Analysis of the Reporting Requirements of Clinical Case Reports Dedicated Journals: Towards Updating the CARE Guideline.

Background: Following personalized medicine and the development of e-publishing, a large number of case report-dedicated journals have emerged. But the lack of integrated guidelines is a major obstacle to the quality of this evidence. The purpose of this study is to analyze the reporting requirements of case report-dedicated journals to update and strengthen the CARE guidelines. Material and Methods: Quantitative and qualitative research approach has been done using the content analysis method. All case report-dedicated journals were selected from Scopus (54 out of a total of 68 journals). By referring to these journals' websites, all the contents of the authors' guideline section and two sample articles were examined as a unit of analysis. Quantitative data includes frequency and percentile; qualitative data was conducted through open coding, creating categories, and abstraction. Results: 51% of journals are related to Elsevier and Hindawi publications. 14.8% of journals have been launched in the form of companions. 52% of journals endorse the CARE guidelines. Among the CARE elements, title, consent form (100%), discussion, abstract (94.4%), and introduction (90.7%) had the most frequent elements, and timeline and patients' perspective had the least repetition in the authors' guideline. Also, 19 new reporting elements and 27 types of case reports were identified. Conclusions: Improving the reporting and content quality of case reports is very important to benefit from knowledge synthesis services. Medical journals publishing case reports should follow a more integrated process. An updated version of reporting guidelines needs to be available for publishers and editors of journals.

The reporting requirements of case reports and adherence of case report reporting guidelines in medical journals: an analysis of the authors' guide sections.

BACKGROUND: Owing to the growth of case reports and changes in the policy of journals in publishing this evidence, the need to standardize them is felt more than before. Therefore, in this study, the authors' guide of medical journals indexed in the Scopus database that published most of the case reports has been analyzed to identify the reporting requirements and emerging case report types. METHODS: A total of 50 journals were selected from the Scopus citation database (the world's largest knowledge base) that published most of the case reports. These and the authors' guideline section on the types and requirements of writing case reports were analyzed by inductive content analysis. RESULTS: Most of the case reports were published in the fields of dermatology and surgery and general medicine. Reporting requirements in author's guide are grouped in four categories: (1) reasons for publication or content value, (2) emphasis on the patient consent form and confidentiality, (3) emphasizing the constraints on the word count and limitation, and (4) recommendation for structure and reporting elements. In terms of adherence to the reporting guidelines, 76% of journals do not adhere to any reporting guideline. In addition, 13 types of case reports were identified in these journals, among which traditional case reports, clinical image, letters, and case series were the most widely used formats. CONCLUSIONS: Improving the publication processes of case reports has been left unattended by international organizations. The policies of journals need to become more integrated, and reporting guidelines should be modified or redeveloped to enhance the quality of publications, cover different reporting requirements, and consequently, benefit from the evidence value available in case reports.

Potential diagnostic and prognostic of efferocytosis-related unwanted soluble receptors/ligands as new non-invasive biomarkers in disorders: a review.

Efferocytosis is the process by which apoptotic cells are removed without inflammation to maintain tissue homeostasis, prevent unwanted inflammatory responses, and inhibit autoimmune responses. Coordination of efferocytosis occurs via many surfaces and chemotactic molecules and adaptors. Recently, soluble positive or negative mediators of efferocytosis, have been more noticeable as non-invasive valuable biomarkers in prognosis and targeted therapy. These soluble factors can be detected in different bodily fluids, such as serum, plasma, and urine as a non-invasive method. There are lots of studies that have tried to show the importance of receptors and ligands in disorders; while a few studies tried to indicate the importance of soluble forms of receptors/ligands and their clinical aspects as a systemic compound and shedding of targets related to efferocytosis. Some of these soluble forms also can be as sensitive as specific biomarkers for certain diseases compared with routine biomarkers, such as soluble circulatory Lectin-like oxidized low-density lipoprotein receptor-1 vs. troponin T in the acute coronary syndrome. Thus, this review tried to gain more understanding about efferocytosis-related unwanted soluble receptors/ligands, their roles, the clinical significance, and potential for diagnosis, and prognosis related to different diseases.

