RESUMEN
Background: Leishmaniasis is highly prevalent worldwide, and while conventional medicine offers numerous treatment methods for cutaneous leishmaniasis, Iranian traditional medicine suggests various remedies. We aimed to evaluate the efficacy of an herbal combination containing Indigofera argentea leaves, Pistacia atlantica resin, and Salvia hispanica seeds in patients with zoonotic cutaneous leishmaniasis. Methods: This study was conducted at the Leishmaniasis Department of Chabahar Health Center in southeastern Iran in 2021. It was a double-blinded randomized clinical trial involving 68 patients enrolled after clinical diagnosis, examination of smear samples using Giemsa staining, and PCR confirmation. The volunteers were randomly divided into intervention and control groups. Both groups received 'Glucantime ® as the primary medication weekly until complete healing or up to 12 weeks. Glucantime ® was administered intralesionally at a dosage of 0.1 cc on the wound's margin, with repeat injections at 1 cm intervals along the wound edge when necessary. In addition to the main drug, the intervention group received the herbal product topically twice daily until wound healing or for up to 4 weeks, while the control group received a placebo in the same manner. Results: 82.35% of patients in the intervention group and 20.58% in the control group achieved complete healing within four weeks. There was a significant difference between the two groups (P < 0.001). Conclusion: The herbal product demonstrated effectiveness in treating patients with zoonotic cutaneous leishmaniasis.
RESUMEN
OBJECTIVE: Bacterial vaginosis is the most common vaginal infection in reproductive-age women. If it is not treated, the quality of life will be reduced. In this study, the herbal medicine product Cymbopogon olivieri was used for its treatment. METHODS: This study was conducted with 90 women. The patients were randomly divided into two groups of 45: Cymbopogon olivieri and metronidazole. The treatment period was 7 days for each group. Improvement status was determined by eliminating at least three out of four of Amsel's criteria. A new variable with two order levels (negative and positive) was constructed. This new variable shows the status of the treatment process. Chi-square and Fisher's exact tests were used to examine the relationship between the new variable and treatment status. RESULTS: The results demonstrate that Cymbopogon olivieri and metronidazole significantly reduced the burning, itching, malodor, abnormal vaginal discharge, pH, clue cell, and positive whiff test (p<0.05). The findings also demonstrate that neither treatment was statistically different from the other for at least three of Amsel's criteria. CONCLUSION: This study shows that the effect of Cymbopogon olivieri on bacterial vaginosis is similar to that of metronidazole. Hence, Cymbopogon olivieri is a suitable option to treat bacterial vaginosis.
Asunto(s)
Cymbopogon , Metronidazol , Vaginosis Bacteriana , Humanos , Femenino , Vaginosis Bacteriana/tratamiento farmacológico , Metronidazol/uso terapéutico , Metronidazol/administración & dosificación , Adulto , Resultado del Tratamiento , Cymbopogon/química , Adulto Joven , Fitoterapia/métodos , Administración Intravaginal , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéuticoRESUMEN
Background: Hypothyroidism is one of the most common endocrine diseases. It is, however, usually challenging for physicians to diagnose due to nonspecific symptoms. The usual procedure for diagnosis of Hypothyroidism is a blood test. In recent years, machine learning algorithms have proved to be powerful tools in medicine due to their diagnostic accuracy. In this study, the authors aim to predict and identify the most important symptoms of Hypothyroidism using machine learning algorithms. Method: In this cross-sectional, single-center study, 1296 individuals who visited an endocrinologist for the first time with symptoms of Hypothyroidism were studied, 676 of whom were identified as patients through thyroid-stimulating hormone testing. The outcome was binary (with Hypothyroidism /without Hypothyroidism). In a comparative analysis, random forest, decision tree, and logistic regression methods were used to diagnose primary Hypothyroidism. Results: Symptoms such as tiredness, unusual cold feeling, yellow skin (jaundice), cold hands and feet, numbness of hands, loss of appetite, and weight Hypothyroidism gain were recognized as the most important symptoms in identifying Hypothyroidism. Among the studied algorithms, random forest had the best performance in identifying these symptoms (accuracy=0.83, kappa=0.46, sensitivity=0.88, specificity=0.88). Conclusions: The findings suggest that machine learning methods can identify Hypothyroidism patients who show relatively simple symptoms with acceptable accuracy without the need for a blood test. Greater familiarity and utilization of such methods by physicians may, therefore, reduce the expense and stress burden of clinical testing.
