Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Diabetic neuropathy: Past, present, and future
153
169
EN
Juan
Quiroz-Aldave
Division of Medicine, Hospital de Apoyo Chepén, Chepén, Peru
jquirozaldave@hotmail.com
N
0000-0001-8286-095X
María
Durand-Vásquez
Division of Family Medicine, Hospital de Apoyo Chepén, Chepén, Peru
mdurandvasquez@hotmail.com
N
0000-0001-7862-9333
Elman
Gamarra-Osorio
Division of Endocrinology, Hospital Víctor Lazarte Echegaray, Trujillo, Peru
elman.gamarra.osorio@gmail.com
N
0000-0003-3707-5340
Jacsel
Suárez-Rojas
Universidad Científica del Sur, Lima, Peru
jsuarezro@cientifica.edu.pe
N
0000-0003-2377-7333
Pela Jantine
Roseboom
Division of Emergency Medicine, Hospital Regional Docente de Trujillo, Trujillo, Peru
pjap.rose@gmail.com
N
0000-0002-4660-0752
Rosa
Alcalá-Mendoza
Division of Physical Medicine and Rehabilitation, Hospital Víctor Lazarte Echegaray, Trujillo, Peru
rosa.alcala.m1@gmail.com
N
0000-0001-9693-1456
Julia
Coronado-Arroyo
Division of Obstetrics and Gynecology, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
juliacristinacoronado@gmail.com
N
0000-0002-4916-8205
Francisca
Zavaleta-Gutiérrez
Division of Neonatology, Hospital Belén de Trujillo, Trujillo, Peru
paquitamed@hotmail.com
N
0000-0002-5497-3735
Luis
Concepción-Urteaga
School of Medicine, Universidad Nacional de Trujillo, Trujillo, Peru
luisconcepcionurteaga@hotmail.com
N
0000-0001-5870-7787
Marcio
Concepción-Zavaleta
Division of Endocrinology, Hospital Jorge Voto Bernales, Lima, Peru
marcio_conc_zav@outlook.es
Y
0000-0001-9719-1875
10.22088/cjim.14.2.153
Background: A sedentary lifestyle and an unhealthy diet have considerably increased the incidence of diabetes mellitus worldwide in recent decades, which has generated a high rate of associated chronic complications.
Methods: A narrative review was performed in MEDLINE, EMBASES and SciELO databases, including 162 articles.
Results: Diabetic neuropathy (DN) is the most common of these complications, mainly producing two types of involvement: sensorimotor neuropathy, whose most common form is symmetric distal polyneuropathy, and autonomic neuropathies, affecting the cardiovascular, gastrointestinal, and urogenital system. Although hyperglycemia is the main metabolic alteration involved in its genesis, the presents of obesity, dyslipidemia, arterial hypertension, and smoking, play an additional role in its appearance. In the pathophysiology, three main phenomena stand out: oxidative stress, the formation of advanced glycosylation end-products, and microvasculature damage. Diagnosis is clinical, and it is recommended to use a 10 g monofilament and a 128 Hz tuning fork as screening tools. Glycemic control and non-pharmacological interventions constitute the mainstay of DN treatment, although there are currently investigations in antioxidant therapies, in addition to pain management.
Conclusions: Diabetes mellitus causes damage to peripheral nerves, being the most common form of this, distal symmetric polyneuropathy. Control of glycemia and comorbidities contribute to prevent, postpone, and reduce its severity. Pharmacological interventions are intended to relieve pain.
diabetic neuropathy, diabetes mellitus, complication, treatment, glycemic control, Hb A1c
http://caspjim.com/article-1-3542-en.html
http://caspjim.com/article-1-3542-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Epidemiological trend of suicide in north of Iran from 2011 to 2018 with a focus on joinpoint regression
170
178
EN
Sharareh
Zabihi afroozi
Department of Nursing, Babol University of Medical Sciences, Iran
sharareh.zabihyafroozy@gmail.com
N
0000-0002-9118-1075
Soraya
Khafri
Social Determinants of Health Research center, Health Research Institute, Babol University of Medical Science, Babol, Iran
khafri@yahoo.com
Y
0000-0002-2398-7560
Aliasghar
Manouchehri
Department of Internal Medicine, School of Medicine, Babol University of Medical Sciences, Iran
drmanouchehr@yahoo.com
N
0000-0003-1741-9791
Mahasti
Emami
School of Health, Iran University of Medical Sciences, Iran
mahastiemami1@gmail.com
N
0000-0002-8204-6218
Hajar
Alizadeh
Department of Nursing, Babol University of Medical Sciences, Iran
hasti.alizade6464@gmail.com
N
0000-0003-2224-0761
Sussan
Moudi
Social Determinants of Health Research center, Health Research Institute, Babol University of Medical Science, Babol, Iran
sussan.moudi@gmail.com
N
0000-0002-6573-8861
Sara
Khaleghi
Student Research Committee, Babol University of Medical Science, Babol, Iran
sara.khaleghi41@gmail.com
N
0000-0002-8393-7514
10.22088/cjim.14.2.170
Background: Deaths due to potential suicide are preventable and this phenomenon is costly for the health care system and contradicts the values and cultural standards of an Islamic country.
Methods: This study is a retrospective study. The research population includes all cases of suicide during the years 2011-2018 who were referred to the emergency department of Babol hospitals. The results were analyzed using SPSS v.23 and Joinpoint Trend Analysis software 4.9.0.0 to identify significant changes in the temporal trends of the outbreak.
Results: The highest percentage of suicides occurred in summer (27.8%), on Saturdays (13%) and at night (53%). A total of 1.9% of the cases were commit suicides (leading to death). The highest frequency of suicide was shown in 1397 (21.2%) and the lowest in 1392 (5.1%) and was more common in women (68.2% vs. 31.8%). Suicide-related deaths was higher in the second four years (63.5%), but suicide rate was significantly higher in the first four years (2011-2014) and the mortality rate due to suicide was higher in men than women.
Conclusion: Suicide attempts were higher in women than men but the death rate was higher in men which means that men attempt suicide more seriously than women. The model also predicted that suicide rates would rise in the coming years. For this reason, this important issue, along with a detailed analysis of the roots of suicidal ideation and preventive measures, should be considered by health officials and social institutions.
Epidemiology, Trend, Suicide, Joinpoint Regression, Iran
http://caspjim.com/article-1-3183-en.html
http://caspjim.com/article-1-3183-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Clinical, endoscopic, and demographic characteristics of idiopathic duodenal ulcers compared with helicobacter pylori positive ulcers
179
184
EN
Manizheh
Ebrahimzadeh Pirshahid
Student Research Committee, Babol University of Medical Sciences, Babol, Iran
ebrahimzadeh.m97@yahoo.com
N
0000-0002-3424-6098
Khadijeh
Haghshenas
Department of Internal Medicine, Babol University of Medical Sciences, Babol, Iran
kh.haghshenas@gmail.com
N
0000-0002-0566-5162
Mehrdad
Kashifard
Department of Internal Medicine, Babol University of Medical Sciences, Babol, Iran
mehrdadkashifard@yahoo.com
N
0000-0002-1936-4731
Javad
Shokri-Shirvani
Department of Internal Medicine, Babol University of Medical Sciences,
j.shokri@mubabol.ac.ir
Y
0000-0002-2090-2234
10.22088/cjim.14.2.179
Background: Helicobacter pylori infection is the most common cause of peptic ulcer disease. However, the prevalence rates of non-helicobacter pylori idiopathic peptic ulcers have increased over the past few years. This study aims to compare the characteristics of Helicobacter pylori-positive with idiopathic duodenal ulcers.
Methods: A cross-sectional cohort study was conducted on 950 patients which were excluded from the analysis process duo to the concomitant presence of gastric ulcer, malignancy, Zollinger Ellison syndrome, Crohn's disease, esophageal varices, history of taking anti-Helicobacter pylori therapy, and history of taking NSAID or aspirin. Eventually, 647 subjects were enrolled for the analysis process. In this case, these subjects were divided into two groups: (I) Helicobacter pylori-positive ulcer group and (II) Helicobacter pylori-negative and non-NSAID (idiopathic) ulcer group.