A qualitative study of the health information seeking behaviour of adolescent girls in Iran indicates that public libraries could help supply information required about puberty.

INTRODUCTION: The present study aimed to identify the puberty related information seeking behaviour of adolescent female members of Zarrinshahr public libraries. METHODOLOGY: Using a phenomenology approach, this study sought to identify the puberty related information seeking behaviours for a population of female adolescent public library patrons located in the Middle East. The data were collected via event based interviews and the samples were selected by purposeful sampling method. After converting the audio to text, the transcripts were imported into MAXQDA 10, they were coded and then, the relevant categories were extracted. RESULTS: The information needs of girls experiencing puberty were identified and divided into four thematic categories: health issues, psychological issues, religious issues (religious precepts), and issues related to physical activity. Girls get this information from a variety of resources such as people, the Internet, social networks, documents, and libraries. The process of information seeking is so problematic for them because they are faced with content, family, social, and financial barriers and mainly lack Internet literacy and search skills. CONCLUSION: Health information seeking constitutes the main part of adolescent girls' daily lives. Identification of adolescent girls' health information needs, the main channels of information seeking, and the barriers the girls face while information seeking can help public libraries adopt the right policies regarding the provision of health information services.

The effect of bio ethical principles education on ethical attitude of prehospital paramedic personnel.

BACKGROUND: Ethical attitude of paramedic personnel is one of the most important factors in their effective and useful performance. Therefore, according to the importance of this issue and immense effect of religious culture on the formation of ethics, this study aimed to effect bio-ethical principles teaching on moral attitude of paramedic emergency personnel in Iran. MATERIAL AND METHODS: The present study was an experimental study carried out in 2020 on 60 of paramedic emergency personnel. Samples were available, randomly selected and assigned to two groups of control and intervention. The intervention was performed for a 2-h workshop of bioethical principles in 4 day based on Quran verses. Moral attitude of both groups was studied before and after each intervention. Data were analyzed using Kolmogorov-Simonov, Chi-square, t-test, one-way, and paired t-test with SPSS version 16 (P ≤ 0/05). RESULTS: Ethical attitude means for both groups of control and intervention demonstrated that ethical attitude has meaningfully increased after the workshop. Demographic variables such as age, gender, and work experience of participants in workshops were not different between these two groups (P < 0/05). The study of these two groups showed that there is no relationship among work experience, gender, marital status, age, and ethical attitude. CONCLUSION: Prehospital emergency is quite different from the other occupations in health-care system and the ethical issues of this field are more important. Therefore, teaching in workplace and through ethical principles based on religious teachings will have a profound effect on improving biological ethics of paramedic prehospital staffs.

Report of a Case of Paraquat Poisoning and Mediastinal Involvement.

Paraquat has been recognized as a highly toxic agent for pest removal and is used worldwide. In adults, paraquat poisoning for suicidal attempts is much more common than accidental exposure poisoning. Approximately 20% of patients with paraquat poisoning develop pneumomediastonium as a complication with a mortality rate of approximately 100%. A 19-year-old man patient was admitted to the poisoning emergency department of Khorshid hospital, who had ingested paraquat. He had nausea and vomiting and had normal vital signs and examination in admission. Initial treatment for the patient was done. The patient signs got worsened on the 21st day of hospitalization and had severe emphysema of the superficial and deep spaces of the neck, followed by bilateral pneumothorax, and severe pneumomediastinum. Unfortunately, the patient died on the 27th day of hospitalization. Purpose of the current study is to raise awareness of rare paraquat toxicity complications, treatment, and especially its lethal complications, including pneumomomediastonium.

Premature pubarche as a first presentation of pituitary macroprolactinoma.

