Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62567420201201A look at the Current Situation of Iranian Molecular Diagnostic Methods and the Implementation of Required Future Policy: A Review Article.1461491699510.22038/rcm.2020.41731.1282ENMassoud HajiaDepartment of Molecular Biology, Health Reference Laboratory, Ministry of Health and Medical Education, Tehran, Iran.0000-0001-5524-7252Journal Article20190716Today, molecular diagnostic methods have an unignorably position in diagnostic laboratories. It is estimated that 60-70% of all decisions depend on molecular detection methods. However, many Iranian physicians still do not fully trust the newly developed protocols in particular. If necessary, they request some confirmatory tests available to ensure a final decision.<br />The purpose of this short study is to investigate the causes of uncertainty in these tests and current challenges in Iranian clinical centers. Therefore, all the effective cases from receiving the samples to publishing the patient reports are looked up.<br /> Significant parameters including pre-analytical, analytical and post-analytical parameters are studied in this study. The reason for some of the current limitations is discussed based on released documents and reported periodic inspections according to published standard criteria. Based on the results, the need for fundamental revisions in some parts of the relevant bodies is clearly identified.Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62567420201201Physician Burnout: a Brief Review of Its Definition, Causes, and Consequences1501561702310.22038/rcm.2020.51483.1335ENMehdi Hassanzade DaloeeCardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0001-9416-832XMina AkbariRadDepartment of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-1071-7983Sahar Rajabzadeh KariziPharmacy Student, Student Research Committee, Faculty of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-2891-2883Mehrdad SarabiMedical student, Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0003-4773-2746Journal Article20200824Burnout among physicians is a potential warning to the health system and one of the prime occupational hazards of recent years. Burnout is characterized by emotional, mental, and physical fatigue. Numerous studies have shown that burnout has a high prevalence among physicians, such that about one-third of them are affected at some point in their career. A recent study from the United States reported that 45.8% of physicians present at least one symptom of burnout. Statistics indicating one suicide per day among physicians show the urgency of the matter and the need for improvement. It has been reported that this syndrome may even start from the beginning of medical studies such that medical students and r=is review article, we describe the main cause and consequences of physician burnout. To investigate the issue, the two keywords of “burnout” and “physician” were searched in PubMed, Medline, Sciences Direct, and Google Scholar. We did a comprehensive literature review to extract any recent related content about the cause and consequences of physician burnout. Drawing from the studied literature, it is concluded that to address the issue, first, the elements of physicians’ wellness and satisfaction should precisely be determined, then necessary interventions should be adopted to improve the situation. Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62567420201201Adherence to Antiretroviral Therapy and Its Determinants in HIV Patients in Mashhad, IRAN, 2018: a Prospective Study1571621728510.22038/rcm.2020.52601.1339ENAmin BojdyInfectious Disease Specialist,
Assistant Professor, Infection Control and hand hygiene Research Center,
Mashhad University of Medical Sciences, Mashhad, Iran0000-0001-7368-9855Mahnaz ArianDepartment of Infectious Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Mona Najaf NajafiDepartment of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-2646-7720Mahdi MottaghiStudents Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad0000-0001-8582-5658Journal Article20201012Introduction:Proper adherence to antiretroviral therapy (ART) provides good viral load suppression, while poor adherence can give rise to resistant strains and failure of the treatment. <br />Methods: We performed a prospective cohort study from December 2017 to March 2018. Of 245 patients, 103 of them were compliant with ART. Patient adherence is determined through the self-report method and pill-count method. Pill-count failed, and only self-reports of adherence were used for analysis. In each visit, we gave each patient medication needed for one month’s treatment and asked them to bring back drug-pockets in the next visit. We also ask the number of tablets they did consume in this period. Mean adherence in three months is considered final adherence. Pearson chi-square model was used for analysis.<br />Results: Mean age ± SD was 40 ± 1.36 years. 44.7% were female. 84.5% of patients are considered adherent (≥ 95% of doses were consumed). Married patients had better adherence (p = 0.04). Age, sex, addiction, imprisonment history, intravenous drug usage were not associated with adherence (p > 0.05). We also extracted previews history of treatment cessation and regimen changes. Efavirenz containing regimens had a higher rate of failure (p = 0.001).<br />Conclusion: Although the adherence level was acceptable, the lack of a self-report control method might overestimate adherence.Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62567420201201Epidemiological and Socio-Demographic Characteristics of Children with Acute Poisoning in Northeast of Iran.1631671732410.22038/rcm.2020.53996.1345ENAli AlamiSocial Medicine Department, Social Determinants of Health Research Center, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran0000-0002-8882-3110Maryam AghaeiStudent Research Committee, School of Medicine, Gonabad University of Medical Sciences, Gonabad, IranSepideh Shayan KarkonSocial development and Health promotion Research Center, Gonabad University of Medical Sciences, Gonabad, IranRaheleh DerafshiDepartment of Pediatrics, Medicine Faculty, Gonabad University of Medical Sciences, Gonabad, Iran0000-0002-8440-7697Journal Article20201203<strong>Introduction:</strong>Acute Poisoning in the developed countries include about 2% of all childhood deaths and more than 5% cause of death in the developing countries. Poisoning usually is defined as taking a substance which can cause an organism becoming injured. The purpose of this study was to identify sociological factors that are important in improving prevention, prognosis, and management of poisoning. <br /> <strong>Methods:</strong> This retrospective evaluated 1200 children in the pediatric ward of the 22 Bahman hospital, Gonabad, Iran, from March 2015 to July 2018. The information about Children was recorded by individual examination of the files in standardized forms including epidemiological and demographic features for statistical analysis and data were analyzed by using the U Test Chi square, Pearson correlation analysis and variance analysis in SPSS Version 21.0.<br /> <br /><strong>Results:</strong> Acute poisoning included 2.3% of referring causes with mean age 3.7 ± 1.3 years. The mean age of poisoned children was significantly lower than other children (p value = 0/002). The majority of cases were accidental poisonings with opium (ICD-10 T40.0X1) and methadone (ICD-10 T40.3X1). Most common symptoms were neurological disorders, vomiting, tachypnea and tachycardia.Common clinical symptoms in children diagnosed with poisoning include: Neurological symptoms including seizures, hallucinations, drowsiness, decreased level of consciousness and confusion (50%), nausea and vomiting (25%), tachypnea and tachycardia (7.1%). Respiratory depression, meiotic pupil, shortness of breath, cough, tears and hallucinations (3.6%) due to referring severe toxic patients to more equipped center no death was recorded in our center.<br /> <br /><strong>Conclusion:</strong> Acute poisoning is one of the most abudant emergencies in children. This study with identifying epidemiological and demographic factors of acute poisoning in children would help to improve prevention, and management of future programs.Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62567420201201Evaluation of Perioral Skin Rejuvenation with Platelet – Rich Plasma1681751734510.22038/rcm.2021.49093.1321ENSuha AloosiFaculty member , College of Dentistry ,Sulaimaniyah UniversityBahjat TahaAhmedinstructor and trainer in Halabjah Center for Dental SpecialtiesJournal Article20200528<strong>Introduction:</strong>Using Platelet- Rich Plasma (PRP )in aesthetic dermatology has been recently considered and its safety and effectiveness have been widely reported. We conducted this study to evaluate the technique and degree of benefit.<br /> <strong>Methods:</strong> Fifteen (15) patients with different ages, sexes, and facial perioral wrinkles have participated in the current research and received a session of monthly PRP injections (three courses), targeting line and wrinkles in the perioral area. In this study, we have prepared the PRP by using a special test tube and then centrifuge it with relative centrifugal force (RCF) of 1700G for 5 minutes, followed by two minutes of soft centrifugation at room temperature.<br /> <strong>Results:</strong> Mean age ± SD was 40 ± 1.36 years. 44.7% were female. 84.5% of patients are considered adherent (≥ 95% of doses were consumed). Married patients had better adherence (p = 0.04). Age, sex, addiction, imprisonment history, intravenous drug usage were not associated with adherence (p> 0.05). We also extracted previews history of treatment cessation and regimen changes. Efavirenz containing regimens had a higher rate of failure (p =0.001).<br /> <strong>Conclusion:</strong> Wrinkles in perioral area management by PRP injection is an easy technique, with high- quality result and high patient satisfaction, no serious side effects, high patient toleration, and short downtime. Platelet- Rich Plasma can be a competitive substitute for other fillers and revitalization methods in lips and perioral rejuvenation.Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62567420201201Comparison of Labetalol and Nitroglycerine,s Effects on Deliberate Hypotension in Septo-Rhinoplasty Ssurgery, a Randomized Clinical Trial1761791742410.22038/rcm.2021.47435.1313ENMajid RrazaviLung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iranorcid.org/0000-0001-Mona Najaf NajafiImam Reza Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Mahnaz AhmadiDepartment of Cardiology, Imam Reza Cardiac Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Iman KashaniFellowship in Pediatric Anaesthesiology,Sheikh pediatric hospital, Faculty of Medicine,Cardiac Anesthesia Research Center, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20200327<strong>Introduction:</strong>Bleeding during ENT surgeries may contribute to impaired view. The less blood in surgical filed, the better quality and more surgeon’s satisfaction is expected. Deliberate hypotension is a technique to achieve this goal. Current study aimed to evaluate effects of Labetalol andNitroglycerinein deliberate hypotension.