Results: The findings showed that 417 patients (64.5%) had duodenal ulcers induced by Helicobacter pylori, and 111 patients (17.1%) had Helicobacter pylori-negative and non-NSAID ulcers. The mean ages of patients in Helicobacter pylori-positive and idiopathic ulcer groups were 39±15 and 42±17, respectively. In this case, 33 patients (29.7%) with idiopathic ulcers and 56 patients (25.1%) with Helicobacter pylori-positive ulcers had upper gastrointestinal bleeding. Also, 22 patients (21%) with idiopathic ulcers and 31 patients (16.5%) with Helicobacter pylori-positive ulcers had multiple duodenal ulcers
Conclusion: The present study demonstrated that the idiopathic ulcers included 17.1% of duodenal ulcers. Also, it was concluded that patients with idiopathic ulcers were predominantly male with an age range older than the other group. In addition, patients in this group had more ulcers.
Idiopathic Ulcer, Helicobacter Pylori, Duodenal Ulcer, Endoscopy.
http://caspjim.com/article-1-3352-en.html
http://caspjim.com/article-1-3352-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Effect of intramuscular injection of human chorionic gonadotropin on endometrium preparation in frozen-thawed embryo transfer cycle: A randomized clinical trial
185
191
EN
Firoozeh
Akbari Asbagh
Department of Infertility, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
fasbagh.md@yahoo.com
N
0000-0001-5365-425X
Fatemeh
Ghasemzadeh
Department of Infertility, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
dr_fa_ghasemzadeh@yahoo.com
Y
0000-0002-0269-2122
Mahbod
Ebrahimi
Department of Infertility, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
maeb214@yahoo.com
N
0000-0003-4722-7635
Fatemeh
Davari-Tanha
Department of Infertility, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
fatedavtanha@gmail.com
N
0000-0002-9465-6371
Elham
Feizabad
Department of Infertility, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
elhamfeizabad@gmail.com
N
0000-0002-0372-5897
Parvin
Akbari Asbagh
Department of Pediatrics, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
parvin.akbariasbagh@yahoo.com
N
0000-0002-5320-4926
Samaneh
Hosseini Quchani
Department of Infertility, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
b.s.hoseini@gmail.com
N
0000-0002-6129-8467
10.22088/cjim.14.2.185
Background: Assisted reproductive therapy (ART) has been developed remarkably in these decades; however, the rate of unsuccessful embryo implantation especially in the frozen-thawed embryo transfer (FET) cycles remains high and is reported up to 70%. The current study was designed to compare the effect of intramuscular injection of hCG on endometrium preparation and embryo implantation, in women undergoing FET compared to the control group.
Methods: This clinical trial was done on 140 infertile women that underwent FET. The study sample was randomly allocated to the intervention group (two 5000 unit ampoules of hCG were injected intramuscularly before the first dose of progesterone administration) and the control group (without hCG injection). In both groups, 4 days after progesterone administration, the cleavage stage embryos were transferred. The study outcomes were biochemical pregnancy, clinical pregnancy and abortion rate.
Results: The average age of intervention and control group was 32.65±6.05 and 33.11±5.36 years, respectively. The basic information between two study groups did not differ significantly. The chemical (30% vs. 17.1%, P=0.073, relative risk (RR)=0.57) and clinical (28.6% vs. 14.3%, P=0.039, RR=0.50) pregnancy rates were higher in the intervention group compared to the control group; these higher ratios were only significant in clinical pregnancy rate. Abortion rate was not significantly (P=0.620) different between the intervention and control groups (4.3% vs. 1.4%, respectively).
Conclusion: This study showed that intramuscular injection of 10000 IU hCG before the endometrial secretory transformation phase in cleavage-stage embryo, improves IVF cycle outcomes.
In vitro fertilization, Human chorionic gonadotropin, Pregnancy outcome
http://caspjim.com/article-1-3555-en.html
http://caspjim.com/article-1-3555-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Probiotics on chronic urticaria: A randomized clinical trial study
192
198
EN
Abbas
Dabbaghzadeh
Pediatric Infectious Diseases Research Center, Mazandaran University of Medical Sciences, Sari, Iran
siamakdabbaghzade@yahoo.com
N
0000-0003-1688-6849
Javad
Ghaffari
Molecular and Cell Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
javadneg@yahoo.com
Y
0000-0002-1447-8916
Siavash
Moradi
Education Development Center, Mazandaran University of Medical Sciences, Sari, Iran
d.smor86@yahoo.com
N
0000-0002-0222-9920
Davood
Sayadian separghan
Molecular and Cell Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
dr.sayadian@yahoo.com
N
0000-0000-0000-0000
10.22088/cjim.14.2.192
Background: Urticaria is a common itchy skin condition characterized by swelling and erythema. A variety of treatments is available today. The purpose of this study was to evaluate the clinical effects of probiotic use in patients with chronic resistant urticaria.
Methods: This four-way blind randomized clinical trial was conducted between June 2019 and June 2020. Study population consisted of patients with chronic urticaria who did not respond well to first line treatment with antihistamines. For the intervention group, antihistamine (cetirizine) and probiotics (femilact capsule) and for the control group, antihistamine (cetirizine) and placebo were administered twice a day for 8 weeks. The “Urticarial Activity for 7 Days” (UAS7) questionnaire was used to assess urticaria activity and the Dermatology Life Quality Index (DLQI) questionnaire was used to assess the quality of life of patients.
Results: Patients’ age range was 7 to 30 years with a mean and standard deviation of 23.6±9.2 years. 31 (81.57%) cases were females and 7 (18.42%) cases were males. Twenty patients were in the intervention group and eighteen patients were in the control group. The mean scores of UAS7 questionnaire were reduced in both groups, but it was more significant in the intervention group (9.6±6.4) compared to the control group (12.7±8.1) at the end of week eight of treatment (P=0.036). Also, there was no significant difference in the quality of life between the two groups after 8 weeks (P=0.805).
Conclusion: This study showed that probiotic consumption along with antihistamines significantly improved the activity of urticaria but not the quality of life of patients.
chronic urticaria, histamine antagonists, probiotics, therapeutics
http://caspjim.com/article-1-2885-en.html
http://caspjim.com/article-1-2885-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Determination of plasma transcobalamin-II and zinc levels in newly–diagnosed and long–standing grand mal epileptic patients
199
204
EN
Amene
Aman-Mohammady
Babol university of Medical sciences, Babol, Iran
rohanresearch88@gmail.com
N
0000-0000-0000-0000
Payam
Saadat
Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
sepanta1968@yahoo.com
Y
0000-0002-5150-4757
Durdi
Qujeq
Department of Biochemistry, Babol University of Medical Sciences, Babol, Iran
rohanresearch88@gmail.com
N
0000-0003-1344-9344
Karimollah
Hajian-Tilaki
Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
drhajian@yahoo.com
N
0000-0001-6830-1916
Kiarash
Saleki
Student Research Committee, Babol University of Medical Sciences, Babol, Iran
kiarash_saleki@icloud.com
N
0000-0001-6830-1916
10.22088/cjim.14.2.199
Background: The changes of plasma transcobalamin-II (TCII) and Zinc (Zn) Levels in epileptic patients are not clearly understood. The aim of the current study was to evaluate the plasma contents of TCII and Zn levels in newly–diagnosed epileptic seizure patients, long-standing grand mal epileptic patients following treatment with sodium valproate and healthy control group.
Methods: Thirty patients aged 36.76±12.91 years with newly–diagnosed and thirty long-standing grand mal epileptic patients aged 35.56 ±12.77 years were diagnosed based on the clinical symptoms. The control subjects were picked out from healthy individuals and matched to the patients, aged 36.30 ±12.80 years. Plasma Zn and TCN-2 was evaluated via spectrophotometry at 546 nm and 450 nm, respectively, using chimerical kits.
