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Sadeghi-Naini M, Jazayeri SB, Kankam SB, Ghodsi Z, Baigi V, Zeinaddini Meymand A, Pourrashidi A, Azadmanjir Z, Dashtkoohi M, Zendehdel K, Pirnejad H, Fakharian E, O'Reilly GM, Vaccaro AR, Shakeri A, Yousefzadeh-Chabok S, Babaei M, Kouchakinejad-Eramsadati L, Haji Ghadery A, Aryannejad A, Piri SM, Azarhomayoun A, Sadeghi-Bazargani H, Daliri S, Lotfi MS, Pourandish Y, Bagheri L, Rahimi-Movaghar V. Quality of in-hospital care in traumatic spinal column and cord injuries (TSC/SCI) in I.R Iran. Eur Spine J 2024; 33:1585-1596. [PMID: 37999768 DOI: 10.1007/s00586-023-08010-x] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 09/10/2023] [Accepted: 10/16/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE This study aimed to implement the Quality of Care (QoC) Assessment Tool from the National Spinal Cord/Column Injury Registry of Iran (NSCIR-IR) to map the current state of in-hospital QoC of individuals with Traumatic Spinal Column and Cord Injuries (TSCCI). METHODS The QoC Assessment Tool, developed from a scoping review of the literature, was implemented in NSCIR-IR. We collected the required data from two primary sources. Questions regarding health system structures and care processes were completed by the registrar nurse reviewing the hospital records. Questions regarding patient outcomes were gathered through patient interviews. RESULTS We registered 2812 patients with TSCCI over six years from eight referral hospitals in NSCIR-IR. The median length of stay in the general hospital and intensive care unit was four and five days, respectively. During hospitalization 4.2% of patients developed pressure ulcers, 83.5% of patients reported satisfactory pain control and none had symptomatic urinary tract infections. 100%, 80%, and 90% of SCI registration centers had 24/7 access to CT scans, MRI scans, and operating rooms, respectively. Only 18.8% of patients who needed surgery underwent a surgical operation in the first 24 h after admission. In-hospital mortality rate for patients with SCI was 19.3%. CONCLUSION Our study showed that the current in-hospital care of our patients with TSCCI is acceptable in terms of pain control, structure and length of stay and poor regarding in-hospital mortality rate and timeliness. We must continue to work on lowering rates of pressure sores, as well as delays in decompression surgery and fatalities.
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Affiliation(s)
- Mohsen Sadeghi-Naini
- Department of Neurosurgery, Lorestan University of Medical Sciences, Khoram-Abad, Iran
| | - Seyed Behnam Jazayeri
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Samuel Berchi Kankam
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- International Neurosurgery Group (ING), Universal Scientific Education and Research Network (Usern), Tehran, Iran
| | - Zahra Ghodsi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Vali Baigi
- Department of Neurosurgery, Lorestan University of Medical Sciences, Khoram-Abad, Iran
| | | | | | - Zahra Azadmanjir
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Dashtkoohi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Zendehdel
- Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Habibollah Pirnejad
- Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
- Erasmus School of Health Policy and Management (ESHPM), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Esmaeil Fakharian
- Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR, Iran
| | - Gerard M O'Reilly
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency and Trauma Centre, The Alfred, Melbourne, Australia
- National Trauma Research Institute, The Alfred, Melbourne, Australia
| | - Alex R Vaccaro
- Department of Orthopedics and Neurosurgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA
| | - Aidin Shakeri
- Neurosurgical Surgery Department, Arak University of Medical Sciences, Arak, Iran
| | | | - Mohammadreza Babaei
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Abdolkarim Haji Ghadery
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran, Iran
| | - Armin Aryannejad
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Piri
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Azarhomayoun
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Salman Daliri
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
| | | | - Yasaman Pourandish
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Laleh Bagheri
- Shahid Rahnemoun Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
- Universal Scientific Education and Research Network (USERN), Tehran, Iran.
