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This is a systematic review and meta-analysis of existing evidence regarding the possible effects of epothilones on spinal cord injury (SCI). This study aimed to investigate the possible effects of epothilone administration on locomotion recovery in animal models of SCI. Despite increasing rates of SCI and its burden on populations, no consensus has been reached about the possible treatment modality for SCI. Meanwhile, low-dose epothilones have been reported to have positive effects on SCI outcomes. Electronic databases of Web of Science, Scopus, Embase, and Medline were searched using keywords related to epothilones and SCI until the end of 2020. Two researchers screened the articles, and extracted data were analyzed using STATA ver. 14.0. Final results are reported as a standardized mean difference (SMD) with a 95% confidence interval (CI). After the screening, five studies were included in the analysis. Rats were used in all the studies. Two types of epothilones were used via intraperitoneal injection and were shown to have positive effects on the motor outcomes of samples with SCI (SMD, 0.87; 95% CI, 0.51 to 1.23; p =0.71). Although a slightly better effect was observed when using epothilone B, the difference was not significant (coefficient, −0.50; 95% CI, −1.52 to 0.52; p =0.246). The results of this study suggest that epothilones have positive effects on the improvement of motor function in rats, when administered intraperitoneally until a maximum of 1 day after SCI. However, current evidence regarding the matter is still scarce.
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Background@#Current therapies are quite unsuccessful in the management of neuropathic pain. Therefore, considering the inhibitory characteristics of GABA mediators, the present systematic review and meta-analysis aimed to determine the efficacy of GABAergic neural precursor cells on neuropathic pain management. @*Methods@#Search was conducted on Medline, Embase, Scopus, and Web of Science databases. A search strategy was designed based on the keywords related to GABAergic cells combined with neuropathic pain. The outcomes were allodynia and hyperalgesia. The results were reported as a pooled standardized mean difference (SMD) with a 95% confidence interval (95% CI). @*Results@#Data of 13 studies were analyzed in the present meta-analysis. The results showed that administration of GABAergic cells improved allodynia (SMD = 1.79;95% CI: 0.87, 271; P < 0.001) and hyperalgesia (SMD = 1.29; 95% CI: 0.26, 2.32; P = 0.019). Moreover, the analyses demonstrated that the efficacy of GABAergic cells in the management of allodynia and hyperalgesia is only observed in rats. Also, only genetically modified cells are effective in improving both of allodynia, and hyperalgesia. @*Conclusions@#A moderate level of pre-clinical evidence showed that transplantation of genetically-modified GABAergic cells is effective in the management of neuropathic pain. However, it seems that the transplantation efficacy of these cells is only statistically significant in improving pain symptoms in rats. Hence, caution should be exercised regarding the generalizability and the translation of the findings from rats and mice studies to large animal studies and clinical trials.
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BACKGROUND: Occupational accidents are of most important consequences of globalization in developing countries. Therefore, investigating the causes of occupational accidents for improving the job situation and making operational policy is necessary. So the aim of this study was to investigate factors affecting the fatal occupational accidents and also calculate the years of life lost for dead workers. METHODS: This cross-sectional study was conducted on data related to the 6052 injured workers that was registered in the 2013 registry system of the Ministry of Health and Medical Education of Iran. Variables including sex, education, age, job tenure, injury cause, referred location of injured workers, occupation, shift work, season, accident day, damaged part of the body were chosen as independent variables. The Chi-squared and Fisher exact tests were used for univariate analysis and then exact multiple logistic regression was carried out to identify independent risk factors of fatal occupational accidents. Finally, for dead workers, years of life lost, according to the injury causes was calculated. RESULTS: Among the 6052 accidents reported, 33 deaths were recorded. Chi-square and Fisher exact tests showed that factors including: current job tenure (p = 0.01), damaged parts of the body (p < 0.001) and injury cause (p < 0.001) are associated with the fatal accidents. Also exact multiple logistic regression analysis showed a significant association between electric shocks as a cause of injury (OR = 7.04; 95% CI: 1.01–43.74; p = 0.02) and current job tenure more than 1 year (OR = 0.21; 95% CI: 0.05–0.70; p = 0.005) with the fatal accidents. The total amount of years of life lost based on causes of injuries was estimated 1289.12 years. CONCLUSIONS: In Iran, fatal accident odds in workers with job tenure more than 1 year was less in comparing to the workers with job tenure less and equal to 1 year. Also odd of death for electrical shock was more than other causes of injuries. So it seems that employing of workers who have more than one-year work experience in a specific job and using of appropriate safeguards will be useful for the reducing of fatal occupational accidents.
