Nazanin-Zeinab Hajmolarezaee; Mohammadhossein Taherynejad; Hassan Mehrad-Majd; Ali Moradi; Yalda Ravanshad; Amirreza Rostami; Salman Farsi; Sara Movahed; Sahar Ravanshad
Abstract
BackgroundLow back pain is a common reason for disability in patients younger than 45 years old who visit physicians. Although there are many attitudes toward treating back pain, there is no commonly accepted approach. This study compared various attitudes toward the examination, diagnosis, and treatment ...
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BackgroundLow back pain is a common reason for disability in patients younger than 45 years old who visit physicians. Although there are many attitudes toward treating back pain, there is no commonly accepted approach. This study compared various attitudes toward the examination, diagnosis, and treatment of chronic low back pain among neurologists, neurosurgeons, and orthopedic surgeons. MethodsIn this cross-sectional study, a checklist including four main aspects of history taking, clinical and para-clinical tests, and treatment of chronic low back pain was designed to be completed by 45 specialists (orthopedic surgeons, neurosurgeons, and neurologists). Results Straight Leg Raising (SLR) was the most frequent test during the examination process. The high priorities among the para-clinics were MRI, lumbosacral graph, EMG-NCV, serology lab test, and CT scan, respectively. A significant difference was found in requesting lumbosacral graph among specialties. Moreover, the priorities for nonsurgical treatment were NSAIDs, nonpharmaceutical treatment, muscle relaxants, gabapentin, and corticosteroids, respectively. ConclusionHistory taking, physical examination, diagnostic approaches, and treatments were significantly different among the different specialties. The results revealed the need for consensus on common and well-established guidelines for a clinical approach to chronic low back pain.
Sahar Ravanshad; Marieh Alizadeh; Aida Bakhshi; Sepideh Hejazi; Mina AkbariRad; Hassan Mehrad-Majd
Abstract
Introduction: The COVID-19 pandemic has underscored the necessity of investigating the relationship between radiological and laboratory findings with disease outcome in COVID-19 patients. This study aimed to explore the association between CT-scan finding and laboratory results with disease outcome, ...
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Introduction: The COVID-19 pandemic has underscored the necessity of investigating the relationship between radiological and laboratory findings with disease outcome in COVID-19 patients. This study aimed to explore the association between CT-scan finding and laboratory results with disease outcome, including recovery without complications, ICU admission, or mortality.Methods: This retrospective cross-sectional study analyzed medical records and laboratory data from COVID-19 patients at our institution from September 2020 onwards. All demographic, laboratory findings, as well as CT-scan data such as ground-glass opacity, consolidation, pleural effusion, cardiomegaly, mediastinal lymphadenopathy, and pulmonary involvement score at admission were collected. Patients were categorized based on outcome status and compared for all study variables. Results: Significance differences were observed for CT-score values between deceased patients and those who recovered (P<0.001), indicating a more severe lung changes in patients who died due to COVID-19. Additionally ICU-admitted patients had higher likelihood of underlying comorbidities and elevated CT-score levels. Laboratory markers such as ESR, Ferritin, LDH, Neutrophil count, and RDW were significantly higher in patients requiring ICU admission (P<0.05). Deceased patients were more likely to have underlying diseases, ground glass opacity, cardiomegaly, and higher CT-scores. Laboratory markers such as ESR, CRP, Ferritin, LDH, and others were also significantly higher in expired patients.Conclusion: There was a strong association between laboratory and CT-scan findings with disease outcomes in COVID-19 patients. The combination of laboratory markers and CT-scan findings can serve as robust predictors of disease outcomes. Further studies are needed to validate these findings in larger cohorts.
Sahar Ravanshad; Zahra Fahimian; Parsa Shoghi; Ali Moradi; Valareza Alizadeh; Negar Javdan; Hassan Mehrad-Majd
Abstract
Introduction: Studying the survival factors of leukemia patients can lead to a reduction in healthcare costs. This study aimed to evaluate the survival rate and potential predictive factors in leukemia patients in northeast Iran.Methods: Baseline demographic and clinical data of patients referred to ...
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Introduction: Studying the survival factors of leukemia patients can lead to a reduction in healthcare costs. This study aimed to evaluate the survival rate and potential predictive factors in leukemia patients in northeast Iran.Methods: Baseline demographic and clinical data of patients referred to Ghaem Hospital between 2014 and 2019 were extracted from their medical records. The survival rates were determined by gathering information from phone calls or archived files.Results: This cohort study consisted of 302 patients with a mean age of 41.09±19.09 years. Among them, 127 (43.3%) had acute lymphoid leukemia, while 166 (56.7%) had myeloid leukemia. The mean overall survival time for all patients was 50.81 months. However, the mean overall survival time for patients with lymphoid leukemia (61.7 months) was significantly higher (P<0.001) than that for patients with myeloid leukemia (41.1 months). Moreover, lymphoid patients had significantly higher one-month and one-year survival rates (93% and 72.8%) than the myeloid group (81% and 53.7%) (P=0.002 and P=0.001). However, significant difference did not exist in the five-year survival rate between the lymphoid and myeloid groups (26.2% vs 18.2%, P=0.174). Cox regression analysis indicated that patient survival was correlated with the type of leukemia (1.45, 95%CI=1.10-8.92, P=0.011), age, hemoglobin levels, as well as WBC, RBC, neutrophil, and platelet count.Conclusion:Our findings indicated that patients with lymphoid leukemia exhibited a higher survival rate than those with myeloid leukemia. Survival outcomes were dependent on patient’s age, leukemia type, and levels of WBC, RBC, neutrophil, platelet, and hemoglobin levels.