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran.
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Khosravi A, Van Hee R, Asadi MH, Amini S, Shakeri A, Changizi-Ashtiyani S. An approach to the milestones of spine surgery in Persian traditional medicine. Acta Chir Belg 2024:1-9. [PMID: 38528815 DOI: 10.1080/00015458.2024.2325798] [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: 05/14/2023] [Accepted: 02/27/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND The diagnosis and treatment of spine disorders have been challenging for thousands of years in different nations and medical schools. Despite this long history, there are many information gaps in this regard. The current research deals with the milestones and progress of spine surgery from ancient times until now, emphasizing the innovations of sages in the Persian traditional medicine era. METHODS The present study is based on searching original and library documents, data from databases such as PubMed, Scopus, and Science Direct, and search engines such as Google Scholar. RESULTS In Persian traditional medicine, Rhazes (865-925 AD) was the first sage who applied spine surgery based on the innovative knowledge of Galen (second century AD) and Paulus Aegineta (seventh century AD). Hally Abbas (tenth century AD), by suturing two separated bones during spine surgery, and Albucasis (936-1013 AD), by inventing, describing, and drawing the surgical instruments involved in surgeries in this area, and also using cauterization in the treatment of children's hunchback, were the innovators of new methods. CONCLUSION The modern knowledge of spine surgery is based on intelligent experiences and prominent thoughts from thousands of years worldwide. However, sometimes, these key points have remained hidden. This issue necessitates investigating this science in different schools and territories for comparative studies, identifying the firsts in the prominent points of this field, preserving the identity of sages and nations, and preventing scientific plagiarism.
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Affiliation(s)
- Azam Khosravi
- Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | | | - Mohammad Hossein Asadi
- Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Saeed Amini
- Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
- Department of Health and Management Sciences, Khomein University of Medical Sciences, Khomein, Iran
| | - Aidin Shakeri
- Department of Neurosurgery, Arak University of Medical Sciences, Arak, Iran
| | - Saeed Changizi-Ashtiyani
- Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
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Azadmanjir Z, Khormali M, Sadeghi-Naini M, Baigi V, Pirnejad H, Dashtkoohi M, Ghodsi Z, Jazayeri SB, Shakeri A, Mohammadzadeh M, Bagheri L, Lotfi MS, Daliri S, Azarhomayoun A, Sadeghi-Bazargani H, O'reilly G, Rahimi-Movaghar V. Post-discharge follow-up of patients with spine trauma in the National Spinal Cord Injury Registry of Iran during the COVID-19 pandemic: Challenges and lessons learned. Chin J Traumatol 2023:S1008-1275(23)00115-3. [PMID: 38016878 DOI: 10.1016/j.cjtee.2023.10.005] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/10/2023] [Accepted: 10/23/2023] [Indexed: 11/30/2023] Open
Abstract
PURPOSE The purpose of the National Spinal Cord Injury Registry of Iran (NSCIR-IR) is to create an infrastructure to assess the quality of care for spine trauma and in this study, we aim to investigate whether the NSCIR-IR successfully provides necessary post-discharge follow-up data for these patients. METHODS An observational prospective study was conducted from April 11, 2021 to April 22, 2022 in 8 centers enrolled in NSCIR-IR, respectively Arak, Rasht, Urmia, Shahroud, Yazd, Kashan, Tabriz, and Tehran. Patients were classified into three groups based on their need for care resources, respectively: (1) non-spinal cord injury (SCI) patients without surgery (group 1), (2) non-SCI patients with surgery (group 2), and (3) SCI patients (group 3). The assessment tool was a self-designed questionnaire to evaluate the care quality in 3 phases: pre-hospital, in-hospital, and post-hospital. The data from the first 2 phases were collected through the registry. The post-hospital data were collected by conducting follow-up assessments. Telephone follow-ups were conducted for groups 1 and 2 (non-SCI patients), while group 3 (SCI patients) had a face-to-face visit. This study took place during the COVID-19 pandemic. Data on age and time interval from injury to follow-up were expressed as mean ± standard deviation (SD) and response rate and follow-up loss as a percentage. RESULTS Altogether 1538 telephone follow-up records related to 1292 patients were registered in the NSCIR-IR. Of the total calls, 918 (71.05%) were related to successful follow-ups, but 38 