RESUMEN
BACKGROUND: The effects of chemical, biological, radiological, and nuclear (CBRN) incidents on human society can be irreparable. Preparing the health system for these incidents is essential. This study aims to identify obstacles to hospital preparedness against CBRN incidents and provide solutions. MATERIALS AND METHODS: This qualitative study was conducted using semi-structured interview method in 2022. The research community included experts in the fields of CBRN, and 17 persons were included in the study through purposive sampling. The interviews were collected by interview guide and recorded face-to-face and online and were analyzed using thematic content analysis method in MS Word 2016. RESULTS: The interviews' analysis was classified into two main categories and 34 sub-categories. Some of the most important obstacles to the hospital preparedness against CBRN incidents were the lack of proper crisis management, the lack of specialist staff, the stress of employees, the lack of turnover and sufficient rest for employees, legal gaps, and so on. The main strategies were determining the type and extent of the risk factor, strong crisis management, the lack of parallelism, continuous monitoring, having a protocol and road map, appropriate training programs, having skilled personnel, rapid response of personnel, positive attitude of the staff, and the favorable condition of the building. CONCLUSION: The appointment of an expert in the field of CBRN and having a specialized unit, the existence of specialized and trained staff along with access to the required facilities, clear instructions, and intra-departmental and inter-departmental cooperation affect the readiness of hospitals against CBRN incidents.
RESUMEN
SUMMARY OBJECTIVE: Bacterial vaginosis is the most common vaginal infection in reproductive-age women. If it is not treated, the quality of life will be reduced. In this study, the herbal medicine product Cymbopogon olivieri was used for its treatment. METHODS: This study was conducted with 90 women. The patients were randomly divided into two groups of 45: Cymbopogon olivieri and metronidazole. The treatment period was 7 days for each group. Improvement status was determined by eliminating at least three out of four of Amsel's criteria. A new variable with two order levels (negative and positive) was constructed. This new variable shows the status of the treatment process. Chi-square and Fisher's exact tests were used to examine the relationship between the new variable and treatment status. RESULTS: The results demonstrate that Cymbopogon olivieri and metronidazole significantly reduced the burning, itching, malodor, abnormal vaginal discharge, pH, clue cell, and positive whiff test (p<0.05). The findings also demonstrate that neither treatment was statistically different from the other for at least three of Amsel's criteria. CONCLUSION: This study shows that the effect of Cymbopogon olivieri on bacterial vaginosis is similar to that of metronidazole. Hence, Cymbopogon olivieri is a suitable option to treat bacterial vaginosis.
RESUMEN
Given the increase in the incidence of breast cancer during the past decades, several studies have investigated the effects of variables on breast cancer, especially obesity. This systematic review and meta-analysis aims to evaluate any effects of obesity on breast cancer risk in women, before and after menopause, and in different continents.All forms of relevant literature examining any association between obesity and breast cancer, including cohort, case-control, and cross-sectional studies, were identified in the PubMed, Scopus, EMBASE, and Web of Science databases from January 1, 1990 until January 13, 2023. Body mass index (BMI) > 30 was used to indicate obesity. Every type of breast cancer was examined as outcome factors. The quality of the papers was evaluated using the Newcastle-Ottawa scale checklist. The Egger and Begg test was used to evaluate publication bias. To assess any extra impact of each research on the final measurement, a sensitivity analysis was carried out.One hundred and two studies were included in this meta-analysis. Respectively, 48 and 67 studies reported associations between obesity and breast cancer in pre and post menopausal women. Combining all studies, the pooled OR of the association between obesity and breast cancer in pre-menopausal women was OR = 0.93 CI: (0.85-1.1), (I2 = 65.4%), and for post-menopausal woman, OR = 1.26 CI: (1.19-1.34), (I2 = 90.5%).Obesity has a protective role in breast cancer among pre-menopausal women, but this relationship is statistically significant only in European women. The chance of developing breast cancer increases in post-menopausal women who are obese. This relationship is significant among Asian, North American, African and European women.