Sepideh Hejazi; Sahar Ravanshad; Samaneh Sajjadi
Abstract
Lung cancer is among the most common types of cancer with considerable mortality and morbidity around the globe. There are various risk factors involved in the development of lung cancer, and cancer prevention plans are mainly based on controlling the modifiable risk factors. While tobacco smoking is ...
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Lung cancer is among the most common types of cancer with considerable mortality and morbidity around the globe. There are various risk factors involved in the development of lung cancer, and cancer prevention plans are mainly based on controlling the modifiable risk factors. While tobacco smoking is considered the main modifiable risk factor of lung cancer, some other modifiable factors including diet have become the center of attention in recent years. Although tobacco smoking control is one of the main strategies for preventing lung cancer in many countries, it has been discussed that eating a healthy diet can also be an adjuvant strategy for reducing the risk of developing lung cancer. In the present narrative review, we did a literature search for studies that addressed the effect of the Mediterranean diet on the development of lung cancer. Our findings show that different types of Mediterranean diets could be beneficial for reducing the risk of developing lung cancer.
Yalda Ravanshad; Mohadese Golsorkhi; Sahar Ravanshad; Zahra sadat Mohajeri; Anoush Azarfar
Abstract
Introduction: Nowadays, fake doctors, known as “Bandis” in our country Iran, represent themselves as traditional healers and use superstitious ideas for the healing of the ill, especially children. Their activities do not comply with any scientific methods. No research has been focused on ...
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Introduction: Nowadays, fake doctors, known as “Bandis” in our country Iran, represent themselves as traditional healers and use superstitious ideas for the healing of the ill, especially children. Their activities do not comply with any scientific methods. No research has been focused on this issue. The present study aimed to evaluate the education and social levels of the patients and their reasons for referring to these quackeries.Methods: This cross-sectional study was conducted on 1,300 children who were managed in the pediatric clinics of Dr. Sheikh Hospital for children, which is a tertiary care center in Mashhad, Iran. Informed consent was obtained from the guardians and patients. Upon examination, the parents of the children were asked to complete a checklist for data collection. Data analysis was performed in SPSS version 16, and the P-value of less than 0.05 was considered statistically significant.Results: In total, 1,300 children (621 females and 679 male) aged 2.5-12 years (mean age: 5.3±2.9 years) were enrolled in the study. Among the guardians, 62.5% were familiar with traditional healers, and 457 (37.2%) of the respondents had visited these individuals at least once. In addition, 106 of these cases had visited traditional healers more than three times. The parents were enquired about the reasons for visiting traditional healers instead of physicians, and 46.7% believed the applied methods by these individuals to be more effective. Moreover, 3.1% mentioned the lower treatment costs compared to physician visits, 2.9% reported the acute diseases of their children that did not respond to medical treatments, and 47.3% acknowledged those methods as real traditional practices.Conclusion: According to the results traditional healers, are a major public health concern. For unjustified reasons, many people prefer their methods to conventional medicine. Therefore, healthcare authorities must raise public awareness in this regarding through systematic plans in order to prevent future complications.
Yalda Ravanshad; Abbasali Zeraati; Mohadese Golsorkhi; Sahar Ravanshad; Anoush Azarfar; Hanieh Jafari
Abstract
Introduction: To date, several randomized trials have compared calcineurin inhibitors, especially tacrolimus, with cyclosporine in patients with steroid-resistant nephrotic syndrome, proposing conflicting results. Use of immunosuppressive therapy for the treatment of resistant nephrotic syndrome ...
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Introduction: To date, several randomized trials have compared calcineurin inhibitors, especially tacrolimus, with cyclosporine in patients with steroid-resistant nephrotic syndrome, proposing conflicting results. Use of immunosuppressive therapy for the treatment of resistant nephrotic syndrome remains a matter of debate, and the evidence on its efficacy and safety is inconclusive.The present study aimed to compare the benefits and limitations of tacrolimus and cyclosporine in the treatment of steroid-resistant nephrotic syndrome. Methods: This systematic review and meta-analysis was conducted via searching for the relevant trials performed until January 2018 in electronic databases such as PubMed, Scopus, ScienceDirect, Cochrane Library, and Web of Science. In total, 285 potentially relevant articles were identified, and four articles were selected for the review. A random effects model was used to analyze data, and the heterogeneity of the articles was assessed using Chi-square-based Cochran’s Q and I2 statistics, and heterogeneity was considered statistically significant with I2>50%. The outcomes were presented as relative risk with 95% confidence interval, and P-value of less than 0.05 was considered statistically significant. In addition, meta-analysis was used for further data analysis. Result: Four eligible randomized controlled trials were evaluated in this systematic review. In terms of partial and complete remission, no significant differences were observed between tacrolimus and cyclosporine. However, lack of response to therapy was significantly lower with tacrolimus (RR=0.289; P=0.02) compared to cyclosporine. No significant differences were observed between the drugs in terms of the infection rate, hypertension, ALT/AST elevation, and gastrointestinal symptoms, while nephrotoxicity (RR=0.395; P=0.004) and hypertrichosis (RR=0.018; P<0.001) were significantly lower with tacrolimus. Conclusions: In conclusion, Tacrolimus is superior to Cyclosporine in treating in patients with steroid resistance nephrotic syndrome in terms of no response to therapy, nephrotoxicity and hypertrichosis