cases died and thus were excluded from data analysis. In the end, post-hospital data from 880 patients alive were gathered. The success rate of follow-ups by telephone for groups 1 and 2 was 73.38% and 67.05% respectively, compared to 66.67% by face-to-face visits for group 3, which was very hard during the COVID-19 pandemic. The data completion rate after discharge ranged from 48% to 100%, 22%-100% and 29%-100% for groups 1 - 3. CONCLUSIONS To improve patient accessibility, NSCIR-IR should take measures during data gathering to increase the accuracy of registered contact information. Regarding the loss to follow-ups of SCI patients, NSCIR-IR should find strategies for remote assessment or motivate them to participate in follow-ups through, for example, providing transportation facilities or financial support.
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Affiliation(s)
- Zahra Azadmanjir
- Health Information Management Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran; Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Moein Khormali
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Sadeghi-Naini
- Department of Neurosurgery, Lorestan University of Medical Sciences, Khoram-Abad, Iran
| | - Vali Baigi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Habibollah Pirnejad
- Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran; Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Mohammad Dashtkoohi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Students Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Ghodsi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Behnam Jazayeri
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Aidin Shakeri
- Department of Neurosurgery, Arak University of Medical Sciences, Arak, Iran
| | | | - Laleh Bagheri
- Shahid Rahnemoun Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad-Sajjad Lotfi
- Trauma Nursing Research Centre, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Salman Daliri
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Amir Azarhomayoun
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Homayoun Sadeghi-Bazargani
- Research Center for Evidence Based Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Gerard O'reilly
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; National Trauma Research Institute, The Alfred, Melbourne, Australia
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Universal Scientific Education and Research Network (USERN), Tehran, Iran; Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran.
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Zeinaddini-Meymand A, Baigi V, Mousavi-Nasab MM, Shool S, Sadeghi-Naini M, Azadmanjir Z, Jazayeri SB, Berchi Kankam S, Dashtkoohi M, Shakeri A, Fakharian E, Kouchakinejad-Eramsadati L, Pirnejad H, Sadeghi-Bazargani H, Bagheri L, Pourandish Y, Amiri M, Pour-Rashidi A, Harrop J, Rahimi-Movaghar V. Pre-Hospital and Post-Hospital Quality of Care in Traumatic Spinal Column and Cord Injuries in Iran. Global Spine J 2023:21925682231202425. [PMID: 37732722 DOI: 10.1177/21925682231202425] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
STUDY DESIGN A retrospective study. OBJECTIVES The quality of care (QoC) for spinal column/cord injury patients is a major health care concern. This study aimed to implement the QoC assessment tool (QoCAT) in the National Spinal Cord/Column Injury Registry of Iran (NSCIR-IR) to define the current state of pre- and post-hospital QoC of individuals with Traumatic Spinal Column and Spinal Cord Injuries (TSC/SCIs). METHODS The QoCAT, previously developed by our team to measure the QoC in patients with TSC/SCIs, was implemented in the NSCIR-IR. The pre-hospital QoC was evaluated through a retrospective analysis of NSCIR-IR registry data. Telephone interviews and follow-ups of patients with SCI evaluated the QoC in the post-hospital phase. RESULTS In the pre-hospital phase, cervical collars and immobilization were implemented in 46.4% and 48.5% of the cases, respectively. Transport time from the scene to the hospital was documented as <1 hour and <8 hours in 33.4% and 93.9% of the patients, respectively. Post-hospital indicators in patients with SCI revealed a first-year mortality rate of 12.5% (20/160), a high incidence of secondary complications, reduced access to electrical wheelchairs (4.2%) and modified cars (7.7%), and low employment rate (21.4%). CONCLUSION These findings revealed a significant delay in transport time to the first care facilities, low use of immobilization equipment indicating low pre-hospital QoC. Further, the high incidence of secondary complications, low employment rate, and low access to electrical wheelchairs and modified cars indicate lower post-hospital QoC in patients with SCI. These findings imply the need for further planning to improve the QoC for patients with TSC/SCIs.