Asunto(s)
Neoplasias de la Mama , Femenino , Humanos , Neoplasias de la Mama/epidemiología , Factores de Riesgo , Estudios Transversales , Menstruación , Obesidad/complicaciones , Obesidad/epidemiologíaRESUMEN
BACKGROUND AND AIM: Dose-response modeling for radiotherapy-induced xerostomia in head and neck cancer (HN) patients is a promising frontier for personalized therapy. Feature extraction from diagnostic and therapeutic images (radiomics and dosiomics features) can be used for data-driven response modeling. The aim of this study is to develop xerostomia predictive models based on radiomics-dosiomics features. METHODS: Data from the cancer imaging archive (TCIA) for 31 HN cancer patients were employed. For all patients, parotid CT radiomics features were extracted, utilizing Lasso regression for feature selection and multivariate modeling. The models were developed by selected features from pretreatment (CT1), mid-treatment (CT2), post-treatment (CT3), and delta features (ΔCT2-1, ΔCT3-1, ΔCT3-2). We also considered dosiomics features extracted from the parotid dose distribution images (Dose model). Thus, combination models of radio-dosiomics (CT + dose & ΔCT + dose) were developed. Moreover, clinical, and dose-volume histogram (DVH) models were built. Nested 10-fold cross-validation was used to assess the predictive classification of patients into those with and without xerostomia, and the area under the receiver operative characteristic curve (AUC) was used to compare the predictive power of the models. The sensitivity and accuracy of models also were obtained. RESULTS: In total, 59 parotids were assessed, and 13 models were developed. Our results showed three models with AUC of 0.89 as most predictive, namely ΔCT2-1 + Dose (Sensitivity 0.99, Accuracy 0.94 & Specificity 0.86), CT3 model (Sensitivity 0.96, Accuracy 0.94 & Specificity 0.86) and DVH (Sensitivity 0.93, Accuracy 0.89 & Specificity 0.84). These models were followed by Clinical (AUC 0.89, Sensitivity 0.81, Accuracy 0.97 & Specificity 0.89) and CT2 & Dose (AUC 0.86, Sensitivity 0.97, Accuracy 0.87 & Specificity 0.82). The Dose model (developed by dosiomics features only) had AUC, Sensitivity, Specificity, and Accuracy of 0.72, 0.98, 0.33, and 0.79 respectively. CONCLUSION: Quantitative features extracted from diagnostic imaging during and after radiotherapy alone or in combination with dosiomics markers obtained from dose distribution images can be used for radiotherapy response modeling, opening up prospects for personalization of therapies toward improved therapeutic outcomes.