Results: Plasma level of TCII in the newly–diagnosed epileptic seizures patients and long-standing grand mal epileptic patients were significantly increased, compared to the healthy controls [14.89 ±3.24 and 21.84± 2.73 vs. 9.55±1.24, (n=30)], respectively. Plasma level of Zn was decreased in the newly–diagnosed epileptic seizure patients, while it was increased in long-standing grand mal epileptic patients compared to the control group [69.28± 6.41 and 80.56 ±6.12 and vs.75.80±1.59, (n=30)], respectively.
Conclusion: This study suggests that sodium valproate may disrupt the homeostatic balance of TCII and Zn, and cause abnormality of their serum level in newly–diagnosed epileptic seizure patients and long-standing grand mal epileptic patients. Further research is recommended to identify the underpinning for these changes.
Transcobalamin-2, zinc, newly –diagnosed, long –standing grand mal, epileptic
http://caspjim.com/article-1-3357-en.html
http://caspjim.com/article-1-3357-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Relationship between anthropometric indices and Mizaj (temperament) in Persian medicine
205
212
EN
Mojgan
Tansaz
Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Tansaz_mojgan@yahoo.com
N
0000-0002-9348-4635
Marjan
Akhtari
Department of Persian Medicine, School of Persian Medicine, Babol University of Medical Sciences, Babol, Iran
m.akhtari1981@gmail.com
N
0000-0002-8949-964X
Mohsen
Naseri
Traditional Medicine Clinical Trial Research Center, Shahed University, Tehran, Iran
naseri@shahed.ac.ir
N
0000-0001-9239-768X
Reza
Majdzadeh
Epidemiology and Biostatistics Department of Public Health School, Knowledge Utilization Research Center, Tehran University of Medical Science, Tehran, Iran
rezamajd@tums.ac.ir
N
0000-0001-8429-5261
Mohsen
Saberi Isfeedvajani
Medicine, Quran and Hadith Research Center and Department of Community Medicine, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
msaberihaji@yahoo.com
N
0000-0002-3455-7013
Mohammad Reza
Shams-Ardakani
Quran and Hadith Research Center and Department of Community Medicine, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
shams@tums.ac.ir
N
0000-0001-7326-5788
Fatemeh
Nejatbakhsh
Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
fnejatbakhsh@yahoo.com
N
0000-0001-0000-0000
Abbas
Ebadi
Behavioral Sciences Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
ebadi1347@bmsu.ac.ir
N
0000-0002-2911-7005
Morteza
Mojahedi
Traditional Medicine and History of Medical Sciences Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
mortazamojahedy@gmail.com
Y
0000-0002-0346-5925
10.22088/cjim.14.2.205
Background: The process of diagnosis and treatment in Persian medicine (PM) are based on the concept of Mizaj (temperament). Among the indices of Mizaj determination, anthropometric indices are less influenceable regarding age change and other environmental factors. The purpose of this study was to investigate the relationship between anthropometric indices and Mizaj.
Methods: Four PM experts determined the Mizaj of 121 participants. Those who had ≥70% agreement in their Mizaj determination by the experts were selected and their anthropometric indices were measured. The best cutoff point of each index and its relationship with the defined Mizaj were extracted using Receiver Operative Characteristic Curve and Binary Logistic Regression.
Results: 52 out of 121 participants entered the main study. The warm-Mizaj people had larger dimensions in height, shoulder, chest, palm and sole width, and head height. Cold-Mizaj people had smaller dimensions in weight, height, shoulder, chest and head. High levels of BMI, chest depth and head dimensions had the highest correlation with the wet Mizaj and lower dimensions of these indices had the highest correlation with the dry Mizaj.
Conclusion: Among the anthropometric indices, chest, palm, sole dimensions, head height and weight had the highest correlation with warmness/coldness and BMI, head width and chest dimensions had the highest correlation with wetness/dryness. The BMI which is more closely related to the soft tissue, only correlates with the wetness/dryness, while, bone dimensions are associated with warmness/coldness. Further studies are needed to metricize the anthropometric indices for Mizaj determination.
Anthropometric indices, Mizaj, Persian Medicine, Personalized medicine, Temperament
http://caspjim.com/article-1-2537-en.html
http://caspjim.com/article-1-2537-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Reliability and validity of the Persian version of psoriatic arthritis screening questionnaire
213
216
EN
Azar
Shirzadian Kebria
Department of Dermatology, Clinical Research Development Unit of Ayatollah Rouhani Hospital ,Babol University of Medical Sciences, Babol ,Iran
rohanresearch88@gmail.com
N
0000-0002-7629-7619
Abolfazl
Eftekhari
Clinical Research Development Unit of Ayatollah Rouhani hospital, Babol University of Medical Sciences, Babol, Iran
rohanresearch88@gmail.com
N
0000-0000-0000-0000
Khadijeh
Ezoji
Social Determinants of Health Research Center, Health Research Institute, Clinical Research Development Unit of Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
rohanresearch88@gmail.com
N
0000-0002-3718-3678
Soudabeh
Tirgar tabari
Department of Dermatology, Clinical Research Development Unit of Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
rohanresearch88@gmail.com
N
0000-0000-0000-0000
Zeinab
Aryanian
Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences Tehran, Iran
rohanresearch88@gmail.com
N
0000-0000-0000-0000
Soraya
Khafri
Department of Social Medicine and Health, Babol University of Medical Sciences, Babol, Iran
rohanresearch88@gmail.com
N
0000-0002-2398-7560
Mansour
Babaei
Mobility Impairment Research Center, Department of Rheumatology, Clinical Research Development Unit of Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
babaeim47@yahoo.com
Y
0000-0002-4179-7787
10.22088/cjim.14.2.213
Background: The Early Arthritis for Psoriatic Patients (EARP) questionnaire is a fast and simple way to screen psoriatic arthritis. This study was carried out to investigate the diagnostic accuracy of the Persian version of the Early Arthritis for Psoriatic Patients (P-EARP) questionnaire.
Methods: A total of 100 psoriasis patients responded to the questionnaire after the translation procedure (translation, back translation). After determining the validity of the questionnaire, the diagnostic accuracy of the P-EARP questionnaire was assessed using the ROC curve (receiver operating characteristic curve). Internal and external reliability of the questionnaire were also evaluated by statistical tests.
Results: In assessing the reliability of the questionnaire using test-retest, correlation coefficient (r=0.994, p <0.001) and Cronbach's alpha (α = 0.85) were obtained. The P-EARP questionnaire had a sensitivity and specificity of 90.48% and 96.55% in ROC analysis, respectively, and cutoff point 3 was regarded as the cutoff point of the P-EARP questionnaire like the original version of the questionnaire (EARP).
Conclusion: The results of this study showed that the P-EARP questionnaire had high sensitivity and specificity for the identification of psoriatic arthritis. The P-EARP questionnaire is an appropriate screening tool for the identification of psoriatic arthritis in the dermatology clinics.
Questionnaire, Psoriatic Arthritis, Reliability and Validity
http://caspjim.com/article-1-2199-en.html
http://caspjim.com/article-1-2199-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
The utero-tonic effects of low dose intravenous ketamine in cesarean section under spinal anesthesia; A randomized double-blind clinical trial
218
225
EN
Mohammad
Haghighi
Anesthesiology Research Center, Department of Anesthesiology, Alzahra hospital, Guilan University of Medical Sciences , Rasht, Iran
manesthesist@gmail.com
N
0000-0003-0331-1683
Soheil
Soltanipour
Department of Community Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
ssoltanipour@yahoo.com
N
0000-0001-7768-1121
Farnoush
Farzi
Anesthesiology Research Center, Department of Anesthesiology, Alzahra hospital, Guilan University of Medical Sciences , Rasht, Iran
Farnoushfarzi1374@gmail.com
N
0000-0001-8850-7735
Mandana
Mansour-Ghanaei
Reproductive Health Research Center, Department of Obstetrics and Gynecology, Al-Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
m-m-ghanaie@gums.ac.ir
N
0000-0003-1503-3502
Gelareh
Biazar
Anesthesiology Research Center, Department of Anesthesiology, Alzahra hospital, Guilan University of Medical Sciences , Rasht, Iran
gelarehbiazar1386@gmail.com
Y
0000-0002-1716-1324
Azadeh
Malekzadeh
Anesthesiology Research Center, Department of Anesthesiology, Alzahra hospital, Guilan University of Medical Sciences , Rasht, Iran
Azadeh.malakzadeh@gmail.com
N
0000-0000-0000-0000
Mahin
Tayefeh Ashrafiyeh
Anesthesiology Research Center, Department of Anesthesiology, Alzahra hospital, Guilan University of Medical Sciences , Rasht, Iran
mahintayefe@gmail.com
N
0000-0002-0706-6681
10.22088/cjim.14.2.218
Background: Recently, the prevalence of cesarean section (CS) has been on the rise and the proper uterine tone is an important issue. We investigated the effects of intravenous (IV) ketamine on intraoperative bleeding and the need for oxytocin in CS under spinal anesthesia (SA).