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Affiliation(s)
| | - Vali Baigi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sina Shool
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Sadeghi-Naini
- Department of Neurosurgery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Zahra Azadmanjir
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Behnam Jazayeri
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Samuel Berchi Kankam
- International Neurosurgery Group (ING), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mohammad Dashtkoohi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Aidin Shakeri
- Department of Neurosurgery, Arak University of Medical Sciences, Arak, Iran
| | - Esmail Fakharian
- Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Habibollah Pirnejad
- Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Homayoun Sadeghi-Bazargani
- Research Center for Evidence Based Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Laleh Bagheri
- Shahid Rahnemoun Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Yasaman Pourandish
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Malihe Amiri
- Department of Neurosurgery, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
| | | | - James Harrop
- Department of Neurological and Orthopedic Surgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
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Modir H, Moshiri E, Shakeri A, Khalatbari M. Comparison of the effects of tranexamic acid, nitroglycerin, and remifentanil on the prevention of bleeding during herniated lumbar intervertebral disc surgery: A randomized clinical trial. Int J Crit Illn Inj Sci 2023; 13:18-25. [PMID: 37180305 PMCID: PMC10167810 DOI: 10.4103/ijciis.ijciis_40_22] [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: 05/14/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 05/16/2023] Open
Abstract
Background Surgery is a well-known and effective method of treating lumbar intervertebral disc herniation. The present study aimed to compare the effects of administering tranexamic acid (TXA), nitroglycerin (NTG), and remifentanil (REF) on hemorrhage prevention during herniated lumbar intervertebral disc surgery. Methods A double-blind clinical trial was conducted on 135 participants undergoing lumbar intervertebral disc surgery. A randomized block design was used for subject assignment to three groups including TXA, NTG, and REF. The hemodynamic parameters, bleeding rate, hemoglobin level, and the amount of infused propofol were measured and recorded after surgery. Data were then analyzed in SPSS software using Chi-square test and analysis of variance. Results The mean age of participants in the study was 42.12 ± 7.93 years, and all three groups were equal in terms of demographic characteristics (P > 0.05). The mean arterial pressure (MAP) of the TXA and NTG groups was notably higher than the REF group (P < 0.008). The mean heart rate (HR) of the TXA and NTG groups was notably higher than the REF group (P < 0.05). The propofol dosage used in the TXA group was higher than the two groups of NTG and REF (P < 0.001). Conclusion Among participants undergoing lumbar intervertebral disc surgery, the greatest MAP variability was observed in the NTG group. Higher mean HR and propofol consumption was observed in the NTG and TXA groups when compared to REF. No statistically significant differences were noted between groups in oxygen saturation or bleeding risk. Based on these findings, REF may be considered a preferred surgical adjunct over TXA and NTG during lumbar intervertebral disc surgery.