Asunto(s)
Neoplasias de Cabeza y Cuello , Xerostomía , Humanos , Dosificación Radioterapéutica , Neoplasias de Cabeza y Cuello/radioterapia , Xerostomía/etiología , Glándula ParótidaRESUMEN
Background: Breast cancer (BC) is the most common cancer and the fifth cause of death in women worldwide. Exploring unique genes for cancers has been interesting. Patients and Methods: This study aimed to explore unique genes of five molecular subtypes of BC in women using penalized logistic regression models. For this purpose, microarray data of five independent GEO data sets were combined. This combination includes genetic information of 324 women with BC and 12 healthy women. Least absolute shrinkage and selection operator (LASSO) logistic regression and adaptive LASSO logistic regression were used to extract unique genes. The biological process of extracted genes was evaluated in an open-source GOnet web application. R software version 3.6.0 with the glmnet package was used for fitting the models. Results: Totally, 119 genes were extracted among 15 pairwise comparisons. Seventeen genes (14%) showed overlap between comparative groups. According to GO enrichment analysis, the biological process of extracted genes was enriched in negative and positive regulation biological processes, and molecular function tracking revealed that most genes are involved in kinase and transferring activities. On the other hand, we identified unique genes for each comparative group and the subsequent pathways for them. However, a significant pathway was not identified for genes in normal-like versus ERBB2 and luminal A, basal versus control, and lumina B versus luminal A groups. Conclusion: Most genes selected by LASSO logistic regression and adaptive LASSO logistic regression identified unique genes and related pathways for comparative subgroups of BC, which would be useful to comprehend the molecular differences between subgroups that would be considered for further research and therapeutic approaches in the future.
Asunto(s)
Neoplasias de la Mama , Humanos , Femenino , Neoplasias de la Mama/genética , Modelos Logísticos , Programas InformáticosRESUMEN
Road traffic accidents (RTAs) are among the top causes of mortality and disability globally, particularly in developing nations like Iran. In this study, RTAs were analyzed to develop precise predictive models for predicting the frequency of accidents in the Kerman Province (southeastern Iran) using the autoregressive integrated moving average (ARIMA) and autoregressive integrated moving average with explanatory variables (ARIMAX) modeling methods. The findings demonstrate that including factors regarding humans, vehicles, and elements of nature in the time-series analysis of accident records resulted in the development of a more reliable prediction model than utilizing only aggregated accident count. The understanding of safety on the road is increased by this research, which also offers a method for forecasting that utilizes a variety of parameters relating to people, cars, and the environment. The findings of this research are likely to contribute to lowering the incidence of RTAs in Iran.
Asunto(s)
Accidentes de Tránsito , Automóviles , Humanos , Irán/epidemiología , Predicción , IncidenciaRESUMEN
OBJECTIVES: The goal of this study was to retrospectively investigate the relationship between renal transplanted volume indexes (Total kidney volume (TKV)/Body surface area (BSA), Renal parenchymal volume (RPV)/BSA, Renal cortical volume (RCV)/BSA, RPV/Body mass index (BMI), RCV/BMI, RPV/Weight, RCV/Weight), and short- and long-term function of the graft. METHODS: One-hundred and twelve live donor-recipient pairs from 2017 to 2018, whose donors underwent preoperative renal computed tomography angiography and recipients survived during 12 months of follow-up, were included in this study. RESULTS: The crude and adjusted linear regressions for the effect of volume measurements by voxel and ellipsoid methods on the estimated glomerular filtration rate (eGFR) at different post-transplantation times demonstrated that the RPV/weight ratio had the most substantial crude effect on the eGFR 12 months and 4 years after renal transplant. Receiver operating characteristic (ROC) curves for six different renal volume ratios demonstrated no significant difference between these ratios in terms of discriminative ability (p value < 0.05). A strong direct correlation between TKV calculated by the ellipsoid formula with RPV and RCV measured using OsiriX software was noted. Analysis of ROC curves for renal volume indices has demonstrated fair to good discriminative ability of our cut-off points to estimate 4-year post-transplantation eGFR > 60 mL/min. CONCLUSION: Renal transplant recipients' volume indices, such as RPV/weight, had strong correlations with eGFR at different points in time, and renal transplant recipients with the volume ratios higher than our cut-off points had a good chance of having a 4-year post-transplantation eGFR higher than 60 mL/min.