Methods: This study, took place at Alzahra hospital during 2020. Pregnant women candidate for elective CS under SA were divided into two groups of ketamine and placebo. In group K, after umbilical cord clamping, 0.25 mg/kg ketamine and in group P 2ccs normal saline was injected. Mean arterial pressure and heart rate were recorded at baseline, before and 5 minutes after cord clamping and at the end of the surgery. The drop in hemoglobin values, the administrated units of oxytocin and side effects were also recorded.
Results: No significant difference was found in terms of patients’ demographic data (P ≥ 0.05). The mean units of administrated oxytocin in group K was 34.61±6.63 and in group P; 48.47±12.15, which was significantly different (P=0.0001). The drop in Hb was less in group K, however not statistically significant (P=0.094). The need for methergine was significantly higher in group P (P=0.0001). The mean HR was significantly higher in group P (P=0.027), however, no significant difference was observed regarding the MAP (P=0.064). The incidence of hallucination (4.8%) and nystagmus (21%) was significantly higher in group K (P= 0.0001), but nausea and vomiting were more significant in group P (P= 0.027).
Conclusion: Prophylactic administration of low-dose ketamine in CS under S.A could significantly reduce the administrated oxytocin units and the need for additional utero-tonics and was associated with less drop in Hb values.
Bleeding, Ketamine, Intraoperative Care, Oxytocin
http://caspjim.com/article-1-3184-en.html
http://caspjim.com/article-1-3184-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Efficacy and safety of endoscopic sphincterotomy with balloon dilation versus endoscopic sphincterotomy alone for extraction of common bile duct stones with a maximum diameter of
10 to15 millimeters
226
230
EN
Mehdi
Yalmeh
Student Research Committee, School of Medicine, Babol University of Medical Sciences, Babol, Iran
yolmeh64@gmail.com
N
0000-0002-7116-6257
Abdolreza
Emami
Student Research Committee, School of Medicine, Babol University of Medical Sciences, Babol, Iran
emami.abdoulreza@gmail.com
Y
0000-0003-0001-4632
Javad
Shokri Shirvani
Department of Internal Medicine, School of Medicine, Babol University of Medical Sciences, Babol, Iran
javadshokry@gmail.com
N
0000-0002-2090-2234
Hassan
Abedi
Department of Internal Medicine, School of Medicine, Babol University of Medical Sciences, Babol, Iran
h.abedi@mubabol.ac.ir
N
0000-0003-2323-4343
Mohamad Taghi
Hamidian
Health Research Institute, Babol University of Medical Sciences, Babol, Iran
meisamhamidian1982@gmail.com
N
0000-0002-4397-1048
Hemmat
Gholinia Ahangar
Health Research Institute, Babol University of Medical Sciences, Babol, Iran
h_gholinia@yahoo.com
N
0000-0003-0517-2429
10.22088/cjim.14.2.226
Background: Various factors, most notably the stone's features, determine the selection of an appropriate method to extract common bile duct (CBD) stones during endoscopic retrograde cholangiopancreatography. In this study, the efficacy and safety of endoscopic sphincterotomy with balloon dilation (ESBD) versus endoscopic sphincterotomy (EST) for CBD stone extraction with a diameter of 10 to 15 millimeters were compared.
Methods: This retrospective cross-sectional study included 154 patients referred to the Rouhani Hospital in Babol, Iran, with CBD stones. Consensus sampling was used. Each individual's demographic information and findings from the procedure were entered into the SPSS software (v. 26). A level of less than 0.05 was considered statistically significant.
Results: A total of 154 patients were included in the study, of which 81 (52.6%) were in the EST, and 73 (47.4%) were in the ESBD group. Complete stones removal rate was higher in the ESBD versus the EST group (79.5% versus 46.9%, P<0.001). No significant differences were observed between the two methods' overall side effects rate (P = 0.469).
Conclusion: For the complete extraction of CBD stones larger than 10 millimeters, the ESBD method outperforms the EST method.
Endoscopic retrograde cholangiopancreatography, common bile duct stone, efficacy, safety, Endoscopic Sphincterotomy, endoscopic sphincterotomy with balloon dilation
http://caspjim.com/article-1-3279-en.html
http://caspjim.com/article-1-3279-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Evaluation of serum C4d levels in patients with systemic lupus erythematosus and its relation to lupus nephritis
231
236
EN
Nayyereh
Saadati
Department of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
saadatin@mums.ac.ir
N
0000-0002-4589-8091
Maryam
Miri
Kidney transplantation complication research center,Mashhad university of medical sciences,mashhad,Iran
mirighm@mums.ac.ir
Y
0000-0002-9962-6753
10.22088/cjim.14.2.231
Background: Lupus nephritis (LN) is a debilitating complication of systemic lupus erythematosus (SLE). Renal biopsy is the gold standard for evaluating LN. Serum C4d is a potential non-invasive method for evaluating LN. The purpose of this study was to evaluate the value of C4d in the assessment of LN.
Methods: This cross-sectional study was conducted on patients with LN who were referred to a tertiary hospital in Mashhad, Iran. Subjects were divided into four groups including LN, SLE without renal involvement, chronic kidney disease (CKD) and healthy controls. Serum C4d. creatinine, and glomerular filtration rate (GFR) were assessed for all subjects.
Results: Forty-three subjects (11, 25.6% healthy controls, 9, 20.9% SLE patients, 13, 30.2% LN and 10, 23.3% CKD patients) participated in this study. CKD group were significantly older than other groups (p>0.05). There was a significant difference in gender distribution between groups (p<0.001). Median serum C4d were 0.6 in healthy controls and CKD group and 0.3 in SLE and LN groups. There was no significant difference in serum C4d between groups (p=0.503).
Conclusion: The findings of this study indicated that serum C4d might not be a promising marker in the assessment of LN. These findings should be documented by further multicenter studies.
Lupus nephritis, Systemic lupus erythematosus, C4d
http://caspjim.com/article-1-2790-en.html
http://caspjim.com/article-1-2790-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Incidence of anemia and red blood cell (RBC) transfusion requirement in breast cancer
237
248
EN
Nur Aklina
Ramli
Department of Clinical Medicine, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, Penang, Malaysia
aklinanur2411@yahoo.com
N
0000-0001-7824-6076
Salfarina Iberahim Sal
Salfarina
Department of Haematology and Transfusion Medicine Unit, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 15200 Kubang Kerian, Kelantan, Malaysia
salfarina78@gmail.com
N
0000-0002-6903-3519
Hasmah
Hussin
Department of Clinical Medicine, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, Penang, Malaysia
hasmah.hussin@usm.my
Y
0000-0002-5423-9303
Ahmad
Arif Che Ismail
Blood Bank Unit, Hospital Raja Perempuan Zainab (II), 15586 Kota Bharu, Kelantan, Malaysia
scania96@gmail.com
N
0000-0001-8952-6276
10.22088/cjim.14.2.237
Background: Cancer-related anaemia is one of the main burdens in oncology, although the available data on its prevalence and treatment options such as blood transfusion are often contradictory. This study aimed to evaluate the prevalence of anaemia and the requirement for packed red blood cell (PRBC) transfusion among women with breast cancer (BC) and to determine the associated factors for chemotherapy-induced anaemia (CIA).
