. Data analysis revealed that, regardless of the groups, postoperative pain intensity significantly decreased (P < 0.0001). However, there were no significant differences between the two groups in terms of mean postoperative pain intensity at any time interval (p > 0.05). Also, there was no significant difference between the two groups in terms of frequency of receiving the diclofenac suppositories after the surgery (p > 0.05). Additionally, there was no statistically significant difference between the two groups in terms of postoperative nausea and vomiting, duration of hospitalisation, duration of postoperative ileus relapse and patients’ satisfaction (p > 0.05). CONCLUSION: Based on the results of this study, it seems that adding lidocaine to PCA with morphine, compared with morphine PCA alone, do not have a significant effect on reducing the pain intensity after cesarean section using spinal anaesthesia. Although, further studies with larger sample size are warranted.
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Affiliation(s)
- Ali Habibi
- Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abbas Alipour
- Department of Epidemiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Afshin Gholipour Baradari
- Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abdolmajid Gholinataj
- Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Reza Habibi
- Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Saloumeh Peivandi
- Department of Gynecology and Obstetrics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Habibian N, Amoli MM, Abbasi F, Rabbani A, Alipour A, Sayarifard F, Rostami P, Dizaji SP, Saadati B, Setoodeh A. Role of vitamin D and vitamin D receptor gene polymorphisms on residual beta cell function in children with type 1 diabetes mellitus. Pharmacol Rep 2019; 71:282-288. [DOI: 10.1016/j.pharep.2018.12.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 12/02/2018] [Accepted: 12/27/2018] [Indexed: 01/08/2023]
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50
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Iranpour S, Hosseinzadeh A, Alipour A. Efficacy of miltefosine compared with glucantime for the treatment of cutaneous leishmaniasis: a systematic review and meta-analysis. Epidemiol Health 2019; 41:e2019011. [PMID: 30999735 PMCID: PMC6635659 DOI: 10.4178/epih.e2019011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 03/31/2019] [Indexed: 11/09/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is most common form of leishmaniasis and is characterized by ulcerative skin lesions. The objective of this study was to conduct a systematic review and meta-analysis of clinical trials that compared the efficacy of miltefosine and glucantime for the treatment of CL. We searched the following databases: Cochrane, PubMed, Embase, Scopus, Web of Science, ProQuest, Cochrane Central Register of Controlled Trials, International Clinical Trials Registry Platform search portal of World Health Organization, Sid, Irandoc, Magiran, and clinicaltrials.gov. We used keywords including “miltefosine,” “glucantime,” and “Leishmania.” The quality of studies was assessed using the Cochrane risk of bias tool. A random-effects model was employed for the analysis. We assessed heterogeneity by the chi-square test and the I2 index statistic. When heterogeneity was present, meta-regression analyses were performed. The Egger method was used to assess publication bias; when it was significant, the trim-and-fill method was used to test and adjust for publication bias. A total of 1,570 reports were identified, of which 10 studies were included in the meta-analysis. In the meta-analysis, there was no significant difference between the efficacy of miltefosine and glucantime; however, subgroup analysis showed that, regarding parasite species other than Leishmania braziliensis, miltefosine was significantly superior to glucantime (intention to treat; relative risk, 1.15; 95% confidence interval, 1.01 to 1.32). In the meta-regression, only the glucantime injection type was significant at the p=0.1 level. The Egger test found statistically significant publication bias; however, including the 3 missing studies in the trim-and-fill analysis did not change the results. This meta-analysis found that miltefosine seems to be more effective than glucantime, at least in species other than L. braziliensis, for treating CL.
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Affiliation(s)
- Sohrab Iranpour
- Student Research Committee, Department of Epidemiology, Faculty of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Community Medicine, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Ali Hosseinzadeh
- Research Center for Modeling in Health, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Alipour
- Department of Community Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Iran
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