Internal Medicine
Shirin Afhami; Negin Esmailpour Bazaz; Alireza Khoshnevisan; Kourosh Sadeghi; Mahmood Reza Sarzaeem; Parastoo Amiri; Ehsan Rahimpour; Mahnaz Montazeri
Volume 31, Issue 1 , March and April 2024, , Pages 96-105
Abstract
Introduction: The rational use of antibiotic prophylaxis before surgery can reduce surgical site infection, microbial resistance, and economic burden. Therefore, the present study was carried out to optimize the use of antibiotic prophylaxis before surgery using a ready-made drug package prepared in ...
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Introduction: The rational use of antibiotic prophylaxis before surgery can reduce surgical site infection, microbial resistance, and economic burden. Therefore, the present study was carried out to optimize the use of antibiotic prophylaxis before surgery using a ready-made drug package prepared in the pharmacy of Dr. Shariati Hospital.Materials and Methods: The current study is a semi-experimental intervention type, carried out in two stages before and after on 260 patients hospitalized in the heart surgery and neurosurgery departments of Dr. Shariati Hospital who were candidates for surgery and received antibiotic prophylaxis before surgery. A checklist containing patients ' information was completed before and after the preparation of antibiotic prophylaxis packages. Data were analyzed in spss18 software with descriptive and analytical statistics (p≤0.05).Results: Before and after the optimization of antibiotic use, a statistically significant difference was observed in the two study groups regarding dosage, administration intervals, time, and duration of administration. (P<0.001) A 63.42% reduction in the number of doses of antibiotic prophylaxis was observed after the implementation of optimization. Also, there was a 57.33% reduction in the cost of antibiotic prophylaxis after the implementation of optimization.Conclusion: The use of a ready-made drug package before surgery optimizes the use of antibiotic prophylaxis. Also, the economic burden caused by inappropriate use of prophylactic antibiotics for the patient and the hospital is significantly reduced with this method.
Internal Medicine
pejman porouhan; Reza Yousefabadi; Alaleh Abbaspour; Babak PeyroShabany; Danial Fazilat-Panah; Ahmad Foroughi; Seyed Alireza Javadinia
Volume 30, Issue 4 , November and December 2023, , Pages 442-452
Abstract
Background: To investigate the survival of patients with brain metastases (BM) in Sabzevar.Materials and Methods: In this retrospective cross-sectional study at two oncologic centers in Sabzevar, patients with BM either at the presentation or at during the follow-up were enrolled. Patients' documents ...
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Background: To investigate the survival of patients with brain metastases (BM) in Sabzevar.Materials and Methods: In this retrospective cross-sectional study at two oncologic centers in Sabzevar, patients with BM either at the presentation or at during the follow-up were enrolled. Patients' documents were reviewed in terms of clinical and pathological features of the primary tumor, first-line treatments and treatments at the time of BM diagnosis and finally overall survival (OS) and BM-related survival rates. The data was entered into SPSS version 26 software and analyzed at a significance level of P<0.05.Results: Eighty-four patients were enrolled (58.33% female, median age 57 [25-83]). Most frequent primary cancers were lung (non-small cell, 38.1%) and breast (34.52%). BM at the diagnosis of primary tumor was presented in 29 patients (34.5%). 61.9% had ≥5 BM, 97.6% were symptomatic, 80% had extracranial metastases (ECM). Headache (22.6%) and focal neurologic deficit (21.4%) were the most frequent reported symptoms. Primary BM treatments were: Surgery 6.1%; SRT 0%; whole brain radiotherapy (WBRT) 87.8%, systemic treatments 6.1%; best supportive care (BSC) 0%. Median OS after BM diagnosis for all was 5 months (surgery: 11, systemic: 3, WBRT: 5). In patients treated with WBRT, 64.8% had ≥5 BM, 83.3% ECM, 16.9% were ≥70 years.Conclusion: Survival of patients with BM is extremely poor. WBRT is the main treatment option. Patients who can tolerate the surgery may survive more.
Internal Medicine
Majid Farrokhifar; milad edrisi; seyed ahmad sajadi; alireza nohi kararodi; hossein rezaei; Mitra Tajmohamadi
Volume 30, Issue 4 , November and December 2023, , Pages 453-461
Abstract
Background: Poisoning in children is one of the most important problems in the public health of today's society. One of the most essential factors in promoting the health of the society is paying special attention to the health of children and adolescents so the purpose of this study was to investigate ...
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Background: Poisoning in children is one of the most important problems in the public health of today's society. One of the most essential factors in promoting the health of the society is paying special attention to the health of children and adolescents so the purpose of this study was to investigate the types of poisoning in children from 6 months to 14 years of age who referred to Heshmatieh Hospital in 2014-2016.Materials and Methods: All children aged 6 months to 14 years who referred to the emergency department of Heshmatieh Hospital, whose final diagnosis was poisoning, were included in the study, and their information was entered in a specially designed form.Results: The most important cause of poisoning is drug poisoning or 4.4% and drug poisoning with 1.42%. 17.5% (22 people) were hospitalized in the ward and 16.7% (21 people) were hospitalized in the emergency room. Most of the children who had opium poisoning were in the age group of 6 months to 2 years old, and most of the children who had drug poisoning and alcohol poisoning were in the age group of 12to14 years (P<0.001). There was no significant statistical difference between gender (P=0.386) and place of residence (P=0.142) with the type of poisoning in children.Conclusion: Adequate information to parents about poisoning, how to prevent and observe safety precautions in the storage of drugs, as well as regulating the supply of non-prescription drugs is necessary to control drug addiction and abuse.