Asunto(s)
Riñón , Humanos , Índice de Masa Corporal , Estudios Retrospectivos , Superficie Corporal , Riñón/diagnóstico por imagen , Tasa de Filtración Glomerular , Peso CorporalRESUMEN
The aim of this prospective cohort study was to explore the effect of statins on long-term respiratory symptoms and pulmonary fibrosis in coronavirus disease 2019 (COVID-19) patients with diabetes mellitus (DM). Patients were recruited from three tertiary hospitals, categorized into Statin or Non-statin groups, and assessed on days 0, 28, and 90 after symptoms onset to record the duration of symptoms. Pulmonary fibrosis was scored at baseline and follow-up time points by high-resolution computed tomography scans. Each group comprised 176 patients after propensity score matching. Data analysis revealed that the odds of having cough and dyspnea were significantly higher in the Non-statin group compared to the Statin group during the follow-up period. Overall, there was no significant difference in the change in pulmonary fibrosis score between groups. However, Non-statin patients with > 5 years of DM were more likely to exhibit a significantly higher fibrosis score during the follow-up period as compared to their peers in the Statin group. Our results suggest that the use of statins is associated with a lower risk of developing chronic cough and dyspnea in diabetic patients with COVID-19, and may reduce pulmonary fibrosis associated with COVID-19 in patients with long-term (> 5 years) DM.
Asunto(s)
COVID-19 , Diabetes Mellitus , Fibrosis Pulmonar , Humanos , Fibrosis Pulmonar/tratamiento farmacológico , Tos , Estudios Prospectivos , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/epidemiología , DisneaRESUMEN
INTRODUCTION: Stroke is the second leading cause of death worldwide. Recent studies have shown that the COVID-19 pandemic has been associated with a higher frequency of stroke. This study aimed to investigate the epidemiologic aspects of stroke two years before and during the COVID-19 pandemic in Kerman. METHOD: This cross-sectional study was conducted in Kerman. The participants included all patients with a confirmed diagnosis of stroke. COVID-19 confirmation was based on a positive PCR test. The data was analyzed with SPSS.V24 software. RESULTS: In this study, 4152 patients with stroke were evaluated. The frequency of stroke before and during the COVID-19 pandemic was the same. The total number of stroke patients with COVID-19 was 298 (8.16%). The frequency of ischemic stroke patients before the COVID-19 pandemic was 1751 and during the pandemic was 1770. Before and after the pandemic, the mean age of ischemic stroke patients was 67.42±14.14 and 64.49±14.46 respectively, which showed a statistically significant difference (P>0.001). Our findings showed a significant difference between the NIHSS of ischemic stroke before and after the pandemic (P<0.001). The mortality rate of stroke patients was 111 before COVID-19 and 115 patients in the first two years of COVID-19. Except for the mortality rate (P<0.001), there was no significant difference in other demographic variables between ischemic stroke patients with and without COVID-19. CONCLUSION: The patients with ischemic stroke during the COVID-19 pandemic were younger and had more neurological deficits than the ischemic stroke patients before the pandemic. COVID-19 was associated with higher mortality in patients with ischemic stroke.
RESUMEN
ABSTRACT Objective: To compare the clinical and radiographic success rates of formocresol, BiodentineTM, and Endo Repair agents in primary molars after 12 months. Material and Methods: This randomized double-blind clinical trial was conducted on healthy children referred to the Department of Pediatric Dentistry, Kerman, Iran, in 2018. One hundred twenty children (human primary molar teeth) aged 3-9 years were selected and randomly divided into three interventions (with pulpotomy medicament agents), including formocresol, BiodentineTM, and Endo Repair. All pulpotomized teeth were restored using stainless steel crowns and evaluated clinically and radiographically during a 12-month follow-up. Fisher exact test was used to determine the association of categorical variables and the data were analysed with SPSS 25. Results: All the available teeth in formocresol and BiodentineTM groups obtained clinical success, whereas 62.5% of the Endo Repair group was successful in this regard. Radiographic success rates of the formocresol, BiodentineTM, and Endo Repair groups were 94.7%, 70%, and 28.1% after a 12-month follow-up, respectively. Moreover, pulp canal obliteration was observed in 26.3%, 25%, and 12.5% of the formocresol, BiodentineTM, and Endo Repair groups. Conclusion: This study reported a high rate of clinical success using both BiodentineTM and formocresol pulpotomy techniques. However, the radiographic success rate of formocresol was higher than that of BiodentineTM, and Endo Repair was not considered a suitable pulpotomy medicament agent.