Prolactinoma is a rare tumor of childhood. Clinical presentations of prolactinoma include amenorrhea, delayed puberty, and galactorrhea. For the first time, in this case, elevated prolactin levels were associated with unexpected premature pubarche. We describe an 8-year, 7-month-old boy with acne and gradual appearance of pubic hair, corresponding to tanner stage 2. Hormonal tests showed severe hyperprolactinemia (prolactin = 246.8 µg/L and pooled prolactin = 175 µg/L and macroprolactin = 5 µg/L) and mildly elevated level of dehdroepiandrostenedion sulfate (DHEAS) and testosterone. Magnetic resonance imaging (MRI) findings confirmed the presence of a pituitary macroprolactinoma, measuring 14 mm × 12 mm × 8 mm on the right side of the pituitary gland. Cabergoline therapy was commenced (0.5 mg/week) and after 3 months, no evidence of pubarche progression was observed. Prolactin level and tumor size markedly reduced. At the 9-month follow-up visit, a normal MRI was reported. This case highlights that even when facing premature pubarche, careful examination is mandatory, and if no obvious etiology is found for premature pubarche, clinicians should consider prolactinoma.

Intraductal papillary mucinous neoplasm of biliary ducts: Literature review and a case report with emphasis on radiological manifestation.

Intraductal papillary mucinous neoplasm of the biliary tract (B-IPMN) is an intraductal growing mucin producing tumor that is precursor of cholangiocarcinoma. Dilation of both upstream and downstream biliary ducts is the radiological key feature that is respectively caused by intraductal obstructive growth and massive mucin production. Although B-IPMN is rare, if the radiologist is familiar with its manifestation, can lead to early diagnosis when surgical resection can be curative. Here, we report a long standing pathologically proved case of B-IPMN with emphasis on radiological manifestation during a long time of 13 years across different imaging modalities.

Development of health literacy among postgraduate students: From information literacy perspective.

OBJECTIVES: Involving the patients in health-related decisions requires high health literacy. Health literacy is related to the concept of information literacy through its emphasis on information skills. Hence, the aim of this study was to investigate the relationship between information literacy and health literacy. STUDY DESIGN: We carried out an original research. MATERIALS AND METHODS: This is an applied research that is carried out in a survey method. The statistical population of this study is MSc and PhD students at School of Health Management and Information Science in Iran University of Medical Sciences who were selected by stratified random sampling. A standard health literacy questionnaire including access dimensions, reading skills, comprehension, evaluation, decision-making, and application of health information was used to assess the health literacy status of the students. To measure information literacy, the questionnaire includes identifying information needs, locating information, organizing information, and evaluating information were used. The data were analyzed by tests of one-sample t-test, Pearson correlation, and simple linear regression with spss software version 18 produced by IBM located at New York. RESULTS: The results showed that the level of information literacy among students was higher than the average level. The average of information literacy rate in the sample is 49.09. In this regard, the most frequent information is gained from the internet, interacting with friends, and asking practitioners and health workers. In addition, there is a positive and significant relationship between all dimensions of information literacy with health literacy and information literacy affects 35.4% of health literacy changes. CONCLUSIONS: It can be said that information literacy is a predictor of health literacy. Furthermore, the pattern of people's health information has moved to new information environments and to improve health having sufficient information seeking and information literacy skills are essential.

Rhabdomyolysis and Muscle Necrosis Induced By Lead Poisoning.

A case is presented on a 40-year-old male with chronic lead poisoning with loss of consciousness, rhabdomyolysis, and acute renal failure after occupational exposure. Physical examination revealed generalized atrophy, tenderness, and swelling in the right limb and a decreased proximal muscle strength in the lower limb. A severe acute polyradiculoneuropathy in lower limbs documented by electromyography. All paraclinical tests were normal except increased blood lead level (75 µg/dl) and blue line in gum of the teeth. The patient was treated with penicillamine (500 mg q8 h) and pyridoxine (50 mg daily) for 8 months, only accessible drug in Iran. Force of patient's muscles in the proximal part of the lower limb was improved, and also the blood lead level reached to normal range. This is the first patient with rhabdomyolysis and muscle necrosis induced by lead poisoning.

Effect of ESS on Olfactory Threshold of Patients with CRS without Nasal Polyps.