<br /> <strong>Methods:</strong> It is a double blind RCT,conducted on 68 septo-rhinoplastypatients in ENT ward, Imam Reza Hospital, Mashhad, during 2017 after obtaining written consent. Patients were assigned to receive Nitroglycerine (n=32) or Labetalol (n=36) randomly. Mean arterial pressure and HR monitored. Total blood loss was estimated and recorded at a Boezaart Surgical Field Grading Scale. Surgeon’s satisfaction with surgical field condition was measured after the procedures using a questionnaire at a 5-point Likert scale.<br /> <strong>Results:</strong> Two studied groups were similar in demographic characteristics. Heart rate was lower in Labetalol group (P <0.001) significantly, but there was no significant difference between two groups regarding mean arterial pressure variations (P = 0.12). Surgeon’s satisfaction with the operation condition was not significantly different (P= 0.28). According to Boezaart scale, no statistically significant difference was found between groups with regard to bleeding volume (P= 0.75). Patients in Labetalol group received less additive drugs to maintain hypotension than another group (P=0.025).<br /> <strong>Conclusion:</strong> Although Labetalol and Nitoglycerine are not much different in reducing blood loss or providing a better view of surgical field but Labetalol is superior in maintaining heart rate and hypotension and noneed toadditive drug.Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62567420201201Recovery Rate of Hyperthyrotropinemia and Its Associated Factors: A Prospective Observational Study1801841748810.22038/rcm.2021.54973.1351ENSepideh BabaniamansourSchool of Medicine, Islamic Azad University Tehran Faculty of Medicine, Tehran, Iran0000-0002-4025-5628Nazanin ErshadiniaSchool of Medicine, Islamic Azad University Sari Branch Faculty of Medicine, Sari, Mazandaran, IranEhsan AliniagerdroudbariSchool of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranAmirmohammad BabaniamansourSchool of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.Atieh MasaliSchool of Medicine, Islamic Azad University Tehran Faculty of Medicine, Tehran, IranAlireza EntezariDepartment of Pediatrics, Boali Hospital, Islamic Azad University Tehran Faculty of Medicine, Tehran, Iran.0000-0003-1319-9883Journal Article20210116<strong>Introduction:</strong>Hyperthyrotropinemia (HT) can be transient or permanent. There is no specific protocol in confirmatory tests to discriminate between transient and permanent forms. The aim of this study was to investigate the prevalence of transient HT and the factors that help to discriminate transient from permanent HT.<br /> <strong>Methods:</strong>This was an observational prospective study in all neonates diagnosed with HT referred to the pediatric clinic of Boali Hospital, affiliated to Islamic Azad University Tehran Faculty of Medicine, Tehran, Iran during September 2017 and January 2019. The recovery rate was investigated during a three-month follow-up while withholding medical treatment. Data were analyzed with SPSS Version 22.0.<br />Results: Totally, 80 neonates (65% girls) were enrolled in this study. Among them, 62 participants (77.5%) recovered without any treatment during the three months of follow-up. The recovery rate was significantly higher in term newborns (p < 0.01). The mean weight of recovered neonates (2767.7 ± 440.2 gr) was significantly higher than that of the neonates who did not recover (2141.7 ± 755.2) (p < 0.01). The mean level of thyroid-stimulating hormone (TSH) of the recovered neonates (9.4 ± 3.0 mIU/L) was significantly lower than in the neonates who did not recover (22 ± 6.5 mIU/L) (p < 0.01).<br /> <strong>Conclusion:</strong> The outcome of HT became mostly permanent in patients with a higher level of TSH. The prematurity and low birth weight were the influential factors on TSH level, which could indirectly increase the risk of HT permanence.Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62567420201201Predictive Value of Spirometry in Screening of Children with Respiratory Disease1851891761110.22038/rcm.2021.55519.1354ENSeyed Javad SayediNeonatal Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-1884-8486Akram RabbaniMSc in Nursing, Mashhad University of Medical Sciences, Mashhad, IranFarzad AryanfarBent_al_Hoda Private Hospital and Maternity, Mashhad, IranElaheh GhayebiePh.D Student, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IranHavva Abdollahi KakroudiMSc in Nursing, Mashhad University of Medical Sciences, Mashhad, IranZahra SepehriB.s in Nursing, Mashhad University of Medical Sciences, Mashhad, Iran.Journal Article20210206<strong>Introduction:</strong>The diagnostic value of spirometry in the evaluation of pulmonary function is known; however, the predictive potential of this method has always been undervalued. In the present systematic review, we aimed to collect all available data to analyze whether spirometry can be used in screening programs to predict future pulmonary diseases.<br /> <strong>Methods:</strong> A database search was performed in Ovid, Science Direct, PubMed, Scopus, Web of Science, Embase, and Google Scholar using “spirometry” and “predictive value” as the main search terms.<br /> <strong>Results:</strong> After excluding irrelevant articles, 19 related studies were selected, and data extraction was performed. The results of the included literature showed that spirometry is a safe and reliable method for the evaluation of pulmonary function. It was also reported that spirometry can provide useful information, which can be complementary to other methods of evaluation.<br /> <strong>Conclusion:</strong> Findings showed that spirometry is a valid and non-invasive method of assessment for the diagnosis of respiratory diseases such as asthma and airway obstruction. Moreover, spirometric parameters may help to predict future pulmonary conditions, at least in children.