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Affiliation(s)
- Hesameddin Modir
- Department of Anesthesiology and Critical Care, Arak University of Medical Sciences, Arak, Iran
| | - Esmail Moshiri
- Department of Anesthesiology and Critical Care, Arak University of Medical Sciences, Arak, Iran
| | - Aidin Shakeri
- Department of Neurosurgery, Arak University of Medical Sciences, Arak, Iran
| | - Mohamad Khalatbari
- Department of Anesthesiology, Students Research Committee, Arak University of Medical Sciences, Arak, Iran
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Modir H, Nikoohemmat M, Moshiri E, Shakeri A. Comparing the bleeding control effect of labetalol, remifentanil and dexmedetomidine during craniotomy; A randomised clinical trial. Adv Hum Biol 2022. [DOI: 10.4103/aihb.aihb_61_22] [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: 11/25/2022] Open
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Shakeri A, Saebi R, Mohammadi A, Dalvandi M, Kamali A. Efficacy of intraoperative epidural dexamethasone and bupivacaine in reduction of pain and disability following lumbar discectomy. J Family Med Prim Care 2022; 11:1810-1814. [PMID: 35800519 PMCID: PMC9254847 DOI: 10.4103/jfmpc.jfmpc_934_21] [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: 04/20/2021] [Revised: 08/12/2021] [Accepted: 10/28/2021] [Indexed: 11/08/2022] Open
Abstract
Background: In lumbar disc herniation, although surgery can provide relief from pain in the low back and lower extremities, many drugs can provide more relief; thus, the aim was the evaluation of epidural dexamethasone and bupivacaine efficacy in lumbar disc herniation surgery. Methods: A total of 42 cases were evaluated in a triple-blind randomized clinical trial study. Patients were divided into intervention and control groups based on permuted block randomization. The patient’s condition was assessed based on the Visual Analogue Scale (VAS) at 3, 6, 12, and 24 h and 1, 3, and 6 months after surgery. In addition, the patient’s disability was assessed by Oswestry disability index (ODI) at 1 and 6 months after surgery. Results: Of the 42 evaluated cases, age (44.0 ± 12.4, P = 0.4) and hospitalization duration (1.9 ± 0.3 days, P = 0.02) had statistically significant difference between two groups. The severity of low back pain before surgery was 2.9 ± 1.9 (P = 0.74), and 3 hours after surgery was 4.9 ± 1.9 in the control group and 2.8 ± 1.3 in the intervention group (P = 0.03), and there was a statistically significant difference between the two groups. In addition, based on the repeated measure test, there was no significant difference between the two groups. ODI value was before surgery 31.7 ± 8.3 (P = 0.77), 5.2 ± 2.4 (P = 0.9) at 1 month after surgery, and 4.5 ± 1.8 (P = 0.6) at 6 months after surgery, and there was no statistically significant difference between the two groups. Conclusion: Dexamethasone and bupivacaine can be effective in post-operation pain control, although this difference between the two groups was not statistically significant.
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Hosseini H, Shakeri A, Rezaei M, Dashti Barmaki M, Rastegari Mehr M. Water chemistry and water quality pollution indices of heavy metals: a case study of Chahnimeh Water Reservoirs, Southeast of Iran. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s42108-019-00051-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Yadollahpour A, Rostami R, Kazemi R, Shakeri A. Prefrontal alpha Asymmetry index predicts response to repetitive transcranial magnetic stimulation. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Shakeri A, Darbari S, Moravvej-Farshi MK. Designing a tunable acoustic resonator based on defect modes, stimulated by selectively biased PZT rods in a 2D phononic crystal. Ultrasonics 2019; 92:8-12. [PMID: 30216782 DOI: 10.1016/j.ultras.2018.09.001] [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] [Received: 04/07/2018] [Revised: 09/01/2018] [Accepted: 09/04/2018] [Indexed: 06/08/2023]
Abstract
Reconfigurable phononic crystals (PnCs) and related devices are highly attractive because of their flexibility for different applications. We present the design procedure for a tunable acoustic resonator based on a 2D PnC, consisting of a periodic array of piezoelectric rods of radii 175 μm as inclusions arranged in air background. A single point defect devised by a rod of radius 161 μm, replacing one of the inclusions, plays the role of the acoustic resonator, leading to a defect frequency in the phononic band gap (fd ≈ 432 kHz). Applying a ∼1% strain to the defect rod, via an external voltage, tunes the defect resonant frequency within the phononic band gap. It is shown that the maximum tunability and the frequency shift depends on the defect size, and is achieved about Δfd = 440 Hz for the defect with the expense of descending quality factor. Considering the pattern of the localized pressure field, we introduce a multi-defect structure with five symmetric defect rods, corresponding to the maxima of field distribution. It is shown that maximum frequency shift of the dominant defect frequency is achieved about Δfd = 1.14 kHz for defect radius of 161 μm, when all five defect rods are strained. The proposed tunable filter based on multi-defect structure results in an enhancement of about 2.6 times in the maximum frequency shift, in comparison with the single defect structure, and introduces a promising approach for realizing tunable acoustic devices.