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Accidents, Occupational , Cross-Sectional Studies , Developing Countries , Education , Education, Medical , Internationality , Iran , Logistic Models , Occupations , Risk Factors , Seasons , ShockABSTRACT
Ultrasonography is currently being used as one of the diagnostic modalities in various medical emergencies for screening of trauma patients. The diagnostic value of this modality in detection of traumatic chest injuries has been evaluated by several studies but its diagnostic accuracy in diagnosis of pulmonary contusion is a matter of discussion. Therefore, the present study aimed to determine the diagnostic accuracy of ultrasonography and radiography in detection of pulmonary contusion through a systematic review and meta-analysis. An extended systematic search was performed by two reviewers in databases of Medline, EMBASE, ISI Web of Knowledge, Scopus, Cochrane Library, and ProQuest. They extracted the data and assessed the quality of the studies. After summarization of data into true positive, false positive, true negative, and false negative meta-analysis was carried out via a mixed-effects binary regression model. Further subgroup analysis was performed due to a significant heterogeneity between the studies. 12 studies were included in this meta-analysis [1681 chest trauma patients, 76% male]. Pooled sensitivity of ultrasonography in detection of pulmonary contusion was 0.92 [95% CI: 0.81-0.96; I2= 95.81, p<0.001] and its pooled specificity was calculated to be 0.89 [95% CI: 0.85-0.93; I2 = 67.29, p<0.001] while these figures for chest radiography were 0.44 [95% CI: 0.32-0.58; I2= 87.52, p<0.001] and 0.98 [95% CI: 0.88-1.0; I2= 95.22, p<0.001], respectively. Subgroup analysis showed that the sources of heterogeneity between the studies were sampling method, operator, frequency of the transducer, and sample size. Ultrasonography was found to be a better screening tool in detection of pulmonary contusion. Moreover, an ultrasonography performed by a radiologist / intensivist with 1-5MHz probe has a higher diagnostic value in identifying pulmonary contusions
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Nowadays, many researches in the field of medicine are conducting all around the world and medical journalism is a way to share the results. In fact, dissemination of the related manuscripts can pre-vent the repetitive research or may even lead to conducting a better survey. Therefore high quality medical journals are considered as up-to-date resources for further investigations [1, 2]. Medical journals are propagating their papers in various media including television pro-grams, newspapers, internet websites and different social media. So they can influence the government policy makers, health-care professionals and even public [3-5]. Moreover, most researchers hear about medical discoveries for the first time through medical journals and their related social media. So as well a high quality journal can help to improve medical science, a journal of poor quality can be damaging and distorting. Indeed, popular journals have the power of inventing a "communication storm" to draw attention to a certain topic. Thus they have to respect the accepted international principles to prevent spreading inaccurate and misleading data [6, 7]. This paper aims to review the previous and current situation of medical journalism by focus on field of emergency medicine
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Smoking and unhealthy diet are two major risk factors for non-communicable diseases. The aim of this study was to investigate the possible association between these two risk factors amongst healthy adults 30-60 years old in Tehran, Iran. Overall, 2602 healthy adults 30 to 60 years old in Tehran were studied. The demographic characteristics, anthropometric and smoking status of the participants were questioned. The frequency of consumption of red meat, white meat, fruits and vegetables, dairy products, bread and cereals and fast food were questioned to be daily, weekly, monthly, once every 6 months or yearly and categorized as "healthy" or "unhealthy". Of the 2602 participants, 974 [37.4%] had smoked more than 100 cigarettes in their life time and continued daily or smoked occasionally. Smokers significantly consumed more fast food and white meat but less fruit and vegetables and dairy product [P<0.0001]. Totally, 586 [22.5%] consumed "unhealthy" diet. A positive association between cigarette smoking and unhealthy diet [OR=1.68; 95% CI: 1.40-2.03] were found. After adjusting the analysis for the effect of age, education and gender, the odds ratio of consuming unhealthy diet for the smoker increased to 1.83 [1.50, 2.25] compared with non-smoker. Our study found a noticeable association between cigarette smoking and unhealthy diet. Smoking cessa-tion and changing diet program for smokers is recommended