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Pulpotomía , Diente Primario , Formocresoles/química , Endodoncia Regenerativa , Radiografía Dental/instrumentación , Método Doble CiegoRESUMEN
BACKGROUND: The purpose of this study was to identify latent classes of the severity of post-traumatic stress disorder (PTSD) among the survivors of the earthquake in Bam, south-eastern Iran, 17 years after the disaster. The most influential predictor variables of PTSD classes were also investigated. METHODS: Eight hundred survivors of the Bam earthquake who were at least four years old in that disaster were selected by multistage sampling. The PTSD Checklist-Civilian Version was used. Latent class analysis was performed to identify subgroups of people with different PTSD symptom profiles. Latent class regression analysis was used to explore the influence of demographic and traumatic variables on each class membership. RESULTS: We found three latent classes of PTSD, with the following profiles emerging: Low Symptom (56.6% of the participants), Moderate Symptom (23.5%), and Severe Symptom (19.9%). Old age [OR = 2.20, 95% CI = (1.46, 3.32)], physical injury [OR = 1.95, 95% CI = (1.24, 3.06)], being trapped under the rubble [OR = 1.81, 95% CI = (1.15, 2.86)], and death of a family member [OR = 1.86, 95% CI = (1.12, 3.09)] were positive risk factors for PTSD and increased the chance of being in classes having more severe symptoms. Having a high educational level was a negative risk factor [OR = 0.86, 95% CI = (0.67, 1.11)]. CONCLUSIONS: The severity of PTSD 17 years after the earthquake shows that natural disasters such as earthquakes have long-term consequences, and earthquake survivors must have psychological support and long term health care. After any catastrophic earthquake, governments should establish psychology and psychotherapy centers for earthquake victims, and these centers should support earthquake victims for a sufficiently long time.
Asunto(s)
Desastres , Terremotos , Trastornos por Estrés Postraumático , Preescolar , Humanos , Factores de Riesgo , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/psicología , Sobrevivientes/psicologíaRESUMEN
BACKGROUND: The first-birth interval directly influences family size and maternal and child mortality. The objective of this study is to investigate factors associated with the time of the first-birth after the first marriage among women in Iran. METHODS: In this cross-sectional study, the first birth history of 1350 women aged 15-49 years was collected in Kerman (southern Iran) in 2018. To assess the predictor variables of the first-birth interval and calculate the adjusted hazard ratios, multivariate Cox regression was used. The P-value < 0.05 was considered as significant. The statistical analysis of data was performed using SPSS version 22. RESULTS: The average of the first-birth interval was 2.5 ∓ 0.8 years. Woman's age at marriage (HR 1.48, 95% CI 1.32-2.48), husband's age at marriage (HR 1.88, 95% CI 1.62-2.03), age at the first menstruation (HR 1.53, 95% CI 1.24-2.53), being rural residents (HR 2.041, 95% CI 1.26-2.95), and having engagement period (HR 1.85, 95% CI 1.52-3.05) were associated with short first-birth interval, and woman's BMI (HR 1.72, 95% CI 1.54-2.77), woman's university educational level (HR 1.47, 95% CI 1.35-2.57), husband' s university educational level (HR 1.39, 95% CI 1.32-2.51), contraception use (HR 2.28, 95% CI 1.12-2.86) and income sufficiency (HR 2.25, 95% CI 1.12-2.96) were associated with long first-birth interval. CONCLUSIONS: Being a rural resident is the most influential predictor of short first-birth interval and income sufficiency is the most influential predictor of long first-birth interval.