Methods: This cross-sectional retrospective study conducted in Kelantan involved 104 newly diagnosed female BC patients from 2015 to 2016 who underwent chemotherapy. For statistical analysis, chi-square was used to compare between CIA and non-CIA groups. In addition, simple and multiple logistic regression were used to determine the association of the CIA.
Results: Our study revealed that 34.6% (n=36) of patients had mild anaemia, and 59.6% (n=62) had normal haemoglobin at pre-chemotherapy. The prevalence of anaemia increased from 40.4% to 77% at the end of our study. About 30.8% of patients received PRBC transfusion during chemotherapy with mean haemoglobin before the first transfusion of 7.9 g/dl. CIA was observed in 54.8% of cases. There was no significant association between CIA concerning the patient characteristic, cancer characteristic, or cancer treatment.
Conclusion: We concluded that a significant proportion (40.4%) of BC patients was anaemic even before chemotherapy, with the red blood cell requirements up to 30.8% throughout chemotherapy. A larger prospective study is needed to determine the predictors for the CIA and subsequently improve patient management.
breast cancer, anaemia, red cell transfusion, chemotherapy
http://caspjim.com/article-1-3312-en.html
http://caspjim.com/article-1-3312-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Genetic markers of the risk of coronary heart disease and coronary artery thrombosis developing in the Kazakh population
249
256
EN
Dana
Taizhanova
NJSC
Taizhanova_kgma@mail.ru
Y
0000-0001-6971-8764
Aliya
Toleuova
NJSC
A.Toleuova@kgmu.kz
N
0000-0002-3381-118X
Dmitry
Babenko
NJSC
babenko@qmu.kz
N
0000-0003-2280-2146
Anar
Turmuhambetova
NJSC
turmuhambetova@qmu.kz
N
0000-0002-4668-3295
Roza
Bodaubay
NJSC
rozachka.89@mail.ru
N
0000-0001-5278-5477
Olga
Visternichan
NJSC
visternichan@qmu.kz
N
0000-0001-5433-264X
Akerke
Kalimbetova
NJSC
akerke.kalimbetova@gmail.com
N
0000-0001-6423-2669
Ludmila
Ahmaltdinova
NJSC
ahmaltdinova@qmu.kz
N
0000-0001-5602-6136
Aigul
Kurmanova
NJSC
Kurmanova@qmu.kz
N
0000-0003-1845-1603
10.22088/cjim.14.2.249
Background: Surgical methods such as coronary artery bypass grafting and percutaneous coronary interventions (PCI) are widely used along with traditional conservative therapy in the treatment of coronary artery disease. The disease outcome directly depends on timely diagnosis and treatment. A significant role in predicting the effectiveness of treatment is given to personification of treatment and management of the patient. In this case, the determining component is its individual genetic status.
Methods: The study groups included persons of Kazakh nationality which identify themselves, their biological parents, and biological grandparents on the maternal and paternal side as Kazakh. Research groups included 108 people at the age from 45 to 65 years of both sexes. Blood samples genotyping was carried out by PCR using highly specific TaqMan samples. Thermo Fisher cloud application was used for genotypes determining on the base of an automatic algorithm.
Results: The article presents the results of the evaluation of gene polymorphisms associated with coronary artery restenosis in a population of Kazakh nationality. 3 SNPs were determined when searching for an association with stenting due to coronary artery thrombosis: rs7543130 (p=0.009324), rs6785930 (p=0.016858), rs7819412 (p=0.061325).
Conclusion: Four polymorphisms associated with the risk of developing coronary heart disease were revealed during the study of polymorphisms among the people of the Kazakh population. Three SNPs were determined when searching for an association with stenting due to coronary artery thrombosis. It should be noted that the Bonferonni correction for multiple comparisons did not reveal significant polymorphisms associated with coronary artery disease, which requires further research with more quantity of samples.
coronary, artery, restenosis, genetic, polymorphism, pre-test, probability
http://caspjim.com/article-1-2249-en.html
http://caspjim.com/article-1-2249-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Efficacy and safety of “Jollab Monzej” as a traditional persian compound medicine for the treatment of multiple sclerosis-related fatigue: A randomized placebo-controlled trial
257
266
EN
Fatemeh
Yousefnia Babaki
Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
fyousefnia@sbmu.ac.ir
N
0000-0002-3080-2982
Mahmood
Khodadoost
Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
mkhodadoost@sbmu.ac.ir
N
0000-0002-6525-0639
Hossein
Rezaeizadeh
School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
hosseinrezaeizade@gmail.com
N
0000-0003-2703-9485
Abdorreza
Naser Moghadasi
Multiple sclerosis Research Center, Neuroscience institute, Tehran University of Medical Sciences, Tehran, Iran
abdorrezamoghadasi@gmail.com
N
0000-0002-8598-0911
Shirin
Fahimi
Traditional Medicine and Materia Medica Research center and Department of Traditional Pharmacy, School of Traditional Medicine , Shahid Beheshti University of Medical Sciences, Tehran, Iran
fahimishirin@yahoo.com
N
0000-0003-2443-7621
Hamed
Hosseini
Center for Research and Training in Skin Diseases and Leprosy (CRTSDL), Tehran University of Medical Sciences (TUMS), Tehran, Iran
hmdhosseini@gmail.com
N
0000-0003-2368-6749
Mina
Movahhed
Traditional Medicine and Materia Medica Research center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
movahhedm54@gmail.com
N
0000-0002-5120-7082
Kurosh
Gharagozli
6. Brain mapping research Center, Loghman Hakim educational hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Gharagozli@yahoo.com
Y
0000-0001-9376-6547
10.22088/cjim.14.2.257
Background: The purpose of this study was to investigate the efficacy and safety of Jollab monzej (JMZ), a Traditional Persian compound medicine, on multiple sclerosis-related fatigue (MSRF).
Methods: We did a double-blind randomized controlled phase3 clinical trial on the JMZ syrup in fifty-six relapsing-remitting MS (RRMS) patients aged 18-55 years with moderate to severe fatigue using the Expanded Disability Status Scale (EDSS) score ≤ 6. We randomly assigned (1;1) participants to the JMZ syrup or placebo syrup groups treated for one month. Participants, investigators, and assessors were unaware of the assignments. The primary outcome was changes in the fatigue score on the Fatigue Severity Scale (FSS), at baseline and one month after treatment using the intention-to-treat (ITT) analysis. The secondary outcomes were changes in the score of Visual Analogue Scale (VAS), Beck Depression Inventory (BDI), and Pittsburgh Sleep Quality Index (PSQI). Outcomes were measured at baseline, one month after treatment, and 2-week follow-up. Safety was detected in all participants.
Results: We randomly assigned 56 participants to the JMZ group (n=28) and placebo group (n=28). Fatigue scores significantly changed in both groups; however, the JMZ group had a greater reduction in FSS score in the ITT analysis. The adjusted mean difference was 8.80 (Confidence interval (CI) 95%, 2.90-14.70, P = 0.00). The mean difference of VAS, BDI, and global PSQI scores were statistically significant (P=0.01, P₌0.00, P₌0.01; respectively). Regarding safety, mild adverse events (AEs) were reported.