OBJECTIVES: Chronic rhinosinusitis (CRS) is characterized by a long-time inflammatory disease of nasal and sinus mucosa. Olfactory dysfunction is common among CRS patients with a prevalence ranging from 48% to 83%. We aimed to assess the effect of ESS on olfactory function of patients with chronic rhinosinusitis without nasal polyps. METHOD: This randomized clinical trial was conducted on 30 patients with chronic rhinosinusitis without nasal polyps. Patients were randomly allocated to two intervention and control groups; patients in intervention group underwent endoscopic sinus surgery by a single surgeon and control group continued standard treatment with nasal irrigation of normal saline (4 times daily) and nasal corticosteroids (one puff in each nostril daily). Olfactory threshold was evaluated using smell threshold test (STT) before, one month and three months after intervention. RESULTS: Eventually 33 patients with a mean age of 42.70 ± 15.50 years in intervention and 43.12 ± 11.50 years in control group underwent analysis (p value=0.930). Mean olfactory threshold was 2.79 ± 0.73 in intervention and 2.67 ± 1.05 in control group prior to intervention (p value=0.345). Mean change of olfactory threshold was 0.30 ± 0.79 in intervention and 0.38±1.09 in control group one month after intervention (p value=0.214). Mean change of olfactory threshold was 0.13 ± 0.94 in ESS and 0.33 ± 0.60 in control group three months after intervention (p value=0.196). CONCLUSION: Our study revealed that changes in olfactory threshold were not significantly different between two ESS and standard medical therapy groups one and three months after intervention.

Popularity and Harms of Aural Foreign Bodies: A Descriptive Study of Patients in Baqiyatallah University Hospital, Tehran, Iran.

OBJECTIVE: To evaluate the prevalence of external ear complications among Iranian aural foreign body users attending to otolaryngology clinic of our hospital. METHODS: In this cross-sectional study patients attending to Otolaryngology clinics of Baqiyatallah hospital were enrolled regardless of their age, gender and reason of attending. Patients between 15 and 60 years of age were included in the present study. Those with positive history of chronic ear diseases, ear surgery, congenital ear disorders, trauma to ear or head and neck region or shock wave trauma were excluded from the study. Demographic information as well as data on chief complaint, educational level, frequency and type of used foreign body and findings of physical examination and Otoscopy by a single otolaryngologist were recorded in a predesigned checklist. RESULTS: Eventually 362 patients (232 male and 130 female) with a mean age of 40.32 ± 16.90 years underwent analysis. Of all patients 244 (67.2%) were using a kind of aural foreign body frequently and Cotton bud was the most popular (63.5%) used foreign body among patients. Drying ear canal was the most common (54.9%) reason of using AFBs among study individuals followed by itching (29.5%) and pyorrhea (11.06%). Also 11 (4.5%) patients were using AFBs as a habit with no specific reason. Itching was the most prevalent symptom reported by both aural foreign body users (78%) and non-users (45.5%); however it was significantly higher among AFB users (p = 0.026). Also hearing loss was significantly more reported by AFB users (p = 0.033). A majority of patients had normal physical examination in both AFB users and non-users group. Inflammation of ear canal was significantly more detected in AFB users (p = 0.004). In addition, rate of right ear wax impaction was higher among AFB users (p = 0.016). CONCLUSION: In conclusion we realized that 67.2% of patients attending to Otolaryngology clinic of our hospital were using a kind of aural foreign bodies and itching was the most common chief complaint of these patients.

The Effect of PRP-enriched Gelfoam on Chronic Tympanic Membrane Perforation: A Double-blind Randomized Clinical Trial.

OBJECTIVE: To evaluate the effect of PRP-enriched gelfoam on the healing of chronic TM perforation in comparison with gelfoam alone. METHODS: In this double-blind randomized clinical trial Patients with chronic tympanic membrane were randomly allocated to two groups; intervention group underwent tympanoplasty with platelet rich plasma (PRP)- enriched gel foams and control group underwent operation with conventional gel foams alone. Patients information was recorded 4 and 12 months after surgery. RESULTS: Eventually 24 patients (12 males and 12 females) with a mean age of 43.33 ± 12.34 years in intervention and 41.33 ± 10.02 years in control group underwent analysis (p = 0.667). Complete TM healing was seen in 8 (66.67%) patients in intervention group and 3 (25%) patients in control group three months after intervention (p = 0.031, OR = 5.98). CONCLUSION: Addition of PRP to conventional gelfoams used in TM perforation repair increases the complete healing rate of TM perforation with less morbidity and complications.