Total Fertility Rate, which is the average number of live births that would be born to a woman over her reproductive life if she experiences the current age-specific fertility rates throughout her lifetime. The fertility pattern can be measured by several indicators such as the first-birth interval (FBI) after marriage. FBI is defined as the duration of time spent by married couples to have their first child since the first day of marriage. Some studies have demonstrated that the length of FBI subsequently influences spacing and childbearing pattern of a family. The aim of this study is first to determine the mean of FBI and second to explore the associated factors of FBI in Kerman, southern Iran. We analyzed data for 1350 women 1549 years old. The outcome variable was the first-birth interval (FBI). Results showed that the average of FBI was 2.5 years. There is a positive association between FBI and age of wives at marriage, first menace age, wives' BMI, wives and husbands' educational level, contraception use, age of husbands at marriage, residence place, income sufficiency, and having engagement period. The women and men who got married at older ages were more likely to report short FBI. It was indicated that Educated women and men and women who experience menstruation at a younger age are more likely to report longer FBI. The knowledge about importance of FBI should be more announced for couples by health services in order to help them manage their child-spacing and fertility. The government also should pay attention on FBI as an important index in determining the average age of country population.
Asunto(s)
Intervalo entre Nacimientos , Salud Infantil , Niño , Anticoncepción , Estudios Transversales , Femenino , Humanos , ReproducciónRESUMEN
PURPOSE: To compare two methods of laparoscopic sacrocolpopexy (LSCP) and sacrospinous ligament fixation (SSLF) in terms of efficacy and safety in the treatment of vaginal apical prolapse. MATERIALS AND METHODS: This prospective, randomized controlled clinical trial was conducted on 32 patients with symptomatic vaginal apical prolapse, referred to the female urology clinic of Kerman University, Iran, during 2018-2019. The patients were re-examined at 12 months after surgery. Objective success was recorded using Pelvic Organ Prolapse Quantification (POP-Q) classification as primary outcome. The subjective success of the methods was determined by the quality-of-life parameters, based on Pelvic Floor Impact Questionnaire (PFIQ-7), Pelvic Floor Distress Inventory (PFDI-20), and Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) scores as secondary outcomes. Moreover, complications were recorded in both groups. RESULTS: The amount of intraoperative bleeding was significantly higher in the SSLF group, compared to the LSCP group (P = 0.01). Persistent pain was observed in two (12%) patients in the LSCP group and five (31%) patients in the SSLF group (P = 0.2). The decrease in the total PFIQ-7 score was in favor of the LSCP group but not statistically significant (p = 0.06). The LSCP group showed bigger improvement in vaginal (p = 0.04) and bowel (p = 0.03) scores. The results of the PISQ-12 and PFDI-20 questionnaires as well as POP-Q examination were not different in two groups. CONCLUSION: Although the surgical methods of LSCP and SSLF can be equally effective in the treatment of apical prolapse, LSCP appears to be superior to SSLF regarding less bleeding.