Conclusion: The results of our study revealed that the administration of JMZ syrup alleviated MSRF and also could improve depression and sleep disorders.
multiple sclerosis, fatigue, herb, Persian Medicine
http://caspjim.com/article-1-3190-en.html
http://caspjim.com/article-1-3190-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Does laparoscopic treatment of deep endometriosis improve sexual dysfunction
267
355
EN
Abolfazl
Mehdizadehkashi
Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
amehdizadehkashi@yahoo.com
N
0000-0002-0471-5463
Shahla
Chaichian
Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
shchaichian@gmail.com
Y
0000-0001-5772-8711
Samaneh
Rokhgireh
Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
rokhgireh.s@iums.ac.ir
N
0000-0002-8090-2893
Kobra
Tahermanesh
Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
tahermanesh.k@iums.ac.ir
N
0000-0003-2969-3085
Shahla
Mirgaloybayat
Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
dr.sh.bayat@gmail.com
N
0000-0003-3161-8877
Reza
Saadat Mostafavi
Department of Radiology, Rasool Hospital, Tehran, Iran
saadat.sr@iums.ac.ir
N
0000-0002-8217-5191
Sepideh
Khodaverdi
Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
khodaverdi.s@iums.ac.ir
N
0000-0002-0340-9683
Marziyeh
Ajdary
Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
ajdari.m@iums.ac.ir
N
0000-0002-4154-7788
Mahin
Ahmadi Pishkuhi
Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Tehran, Iran
mahin.ahmadipishkuhi@gmail.com
N
0000-0002-3475-1289
10.22088/cjim.14.2.267
Background: Endometriosis is one of the common gynecological problems during the reproductive years, affecting the quality of life, fertility, and sexual function of women. It is known that sexual dysfunction and quality of life are interrelated. Therefore, this study aimed to evaluate the effect of resection of endometriosis lesions via laparoscopic surgery on the improvement of sexual dysfunction in women with endometriosis.
Methods: This clinical trial was performed on 30 patients with endometriosis. The Female Sexual Function Index, Endometriosis Health Profile-30, and Visual Analog Scale were completed for the patients before laparoscopic surgery and three, six, and 12 months after surgery. The results were examined and compared before and after the intervention using the ANOVA test.
Results: The present results showed that the mean pain score of the patients (dysmenorrhea, dyspareunia, and pelvic pain) was significant after laparoscopic surgery (P<0.005). The female sexual function improved after laparoscopic surgery compared to the preoperative phase, and changes in the domains of psychological stimulation, humidity, and sexual orgasm were significant (P<0.005). Moreover, the female quality of life scores increased in all dimensions compared to the preoperative phase, although these improvements were not statistically significant.
Conclusion: The present results revealed that laparoscopic surgery is an effective treatment, leading to a considerable improvement in female sexual function.
Endometriosis, Laparoscopy, Sexual dysfunction
http://caspjim.com/article-1-3258-en.html
http://caspjim.com/article-1-3258-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Evaluation of morphine, methadone, digoxin, and dronabinol poisoning during the years 2017 to 2019 in Ilam, Iran
356
364
EN
Kourosh
Saki
Department of Psychiatry, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
saki.k@ymail.com
N
0000-0100-0097-1129
Mahmoud
Bahmani
Biotechnology and Medicinal Plants Research Center, Ilam University of Medical Sciences, Ilam, Iran
pharmabiology2021@gmail.com
N
0000-0002-9193-9192
Golnaz
Zamanian
Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
gzamanian@ymail.com
N
0000-0003-0130-0002
Naser
Abbasi
Biotechnology and Medicinal Plants Research Center, Ilam University of Medical Sciences, Ilam, Iran
ilamfarma@gmail.com
N
0000-0001-1505-0837
Ali
Aidy
Biotechnology and Medicinal Plants Research Center, Ilam University of Medical Sciences, Ilam, Iran
aliaidy@ymail.com
N
0000-0002-9643-0130
Aliasghar
Manouchehri
Department of Internal Medicine, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran
mahmood.bahmani@gmail.com
Y
0000-9193-0130-0130
Sudip Kumar
Mandal
B.C. Roy College of Pharmacy and Allied Health Sciences, Meghnad Saha Sarani, Bidhan Nagar, Durgapur-713206, West Bengal, India
gotosudip79@gmail.com
N
0000-0003-0097-1129
Paramita
Ganguly
Department of Pharmaceutical Technology, Brainware University, 398-Ramkrishnapur Road, Barasat, Kolkata-700125, West Bengal, India
proyganguly1@gmail.com
N
0000-0001-1505-0837
Samira
Shokri
Department of Environmental Health Engineering, Division of Food Safety & Hygiene, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Shokrisamira22@yahoo.com
N
0000-0100-4532-0130
10.22088/cjim.14.2.356
Background: Every year, drug poisoning is the most prevalent reason for referring patients to medical centers. This study aimed to evaluation of morphine, methadone, digoxin, and dronabinol poisoning in Shahid Mostafa Khomeini Hospital in Ilam.
Methods: In this In this Cross-sectional study, patient samples suspected of morphine, methadone, digoxin, and dronabinol poisoning referred to the toxicology laboratory of Ilam University of Medical Sciences were analyzed using the HPLC method, and the results were analysed using SPSS software.
Results: Results showed that the percentage of drug use is greater in men than in women. The highest percentage of morphine and methadone poisonings were detected in those under the age of 40, whereas the highest percentage of digoxin poisonings were recorded in those over the age of 80. As a result, the average age of digoxin users was substantially greater in men than in women. Methadone consumers showed significantly greater blood levels than others. In addition, there was a significant difference (P<0.01) in blood levels between men and women who used morphine.
Conclusion: In general, it is important to understand the status of drug poisoning with drugs such as morphine, methadone, digoxin, and dronabinol, as well as the prognosis associated with the treatment process of such poisoning.
Poisoning drug, Dronabinol, Digoxin, Methadone, Morphine
http://caspjim.com/article-1-3569-en.html
http://caspjim.com/article-1-3569-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
The experiences of hospitals in changing the function of a non-teaching hospital to a teaching hospital: Short-Communication
365
370
EN
Niusha
Shahidi sadeghi
Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
sadeghi.niusha@gmail.com
N
0000-0002-3623-1420
Mohammadreza
Maleki
Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
mrmaleki43@gmail.com
N
0000-0002-2708-5310
Hasan
Abolghasem gorji
Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
gorji.h@iums.ac.ir
N
0000-0002-6328-1925
Soudabeh
Vatankhah
Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
s-vatankhah@iums.ac.ir
N
0000-0002-4277-9484
Bahram
Mohaghegh
Department of Public Health, School of Health, Qom University of Medical Sciences, Qom, Iran
bmohaghegh@gmail.com
Y
0000-0002-7697-8238
10.22088/cjim.14.2.365
Background: In recent years, there have been many non-teaching hospitals that have become teaching hospitals. Although the decision to make this change is made at the policy level; But the unknown consequences can create many problems. The present study investigated the experiences of hospitals in changing the function of a non-teaching to a teaching hospital in Iran.
Methods: A Phenomenological qualitative study was conducted using semi-structured interviews with 40 hospital managers and policy makers who had the experience of changing the function of hospitals in Iran through a purposive sampling in 2021. Thematic analysis using inductive approach and MAXQDA 10 was used for data analysis.
Results: According to the results extracted 16 main categories and 91 subcategories. Considering the complexity and instability of command unity, understanding the change of organizational hierarchy, developing a mechanism to cover client’s costs, considering increase management team’ legal and social responsibility, coordinating policy demands with Providing resources, funding the teaching mission, organizing the multiple supervisory organizations, transparent communication between hospital and colleges, understanding the complexity of processes, considering change the performance appraisal system and pay for performance were the solutions for decrease problems of changing the function of non-teaching to teaching hospital.
Conclusion: Important matter about the improvement of university hospitals is evaluating the performance of hospitals to maintain their role as progressive actors in hospital network and also as the main actors of teaching future professional human resources. In fact, in the world, hospital becoming teaching is based on the performance of hospitals.
teaching hospitals, Systems Integration, Health Systems Agencies, university hospitals
http://caspjim.com/article-1-3009-en.html
http://caspjim.com/article-1-3009-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Unexpected high frequency of anti-thyroid peroxidase (anti-TPO) antibodies in Golestan province, Iran
371
375
EN
Hadise
Heidarpour
Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
Heidarpour.hadise@gmail.com
N
0000-0001-7716-3682
Farnaz
Hooshmand
Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
Farnaz.hooshmand.1377@gmail.com
Y
0000-0003-4048-6626
Fazel
Isapanah Amlashi
Golestan Research Center of Gastroentrology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran / Neuroscience Research Centre, Golestan University of Medical Sciences, Gorgan, Iran
Fazelamlashi@gmail.com
N
0000-0003-2990-8023
Behnaz
Khodabakhshi
Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
N
Mahsa
Mahmoudi
Student Research Committee, Golestan University of Medical Sciences, Gorgan, Iran
N
Taghi
Amiriani
Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
Dr_amiriani@yahoo.com
N
0000-0002-7750-0367
Sima
Besharat
Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
s.besharat.gp@yahoo.com
N
0000-0002-0540-6056
10.22088/cjim.14.2.371
Background: Anti-TPO antibodies are one of the characteristic factors in autoimmune thyroiditis (AIT). Previous studies reported a high prevalence of anti-TPO antibodies (Abs) in Iran. We have therefore assessed the prevalence of anti-TPO Abs in Gorgan, Iran.