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Lumbar hernias [LH] accounts for less than 1.5% of total hernia incidence. It can occur in two separate triangular areas of the flank. About 300 cases have been reported in the literature. Here, we report a 55-year old man with acute painful left side flank mass and final diagnosis of LH. The mass was appeared about three hours before admission and his pain was slight at first but became more severe gradually. He had stable vital sign and the only positive finding on his physical examination was the sphere shape, firm, mobile, and mild tender mass at his left flank
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<p><b>OBJECTIVE</b>An accurate scoring system for intra-abdominal injury (IAI) based on clinical manifestation and examination may decrease unnecessary CT scans, save time, and reduce healthcare cost. This study is designed to provide a new scoring system for a better diagnosis of IAI after blunt trauma.</p><p><b>METHODS</b>This prospective observational study was performed from April 2011 to October 2012 on patients aged above 18 years and suspected with blunt abdominal trauma (BAT) admitted to the emergency department (ED) of Imam Hussein Hospital and Shohadaye Hafte Tir Hospital. All patients were assessed and treated based on Advanced Trauma Life Support and ED protocol. Diagnosis was done according to CT scan findings, which was considered as the gold standard. Data were gathered based on patient's history, physical exam, ultrasound and CT scan findings by a general practitioner who was not blind to this study. Chi-square test and logistic regression were done. Factors with significant relationship with CT scan were imported in multivariate regression models, where a coefficient (β) was given based on the contribution of each of them. Scoring system was developed based on the obtained total β of each factor.</p><p><b>RESULTS</b>Altogether 261 patients (80.1% male) were enrolled (48 cases of IAI). A 24-point blunt abdominal trauma scoring system (BATSS) was developed. Patients were divided into three groups including low (score<8), moderate (8≤score<12) and high risk (score≥12). In high risk group immediate laparotomy should be done, moderate group needs further assessments, and low risk group should be kept under observation. Low risk patients did not show positive CT-scans (specificity 100%). Conversely, all high risk patients had positive CT-scan findings (sensitivity 100%). The receiver operating characteristic curve indicated a close relationship between the results of CT scan and BATSS (sensitivity=99.3%).</p><p><b>CONCLUSION</b>The present scoring system furnishes a high precision and reproducible diagnostic tool for BAT detection and has the potential to reduce unnecessary CT scan and cut unnecessary costs.</p>
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Adult , Female , Humans , Male , Abdominal Injuries , Diagnosis , Prospective Studies , Research Design , Tomography, X-Ray Computed , Trauma Severity Indices , Wounds, Nonpenetrating , DiagnosisABSTRACT
High cholesterol levels are associated with increased risk of coronary heart disease and stroke. Under-standing the distribution of serum cholesterol levels in each country is valuable index for use in public health planning. This study aimed to construct nomograms of total cholesterol [TC] levels and establish the cut-points specific to Iranian population. Data on serum TC levels of 19,630 non-institutionalized individuals aged 25-64 years from third national survey on non-communicable diseases [SuRFNCD] in 2007 were used to construct cholesterol nomograms. We pro-posed cutoff values for borderline and high TC levels based on rounded 75th and 90th percentiles in three age groups [25-34, 35-44 and 45-64] respectively. Average yearly increase of TC for males up to the age of 45 and females up to 64 were 1.15 and 1.03 mg/dl, respectively. TC levels were higher in females. In males, cutoff values for "borderline and high" TC levels were 195 and 220 mg/dl in 25-34, 210 and 240 mg/d in 35-44 and 215 and 245 mg/dl in 45-64 years old individuals. In women, these values were 200 and 225 mg/dl in 25-34,215 and 240 mg/dl in 35-44 and 235 and 265 mg/dl in 45-64 years old individuals respectively. Since TC levels are different in two sexes and change with age, we proposed different cutoffs for sex and age group. We think these cutoffs could be used in national public health planning