Internal Medicine
mojde navinejad; MAHTAB KHAJEH
Volume 28, Issue 3 , May and June 2021, , Pages 407-411
Abstract
Introduction: Appendicitis is one of the medical emergencies and one of the most common causes of acute and severe abdominal pain worldwide. If appendicitis is not treated in time, the inflamed tissue of the appendix ruptures, followed by peritonitis and shock. Because the process of appendicitis is ...
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Introduction: Appendicitis is one of the medical emergencies and one of the most common causes of acute and severe abdominal pain worldwide. If appendicitis is not treated in time, the inflamed tissue of the appendix ruptures, followed by peritonitis and shock. Because the process of appendicitis is an inflammatory process, the acute phase proteins and whole blood bilirubin appear to produce high levels in the serum under these conditions.
Materials and Methods: The present study is a descriptive cross-sectional study that was conducted in 2014-2015 with the participation of 208 patients over 15 years of age with symptoms of acute appendicitis referred to the emergency department of Dr. Beheshti in Sabzevar. In order to check the level of total bilirubin, 2 cc blood samples were taken from the patients before injecting any antibiotics and performing surgery. After the operation, macroscopic findings such as appendix size, perforation or absence during surgery and pathological findings were collected by the researcher.
Results: The results showed that there was a significant relationship between total bilirubin and perforation in terms of macroscopy and pathology (p< 0.001).
Conclusion: There is a significant relationship between whole blood bilirubin level before surgery and acute appendicitis perforation and can be used along with clinical signs as a laboratory criterion to predict perforation.
Internal Medicine
hassan Ramshini; afsaneh kaffash
Volume 27, Issue 6 , January and February 2021, , Pages 852-859
Abstract
Introduction: The coronavirus disease 2019 (COVID-19) or severe acute respiratory syndrome coronavirus 2, has become the current health concern to the entire world. Initially appeared in Wuhan, China around December 2019, it spread to almost 216 countries due to its high contagious nature, so the World ...
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Introduction: The coronavirus disease 2019 (COVID-19) or severe acute respiratory syndrome coronavirus 2, has become the current health concern to the entire world. Initially appeared in Wuhan, China around December 2019, it spread to almost 216 countries due to its high contagious nature, so the World Health Organization recently declared the pandemic feature of the infection. SARS-CoV-2(COVID-19) which is genetically similar to SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV) is an enveloped, single and positive-stranded RNA virus with a genome comprising 29,891 nucleotides, which encode the 12 putative open reading frames responsible for the synthesis of viral structural and nonstructural proteins which are very similar to SARS-CoV and MERS-CoV proteins. Currently, there are no approved treatments for COVID-19. For this reason, we reviewed existing publications about Coronavirus Disease 2019 (COVID-19) regarding epidemiology, pathophysiology, diagnosis and treatments. Materials and Methods: Given the various investigations on the Virus (15928 publications in MEDLINE database, Until May 26, 2020) and various clinical data generated by the large number of laboratories, clinicians need accurate evidence regarding effective medical treatments for this infection. In this review, MEDLINE, SCIENCE DIRECT and Scopus databases were searched for relevant articles. Results: Since the emergence of COVID-19 infection there was a large interest in the development of an effective therapy for this disease. In this review, we summarized the available literature on possible therapeutic options including in vitro, animal and human studies. This review has presented a picture of the current findings on the epidemiology, clinical features, diagnosis, management, and prevention of COVID-19. Conclusion: The COVID-19 epidemic represents the world's biggest public health crisis. Clinical trials that have begun to look for potential treatments for COVID-19 are very high, but unfortunately have not yet led to the development of an effective drug. Thus, to overcome on this crisis preventive and coordinated emergency measures between all countries are needed.
Internal Medicine
mahmoud parham; Sajad Rezvan; fatemeh amirkanian; akram barati; mohmmad hassan nikkhah
Volume 27, Issue 4 , November and December 2020, , Pages 570-576
Abstract
Introduction: Metabolic syndrome is known as a risk factor for dementia and various degrees of cognitive impairment. The aim of this study was to Comparative study of diagnostic value of Montreal cognitive assessment (MoCA) and Mini–Mental state examination (MMSE) tests for assessment and cognitive ...
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Introduction: Metabolic syndrome is known as a risk factor for dementia and various degrees of cognitive impairment. The aim of this study was to Comparative study of diagnostic value of Montreal cognitive assessment (MoCA) and Mini–Mental state examination (MMSE) tests for assessment and cognitive impairments screening in patients with metabolic syndrome.
Materials and Methods: This descriptive-analytical study was performed on 107 patients with metabolic syndrome. Cognitive impairment was examined by MoCA and MMSE tests. Data were analyzed by SPSS 18 software.
Results: Mean score of MMSE and MoCa tests were 23.28 ± 2.66 and 22.06 ± 2.93, respectively. 84 patients (78.5%) had a MoCA test impairment (cognitive impairment). Based on the MMSE test, 66 patients (61.68%) had cognitive impairment. The sensitivity and specificity of the MMSE test were 73.81% and 82.61% respectively. MMSE diagnostic test with age (p=0.000, CC= -0.459), BMI (p = 0.000, CC = -0.338), FBS (p = 0.000, CC=-0.51), the levels of triglyceride (TG) (p = 0.000, CC = -0.56) and HDL (p = 0.000, CC = -0.54) were significantly correlated.
Conclusion: Cognitive impairment is noticeable in patients with metabolic syndrome and it seems that metabolic syndrome markers such as fasting blood glucose, triglyceride levelsand ets associated with cognitive impairment in these patients. MMSE test is a desirable sensitivity and specificity in evaluating cognitive impairment in patients with metabolic syndrome. However, because of the lack of studies in this field, are recommended for more comprehensive conclusions.