Methods: This cross-sectional study, conducted from 2015 to 2018 in Gorgan city, Northeast of Iran. The Participants included women with Poly cystic ovary syndrome (PCOs), celiac patients, men with hepatitis C infection, and age and sex-matched controls. ELISA method was used for the analysis of laboratory tests.
Results: The number of enrolled subjects in PCOs, celiac disease, and Hepatitis C infection groups were 76, 67, and 60, respectively. Anti-TPO Abs positivity was significantly higher in patients with PCOS than in the control group (18.4% vs. 0.00%; p = 0.000). There were no significant differences in the frequency of anti-TPO Abs positive cases between CD patients and the controls (26.9% vs. 21.1% p =0.413). The incidence of anti-TPO Abs positivity was significantly higher in the control group (10% vs. 25%; P = 0.031).
Conclusion: Very high level of anti-TPO Abs was observed in both patients and healthy population in Golestan province. Considering this rate and its association with autoimmune disorders, it is suggested to prioritize screening programs for related disease in this area.
Anti-thyroid Peroxidase (anti-TPO), Autoimmune thyroiditis (AIT), Celiac disease, Hepatitis C infection, Iran
http://caspjim.com/article-1-2964-en.html
http://caspjim.com/article-1-2964-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Trigeminal neuralgia: IncobotulinumtoxinA (Xeomin), can it decrease the pharmacological intervention? (A case series)
376
379
EN
Meghdad
Hosseini
Department of Neurology, Shahid Beheshti University of Medical Science, Tehran, Iran
mubmeghdad271@gmail.com
N
0000-0000-0000-0000
Farhad
Asarzadegan
Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
alijanpour.sh@live.com
Y
0000-0000-0000-0000
Erfan
Shafiee
Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
alijanpour.sh@live.com
N
0000-0000-0000-0000
Shayan
Alijanpour
Student Research Committee, Faculty of Nursing and midwifery, Tehran University of Medical Science, Tehran, Iran
sh.alijanpour@mubabol.ac.ir
N
0000-0001-7970-8009
10.22088/cjim.14.2.376
Background: Trigeminal neuralgia is one of the most disabling facial pain syndromes. In recent years' new therapeutic strategy, incobotulinumtoxin A has emerged. The aim of the current study was to determine the time and duration of pain in 3 cases with pharmacological treatment and incobotulinumtoxin A.
Case presentation: In three patients with different onsets, trigeminal neuralgia was diagnosed. Pain severity was assessed by the visual analogue scale. Patient demographics and clinical data were filled in a checklist. They were females with age ranging from 39 to 49 years. Two patients had normal MRI and one patient had no any recent MRI. One center and specialist injection Xeomin 50 units for one time. Despite long time oral treatment, their symptoms had no significant improvement, but after incobotulinumtoxin A injection, pain frequency, severity and duration decreased in patients.
Conclusion: Result showed that the frequency, severity and duration of pain attacks was efficiently decreased by incobotulinumtoxin A with low side-effects. Its complication and side-effect should be considered in the future.
Trigeminal, Neuralgia, Pain, Iran.
http://caspjim.com/article-1-3161-en.html
http://caspjim.com/article-1-3161-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Late presentation of incomplete jejunoileal junction atresia with recurrent midgut volvulus; A case report for chronic midgut volvulus in adults
380
385
EN
Abdolreza
Emami
Student Research Committee, School of Medicine, Babol University of Medical Sciences, Babol, IR Iran
emami.abdoulreza@gmail.com
N
0000-0003-0001-4632
Yasser
Asghari
Department of Surgery, School of Medicine, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, IR Iran
yasser_asghari@yahoo.com
N
0000-0002-9473-5651
Hasan
Abedi Valukalaei
Department of Internal Medicine, School of Medicine, Babol University of Medical Sciences, Babol, IR Iran
h.abedi@mubabol.ac.ir
Y
0000-0001-7752-5225
Mohammad
Sakhaei
Islamic Azad University Sari Branch, Sari Campus, Iran
yaghobsakhaei@yahoo.com
N
0000-0003-3961-4395
10.22088/cjim.14.2.380
Background: Despite the prevalence of intestinal malformation in Childs, late-onset during adulthood is rare and usually diagnosed incidentally. It may be present as subtle or vague abdominal pain following mid-gut volvulus. Computerized tomography may help diagnosis, but surgery remains the gold standard of diagnosis and treatment.
Case Presentation: We presented a 24-year-old woman who complained of chronic intermittent abdominal pain, progressive food intolerance, and severe weight loss. Magnetic resonance enterography revealed dilated jejunum and collapsed ileum with slight bowel rotation around its mesentery (whirlpool sign), which was suggestive for mal-rotation of the intestine complicated by midgut volvulus, then the diagnosis was confirmed by laparotomy. During six months of follow-up after surgery, the patient's appetite improved significantly with eight kilograms of weight gain and resolution of abdominal pain.
Conclusion: It may be a rationale to consider intestinal malformation as a differential diagnosis in a patient who complained of chronic abdominal pain with progressive weight loss, anorexia, and recurrent bowel obstructive symptoms.
Midgut Malrotation, Volvulus, Adult, Congenital Abnormalities, Case Report
http://caspjim.com/article-1-3110-en.html
http://caspjim.com/article-1-3110-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Isolated greater omentum solid mass, a rare manifestation of hydatid disease; A Case Report and Review of Literature
386
390
EN
Ali
Jangjoo
Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
jangjooa@mums.ac.ir
N
0000-0002-3444-879X
Sina
Norouzi Asl
Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
sinanorouzi1362@gmail.com
N
0000-0002-7470-4663
Yeganeh
Azadmanesh
Department of Emergency Medicine, Razavi Hospital, Mashhad, Iran
yeganeh_60222@yahoo.com
N
0000-0003-1494-4718
Tooraj
Zandbaf
Department of General Surgery, Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran
tooraj.zandbaf@gmail.com
Y
0000-0002-4882-5058
10.22088/cjim.14.2.386
Background: Echinococcus granulosus causes hydatid disease, which is found in various countries of the world, including Iran. The liver and lungs are prevalent involved structures in hydatid disease. One of the least common sites in hydatid disease seems to be the omentum. Seven cases of mesenteric, diaphragmatic, omental, pelvic, and retroperitoneal hydatid cysts have been reported in Iran within last 20 years. The appearance of hydatid disease as a primary mass in the greater omentum without hepatic involvement is very rare and no similar case was introduced in Iran in our searches.
Case Presentation: Our patient was a 33-year-old woman who underwent a diagnostic laparoscopy due to abdominal pain and an abdominal mass. During laparoscopy, there was a solid mass with a size of about 10 × 5 cm in the greater omentum that was resected. The histopathological examination of the mass showed the hydatid disease.
Conclusion: The hydatid cyst can appear anywhere on the body, and no part of the body is guarded. Since these uncommon locations often cause nonspecific symptoms, the hydatid cyst should be included in the differential diagnosing of omental cysts, particularly in endemic countries like Iran.