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Peritoneal dialysis is one of the most prevalent types of dialysis prescribed to the patients suffering from renal failure. Studies on the factors affecting the survival of these patients have mainly used log-rank test and Cox analysis. The present study aimed to investigate the risk factors affecting short- and long term survival of patients on continuous ambulatory peritoneal dialysis [CAPD] using cure model. The data obtained retrospectively from 20 medical centers in Iran, between 1996 and 2009. All patients with renal failure who had been treated by CAPD and followed at least 3 months were included in the study. The STATA [11.0] software and CUREREGR module were used for survival analysis using cure model. Totally 2006 patients were included in this study. The major reasons for renal failure were hypertension [35.4%] and diabetes [33.6%]. The median of survival time was 4.8 years with a 95% confidence interval of 4.3 to 5.6 years. The percentage of long-lived patients surviving was 40% [95% CI: 32%, 47%]. The analysis showed that the effect of diabetes, serum albumin level, age, diastolic blood pressure, and medical center was significant on the long-term survival of the patients. In addition, in short-term survival the effects of age, albumin, and medical center were significant By improving the quality of medical care in centers, nutritional status, controlling co-morbidities can help the patients on CAPD with better health and increase their short and long term survival
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Humans , Male , Female , Survival Analysis , Survival Rate , Age Factors , Risk Factors , Serum Albumin , Nutritional StatusABSTRACT
Assessing growth is a useful tool for defining health and nutritional status of children. The objective of this study was to construct growth reference curves of Iranian infants and children [0-6 years old] and compare them with previous and international references. Weight, height or length of 2107 Iranian infants and children aged 0-6 years old were measured using a cross-sectional survey in Tehran in 2010. Standard smooth reference curves for Iranian population were constructed and compared to multinational World Health Organization 2006 reference standards as well as a previous study from two decades ago. Growth index references for Iranian girls are increased in compare to data from two decades ago and are approximately close to the international references. In boys; however, the increment was considerably large as it passed the international references. Not only the values for indexes was changed during two decades, but also the age at adiposity rebound came near the age of 3, which is an important risk factor for later obesity. During two decades, growth indexes of Iranian children raised noticeable. Risk factors for later obesity are now apparent and demand immediate policy formulations. In addition, reference curves presented in this paper can be used as a diagnostic tool for monitoring growth of Iranian children
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Humans , Female , Male , Body Height , Body Mass Index , Cross-Sectional Studies , Infant , ChildABSTRACT
Students, clergymen and teachers as role models can be very important in encouragement or prevention of cigarette smoking in young people. The aim of this study was to compare prevalence of smoking in 3 male groups of teachers, clergymen and university students. Also, study their knowledge and attitude towards it and the prediction of their future consumption. In a cross sectional study in 2009 in Tehran, Iran, 1,271 male students, 549 clergymen and 551 teachers were randomly enrolled. Each participant completed the global adult tobacco survey questionnaire. Knowledge, attitude and prediction of smoking for the next 5 years were questioned in these 3 groups. Chi-squared test and logistic regression were used for analysis. P < 0.05 was considered significant. Prevalence of cigarette smoking was 31.1%, 21.9% and 27.2% among students, clergymen and teachers, respectively. Smoking in students was not associated with poor knowledge but were in teachers and clergymen. The odds ratio of smoking in students, clergymen and teachers was higher among those with having inappropriate attitude towards it [OR = 1.6, 6.1 and 4.5]. Those with poor knowledge had an inappropriate attitude and predicted higher chance of cigarette consumption in the next 5 years [P < 0.0001]. Inappropriate attitude in all 3 groups resulted in higher prediction of future smoking [P = 0.008]. This study revealed that the prevalence of smoking among male students and teachers was higher than general population and clergymen who equally smoked. Also, level of knowledge and attitude of students were lower than teachers and clergymen