Asunto(s)
Laparoscopía , Prolapso de Órgano Pélvico , Prolapso Uterino , Femenino , Procedimientos Quirúrgicos Ginecológicos/métodos , Humanos , Laparoscopía/efectos adversos , Laparoscopía/métodos , Ligamentos/cirugía , Diafragma Pélvico , Prolapso de Órgano Pélvico/cirugía , Proyectos Piloto , Estudios Prospectivos , Calidad de Vida , Mallas Quirúrgicas , Encuestas y Cuestionarios , Resultado del Tratamiento , Prolapso Uterino/cirugíaRESUMEN
Background: Due to the increasing prevalence of intestinal diseases, colonoscopy is considered a safe and fast diagnostic and treatment method for these patients. According to studies, most patients waiting for a colonoscopy experience fear and anxiety. This study aimed to investigate the effect of a pre-colonoscopy education program on the fear and anxiety of patients undergoing colonoscopy. Materials and Methods: This randomized clinical trial study was conducted on patients undergoing colonoscopy in hospitals in southeast Iran. A total of 90 participants were selected by convenient sampling and randomly assigned to two groups control (n = 45) and intervention (n = 45). The patients in the intervention group received nursing interventions before colonoscopy, while the patients in the control group received only routine care. The data were collected using a researcher-made fear of colonoscopy scale, its Cronbach's alpha coefficient (0.92), and the Spielberger State-Trait Anxiety Inventory. The data were analyzed with a Chi-square t-test and pair t-test. Results: The data showed that anxiety and fear of colonoscopy in the patients in the intervention group significantly decreased compared to the patients in the control group (p < 0.001). Conclusions: Using non-pharmacological methods before colonoscopy can reduce the fear and anxiety in patients who are candidates for this procedure and similar invasive procedures. The intervention performed in this study can be used together with other methods to control patients' fear and anxiety. Especially for nurses, It is recommended to do pre-colonoscopy education programs for these clients.
RESUMEN
Objective: In this study, we analyzed the therapeutic effect of periurethral injection of autologous muscle-derived stem cell versus mid-urethral sling surgery at a 1-year follow-up. Method: This randomized controlled clinical trial was conducted on 30 women with stress urinary incontinence (SUI) who had not responded to conservative treatments, after registering the participants and obtaining informed consent. Patients were divided into two groups of 15 each treated with periurethral injection of muscle-derived stem cells (MDSCs) and mid-urethral sling surgery, respectively. Follow-ups were done at 1, 3, 6, and 12 months after the treatment using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UISF) and Incontinence Quality of Life Questionnaire (I-QOL) questionnaires, clinical examination, cough test, and 1-hour pad test. The results were analyzed within the groups and then compared between the two groups. Moreover, both groups were compared in terms of postoperative complications. Results: At the 1-year follow-up, in the stem cell group, 10 patients (66.6%) experienced improvements after the periurethral injection of stem cells; half of these patients (33.3%) reported a full recovery. In the mid-urethral sling group, 13 patients (93.3%) experienced improvement, and 12 patients (80%) reported a full recovery. The analysis of ICIQ-UISF and I-QOL questionnaires indicated that the responses in both groups were significant, but the response in the stem cell group was significantly lower compared with the standard surgery group. No considerable complications were observed in the two groups. Conclusion: Although the periurethral injection of MDSCs considerably improves the symptoms with minimum complications in women with SUI, its therapeutic response is significantly lower compared with mid-urethral sling surgery.
RESUMEN
BACKGROUND: Uterine cervical malignancy is one of the commonly detected malignancies related to the human papillomavirus (HPV) and is increasing incidentally in developing countries. Therefore, the use of an efficient diagnostic method is required as an effectual step for cervical cancer prevention and treatment. The purpose of the study was to diagnose various types of HPV in the cervical cytology specimens in the South-East of Iran. METHODS: This cross-sectional study was performed on 1079 cervical fluid cytology specimens referred for two years, between 2018-2020. Polymerase chain reaction (PCR) and hybridization (INNO-LiPA HPV Genotyping EXTRA II assay) were used to determine HPV DNA and their genotypes, respectively. RESULTS: HPV was positive in 37.7% (407 of 1079) patients with a mean age of 34.62 ± 8.82. Among positive cases, 252 (62%) had only one HPV genotype and 155 (38.05%) had multiplex HPV genotypes, which included 94 (60.7%), 38 (24.6%), 18 (11.6%) and 5 (3.2%) cases with two, three, four and five or more genotypes, respectively. The samples with multiple strains revealed 31 HPV genotypes with the four most prevalent being HPV6 (14.7%), HPV16 (10.9%), HPV53 (9.6%) and HPV51 (5.9%). CONCLUSION: HPV infection is the main health challenge for women that requires improved health service programs and appropriate epidemic vaccination.