Hydatid disease, Hydatid Cyst, Echinococcus Granulosus, Greater Omentum, Echinococcosis, Case Report
http://caspjim.com/article-1-3159-en.html
http://caspjim.com/article-1-3159-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Concomitant occurrence of appendiceal mucocele and ulcerative colitis: Case reports
391
395
EN
Hafez
Fakheri
Gut and liver Research Center, Non-communicable Research Institute, Mazandaran University of Medical Sciences, Sari, Iran
hafezfakheri@gmail.com
N
0000-0002-0579-6111
Zohreh
Bari
Gut and liver Research Center, Non-communicable Research Institute, Mazandaran University of Medical Sciences, Sari, Iran
zohreb252@yahoo.com
Y
0000-0001-6962-7686
Mohammad
Yaghoobi
Division of Gastroenterology, Department of Medicine, McMaster University Medical Center, Hamilton, Ontario, Canada
yaghoob@mcmaster.ca
N
0000-0002-2883-9372
Parham
Rabiee
Department of Radiology, Shaheed Rajaie Cardiovascular and Medical Research Center, Tehran, Iran
rabiee.parham@gmail.com
N
0000-0001-7981-1516
10.22088/cjim.14.2.391
Background: Appendiceal mucocele (AM) is a rare disease, manifested by accumulation of mucus in appendiceal lumen. The role of ulcerative colitis (UC) in the occurrence of appendiceal mucocele is not known. However, it is suggested that AM may be a presentation of colorectal cancer in IBD patients.
Case Presentation: Here, we presented 3 cases of concomitant AM and ulcerative colitis. The first patient was a 55-year-old woman with 2-year history of left sided UC; the second person was a 52-year-old woman with 12-year history of pan-UC; and the third patient was a 60-year-old man with 11-year history of pan-colitis. They were all referred due to indolent right lower quadrant abdominal pain. Imaging evaluations suggested the presence of appendiceal mucocele and therefore, they all went under operation. Pathologic evaluation reported AM of mucinous cyst adenoma type; low-grade appendiceal mucinous neoplasm of appendix with intact serosa; and cyst-adenoma type AM for the three above-mentioned patients, respectively.
Conclusion: Although concomitant occurrence of AM and ulcerative colitis is rare, regarding the potential of neoplastic changes in AM, physicians must keep in mind the diagnosis of AM in UC patients with non-specific abdominal RLQ pain or bulged appendiceal orifice during colonoscopy.
Appendiceal mucocele, ulcerative colitis
http://caspjim.com/article-1-2774-en.html
http://caspjim.com/article-1-2774-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Synchronous celiac artery and superior mesenteric artery compression syndrome: The effect of collateral circulation on the treatment procedure
396
400
EN
Ulaş
Aday
Department of Gastrointestinal Surgery, Dicle University Schol of Medicine, Diyarbakır/Turkey
ulasaday@gmail.com
Y
0000-0002-3161-0923
Abdullah
Oguz
Department of General Surgery, Dicle University School of Medicine, Diyarbakır/Turkey
dragtiz@hotmail.com
N
0000-0002-8711-8110
Hikmet
Özesmer
Department of General Surgery, Dicle University School of Medicine, Diyarbakır/Turkey
hikmet.21@windowslive.com
N
0000-0002-0280-2504
Mehmet Veysi
Bahadır
Department of General Surgery, Dicle University School of Medicine, Diyarbakır/Turkey
mvbahadır@yahoo.com
N
0000-0002-1061-6744
10.22088/cjim.14.2.396
Background: Maintaining collateral circulation is highly important in the stenosis of celiac artery (CA), superior mesenteric artery (SMA), and inferior mesenteric artery (IMA). The SMA compression is commonly reported to be accompanied by the CA compression caused by the median arcuate ligament (MAL) while the synchronous compression of CA and SMA by other ligaments has been rarely reported.
Case Presentation: In this report, we present a 64-year-old female patient who presented with a postprandial abdominal pain and weight loss. Initial evaluation indicated a synchronous compression of CA and SMA caused by MAL. The patient was planned for laparoscopic MAL division due to the presence of sufficient collateral circulation between the CA and SMA that was facilitated through the superior pancreaticoduodenal artery. Following laparoscopic release, the patient improved clinically and postoperative imaging indicated that the compression on the SMA was still present and the collateral circulation was sufficient.
Conclusion: We suggest that laparoscopic MAL division can be the primary method of choice in cases with sufficient collateral circulation between the CA and SMA.
Multilagament compression syndrome, collateral circulation, laparoscopic treatment
http://caspjim.com/article-1-2535-en.html
http://caspjim.com/article-1-2535-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Langerhans cell histiocytosis presented as bilateral otitis media with effusion, a rare case report
401
405
EN
Soheil
Motamed
Department of Otorhinolaryngology, Afzalipour faculty of medicine, Kerman University of Medical Sciences, Kerman, Iran/ Student research committee, Kerman University of Medical Sciences, Kerman, Iran
smotamed2009@gmail.com
N
0000-0002-5255-6751
Maryam
Amizadeh
Department of Otorhinolaryngology, Afzalipour faculty of medicine, Kerman University of Medical Sciences, Kerman, Iran
amizade.m@yahoo.com
Y
0000-0002-0413-8598
Shahriar
Dabiri
Department of Pathology, Afzalipour faculty of medicine, Kerman University of Medical Sciences, Kerman, Iran
dabiri12@gmail.com
N
0000-0002-5922-3976
10.22088/cjim.14.2.401
Background: Langerhans cell histiocytosis (LCH) or histiocytosis X is considered as a rare disease that may have effect on multiple organs. The initial presentation of LCH is varied. The signs and symptoms of otologic histiocytosis can be the same as the acute or chronic infectious ear diseases. Definitive diagnosis of LCH is confirmed by biopsy and immunohistochemically staining of S-100 protein and CD1a antigen. Chemotherapy is the main mode of treatment.
Case presentation: In this report, we explained the clinical manifestation, diagnosis and treatment of a case of 15 month-old girl with diagnosed of LCH that initially presented with otitis media with effusion (OME).
Conclusion: LCH is a rare disease that presented with variable sign and symptoms and have an effect on multiple organs. LCH should be regarded in cases with recurrent ear infection without response to medical treatments. Moreover, biopsy with IHC is the gold standard of diagnosis and chemotherapy is the main form of treatment.
Langerhans cell histiocytosis, histiocytosis X, otitis media with effusion, children
http://caspjim.com/article-1-3135-en.html
http://caspjim.com/article-1-3135-en.pdf
Babol University of Medical Sciences
Caspian Journal of Internal Medicine
2008-6164
2008-6172
14
2
2023
3
1
Prompt and Aggressive Treatment of Deep Neck Infection in Neglected Diabetic Patient - A Case Report and Literature Review
406
411
EN
Stella
Pravita
Faculty of Medicine, Airlangga University, Surabaya, Indonesia
stellapravita@gmail.com
N
0000-0001-8096-1319
Sony
Wibisono
Endocrinology Division, Department of Internal Medicine Dr. Soetomo General Hospital, Surabaya, Indonesia
sonywibisono@gmail.com
N
0000-0001-6944-4628
Ivana Purnama
Dewi
Faculty of Medicine, Airlangga University, Surabaya, Indonesia
916ivana@gmail.com
Y
0000-0002-1602-3384
10.22088/cjim.14.2.406
Background: Deep neck infection (DNI) is an infection that occurs in the deep neck fascia and spaces commonly found in diabetic patients. Impaired immune system due to hyperglycemic condition in diabetic patients leads to different clinical presentations, prognosis, and management and therapy in this group of patients.
Case Presentation: We reported a case of deep neck infection and abscess in a diabetic patient that resulted in acute kidney injury and airway obstruction. We have done CT-scan imaging that supported the diagnosis of a submandibular abscess. Prompt and aggressive treatment of DNI with antibiotics, blood glucose control, and the surgical incision has exhibited a favourable outcome.
Conclusions: Diabetes mellitus is the most common comorbidity found among patients with DNI. Studies showed that hyperglycemia impaired bactericidal functions of neutrophils, cellular immunity, and complement activation. Aggressive treatment, including early incision and drainage of abscess, dental surgery to eradicate the source of infection, prompt, empirical antibiotic administration, and intensive blood glucose regulation, will result in favourable results without a prolonged hospital stay.
diabetes mellitus, deep neck infection, abscess
http://caspjim.com/article-1-3344-en.html
http://caspjim.com/article-1-3344-en.pdf