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Affiliation(s)
- A Shakeri
- Nano Plasmophotonic Research Group, Faculty of Electrical and Computer Engineering, Tarbiat Modares University, P.O. Box 14115-146, Tehran 1411713116, Iran
| | - S Darbari
- Nano Plasmophotonic Research Group, Faculty of Electrical and Computer Engineering, Tarbiat Modares University, P.O. Box 14115-146, Tehran 1411713116, Iran.
| | - M K Moravvej-Farshi
- Nano Plasmophotonic Research Group, Faculty of Electrical and Computer Engineering, Tarbiat Modares University, P.O. Box 14115-146, Tehran 1411713116, Iran
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Kazemnejadi M, Shakeri A, Nikookar M, Shademani R, Mohammadi M. Selective and metal-free epoxidation of terminal alkenes by heterogeneous polydioxirane in mild conditions. R Soc Open Sci 2018; 5:171541. [PMID: 29892358 PMCID: PMC5990723 DOI: 10.1098/rsos.171541] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 03/21/2018] [Indexed: 06/08/2023]
Abstract
Polydioxirane (PDOX) was prepared by the treatment of polysalicylaldehyde with Oxone and was found as a selective, highly efficient and heterogeneous reagent for epoxidation of alkenes which can be successfully isolated. This work also introduced a simpler, safer and milder way for epoxidation of alkenes with dioxirane groups than before. PDOX can be simply recovered from the reaction mixture by plain filtration and reused for eight runs without significant reactivity loss.
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Affiliation(s)
- M. Kazemnejadi
- Department of Chemistry, College of Sciences, Golestan University, Gorgan, Iran
| | - A. Shakeri
- Faculty of Chemistry, University College of Science, University of Tehran, Tehran, Iran
| | - M. Nikookar
- Department of Chemistry, College of Sciences, Golestan University, Gorgan, Iran
| | - R. Shademani
- Department of Marine Technology, Amirkabir University of Technology, Tehran, Iran
| | - M. Mohammadi
- Department of Chemistry, College of Sciences, Golestan University, Gorgan, Iran
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Sadeghian F, Ebrahimi P, Shakeri A, Jamali M. Extraction ofCitrus paradisiVolatile Components by Headspace Single-Drop Microextraction and Statistical Modeling. J Chromatogr Sci 2016; 54:1263-9. [DOI: 10.1093/chromsci/bmw038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Indexed: 11/14/2022]
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Etemadrezaei H, Zabihyan S, Shakeri A, Ganjeifar B. 17-Year-Delayed Fistula Formation After Elective Spinal Instrumentation: A Case Report. Iran Red Crescent Med J 2015; 17:e28090. [PMID: 26082855 PMCID: PMC4464381 DOI: 10.5812/ircmj.17(5)2015.28090] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 03/19/2015] [Accepted: 04/18/2015] [Indexed: 11/16/2022]
Abstract
Introduction A late-developing infection after an uneventful initial spinal instrumentation procedure is rare. Delayed infection and new fistula formation have been reported from a few months to 13 years. Here we report an unusual 17-year-delayed fistula formation after primary spinal instrumentation. The patient underwent hardware removal surgery with antibiotic therapy as a definitive treatment. Case Presentation Here we report an unusual 17-year delayed fistula formation after primary spinal instrumentation due to spinal trauma. He was admitted to Ghaem General Hospital, a chief referral center, Mashhad, North-East of Iran in August 2014. The patient underwent hardware removal surgery with antibiotic therapy as a definitive treatment. Conclusions Late inflammation may occur around spinal instruments and results in cutaneous fistula formation. After oral or intravenous antibiotic treatment, total device extraction is the cornerstone of treatment.
