Review
Massoud Hajia
Abstract
Today, 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 ...
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Today, 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.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. 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.
Review
Mehdi Hassanzade Daloee; Mina AkbariRad; Sahar Rajabzadeh karizi; Mehrdad Sarabi
Abstract
Burnout 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 ...
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Burnout 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.
Original article
Amin Bojdy; Mahnaz Arian; Mona Najaf Najafi; Mahdi Mottaghi
Abstract
Introduction: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. Methods: We performed a prospective cohort study from December 2017 to March 2018. Of 245 patients, 103 of them were ...
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Introduction: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. 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.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).Conclusion: Although the adherence level was acceptable, the lack of a self-report control method might overestimate adherence.
Original article
Ali Alami; Maryam Aghaei; Sepideh Shayan Karkon; Raheleh Derafshi
Abstract
Introduction: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 ...
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Introduction: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. Methods: 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. Results: 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. Conclusion: 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.
Original article
Suha Aloosi; Bahjat Taha Ahmed
Abstract
Introduction: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. Methods: Fifteen (15) patients with different ages, sexes, and facial ...
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Introduction: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. Methods: 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. 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). Conclusion: 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.
Original article
Majid Rrazavi; Mona Najaf Najafi; Mahnaz Ahmadi; Iman Kashani
Abstract
Introduction: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 ...
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Introduction: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. Methods: 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. Results: 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). Conclusion: 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.
Original article
Sepideh Babaniamansour; Nazanin Ershadinia; Ehsan Aliniagerdroudbari; Amirmohammad Babaniamansour; Atieh Masali; Alireza Entezari
Abstract
Introduction: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 ...
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Introduction: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. Methods: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.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). Conclusion: 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.
Systematic review
Seyed Javad Sayedi; Akram Rabbani; Farzad Aryanfar; Elaheh Ghayebie; Havva Abdollahi kakroudi; Zahra Sepehri
Abstract
Introduction: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 ...
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Introduction: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. Methods: 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. Results: 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. Conclusion: 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.