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Affiliation(s)
- Hamid Etemadrezaei
- Department of Neurological Surgery, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran
| | - Samira Zabihyan
- Department of Neurological Surgery, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran
| | - Aidin Shakeri
- Department of Neurological Surgery, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran
| | - Babak Ganjeifar
- Department of Neurological Surgery, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran
- Corresponding Author: Babak Ganjeifar, Department of Neurological Surgery, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran. Tel: + 98-5138012613, Fax: + 98-5138413493, E-mail:
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Sharifi-Mood B, Metanat M, Rakhshani F, Shakeri A. Co-infection of Malaria and Crimean-Congo Hemorrhagic Fever. Iran J Parasitol 2011; 6:113-5. [PMID: 22347306 PMCID: PMC3279885] [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: 02/15/2011] [Accepted: 07/18/2011] [Indexed: 11/30/2022]
Abstract
Southeast of Iran is an endemic area for Malaria and Crimean-Congo hemorrhagic fever (CCHF). In 1999, we faced with an outbreak of CCHF in Sistan and Baluchistan Province, in the border of Pakistan and Afghanistan. The most cases of Malaria in Iran are also reported from this area. This article presents a 17-year- old woman who admitted to our hospital because of acute fever, headache, epistaxis, hemorrhagic lesions on the skin and vaginal bleeding. Finally, she was recognized as a case that was co -infected with CCHF and malaria.
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Affiliation(s)
- B Sharifi-Mood
- Research Center for Infectious Diseases & Tropical Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
,Corresponding Author:Tel: +98/541/3236969, Fax: +98/541/ 3212975; E-mail:
| | - M Metanat
- Research Center for Infectious Diseases & Tropical Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - F Rakhshani
- Department of Health, Zahedan University of Medical Sciences, Zahedan, Iran
| | - A Shakeri
- Department of Anesthesiology, Zahedan University of Medical Sciences, Zahedan, Iran
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Ghabili K, Khosroshahi HT, Shakeri A, Tubbs RS, Bahluli A, Shoja MM. Can Doppler ultrasonographic indices of the renal artery predict the presence of supernumerary renal arteries? Transplant Proc 2010; 41:2731-3. [PMID: 19765420 DOI: 10.1016/j.transproceed.2009.07.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Variations of the renal arteries, including the presence of supernumerary renal arteries, are important to be identified prior to renal transplant. Angiography has been the gold standard test for the pretransplant evaluation of the renal vasculature. However, this modality is expensive and invasive. The aim of this study was to assess whether Doppler ultrasonographic (DU) indices of the renal artery could predict the presence of supernumerary renal arteries. METHODS AND MATERIALS Retrospectively, we analyzed multidetector computed tomography angiography (presence or absence of the supernumerary renal artery), DU (peak systolic velocity, resistive index, pulsatility index, end-diastolic velocity, and acceleration time) findings of 30 healthy potential renal transplant donors. Recipient operator characteristic (ROC) curves were used to examine the predictive values of the available DU indices for supernumerary renal arteries. RESULTS The mean age of donors was 28.4 +/- 4.1 years. Of 60 kidneys evaluated, a supernumerary renal artery was found in 10%. The ROC curve analysis revealed an area under the curve of noninformative (below 0.5) for all DU parameters, indicating that none of the studied parameters could predict the presence of a supernumerary renal artery. CONCLUSIONS Although the smaller diameter of the main renal artery has previously been found to predict the presence of supernumerary renal arteries, the present study revealed that DU indices of the renal artery may not indicate the presence of supernumerary renal arteries.
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Affiliation(s)
- K Ghabili
- Tuberculosis and Lung Diseases Research Center, Tabriz University Medical Sciences, Tabriz, Iran.
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Ardalan M, Shoja M, Ghabili K, Taheri S, Shakeri A, Etemadi J, Einollahi B. Fulminant Acute Pancreatitis in a Patient with Familial Mediterranean Fever on CAPD: What Caused the Pancreatitis? Perit Dial Int 2009. [DOI: 10.1177/089686080902900617] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- M.R. Ardalan
- Department of Nephrology Tabriz University (Medical Sciences) Tabriz, Iran
| | - M.M. Shoja
- Tuberculosis and Lung Disease Research Center Tabriz University (Medical Sciences) Tabriz, Iran
| | - K. Ghabili
- Tuberculosis and Lung Disease Research Center Tabriz University (Medical Sciences) Tabriz, Iran
| | - S. Taheri
- Tabriz University (Medical Sciences) Nephrology and Urology Research Center Tabriz University (Medical Sciences) Tabriz, Iran
| | - A. Shakeri
- Baqiyatallah University of Medical Sciences, Tehran Department of Radiology Tabriz University (Medical Sciences) Tabriz, Iran
| | - J. Etemadi
- Department of Nephrology Tabriz University (Medical Sciences) Tabriz, Iran
| | - B. Einollahi
- Tabriz University (Medical Sciences) Nephrology and Urology Research Center Tabriz University (Medical Sciences) Tabriz, Iran
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Ardalan MR, Shoja MM, Ghabili K, Taheri S, Shakeri A, Etemadi J, Einollahi B. Fulminant acute pancreatitis in a patient with familial mediterranean fever on CAPD: what caused the pancreatitis? Perit Dial Int 2009; 29:676-678. [PMID: 19910573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
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Abstract
BACKGROUND The prevalence of atherosclerotic renal artery disease has increased with improved life expectancy. Because renal artery stenosis is a potentially correctable cause of hypertension and ischemic nephropathy, early identification of this entity may lead to proper hypertension control and improved renal function and survival. The aim of this study was to determine the prevalence and patterns of subclinical renal artery stenosis in patients with aorticoiliac atherosclerosis. PATIENTS AND METHODS The abdominal angiographies of 44 patients with high-grade aorticoiliac occlusive disease (> 70% stenosis) were reviewed for evidence of renal artery stenosis. This was compared to a group of 20 patients with mild-to-moderate aorticoiliac disease (< 70% stenosis). These patients had no history of renal artery disease or renal failure. RESULTS In patients with high-grade aorticoiliac occlusive disease, renal artery stenosis was found in 25 patients (56.8%); 13 with unilateral (29.5%) and 12 (27.3%) with bilateral involvement. A hemodynamically significant stenosis (> 50%) was found in 11 patients (25%), one of whom had bilateral stenosis (2.3%). High-grade renal artery stenosis (> 70%) or complete arterial occlusion was noted on seven sides (7.9%). The most common sites of stenosis were the origin and first centimeter of the renal artery. In patients with mild-to-moderate aorticoiliac disease, renal artery stenosis was found in two patients (10%). CONCLUSIONS The present study revealed that subclinical renal artery disease may be present in more than half of the patients with high-grade aorticoiliac atherosclerosis highlighting the need for proper risk stratifications and screening programs. Based on our results, we suggest that examination of the renal arteries in these patients may be necessary in order to delay or prevent complications. Additionally, such information may have important therapeutic implications in planning reconstructive vascular surgeries or percutaneous angioplasties.
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Affiliation(s)
- A Shakeri
- Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran
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