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Dr Homayoon Bashiri, Dr Farshad Sheikhesmaili,
Volume 26, Issue 7 (1-2022)
Abstract
Background and Aim: The prevalence of gallstones in patients with diabetes mellitus is higher than non-diabetic patients. The pathophysiological mechanism of gallstone formation in type 2 diabetic patients is still unclear. Therefore, the aim of this case-control study was the evaluation of gallbladder motor function as one of the contributing factors to gallbladder dysfunction in type 2 diabetic patients by gallbladder ultrasound.
Materials and Methods: In this study, case group included 54 patients with diabetes mellitus and control group consisted of 51 age, sex, and BMI-matched healthy subjects. Ultrasound was performed for all subjects in two groups, one in fasting and the other after eating light meals. Gallbladder volume was measured in the fasting state (V1) and post meal (V2), and the resulting ejection fraction of the gallbladder was calculated. Also, in these subjects, demographic variables such as age, sex, BMI and number of births were analyzed.
Results: Sex ratio age, number of births and BMI was the same in both case and control groups (P> 0.05). In independent t-test analysis, there was no significant relationship between mean V1, V2 and EF in the case and control groups (P> 0.05). Also, there was no significant difference between sex and mean V1, V2 and EF in both groups (P> 0.05). The prevalence of gallstones in the diabetic group was significantly higher than the control group (P = 0.026).
Conclusion: The results of the present study confirmed the high prevalence of gallstones in diabetic patients but there were no statistical deference between groups for gallbladder motor function. However, probably other factors are involved in the formation of gallstones in diabetic individuals.
Samar Tavana, , Nazafarin Hatami-Mazinani, Seyed Ruhollah Mousavinasab, Mohammad Amin Agah, Adeleh Sahebnasagh,
Volume 26, Issue 7 (1-2022)
Abstract
Background and Aim: Community-acquired pneumonia (CAP) remains one of the leading causes of hospital admissions and a common cause of death. Population-based studies assessing the etiology and incidence of CAP are lacking in developing countries. In this prospective study, we assessed the incidence, etiology, and outcomes of CAP in the Iranian population.
Materials and Methods: This five-year hospital based cross-sectional and descriptive study included 357 patients with CAP, between 18 and 95 years of age. Demographic criteria and clinical data of CAP including fever, cough, sputum, dyspnea, hemoptysis, gastrointestinal symptoms and loss of consciousness were recorded. Laboratory findings and prescribed antibiotics were retrieved from the patients’ records. Results of bronchoalveolar lavage fluid and sputum specimens and also culture results were recorded.
Paired t-test, independent-samples T Test and chi-square were used to examine the relationships among different variables. P<0.05 was considered significant.
Results: The total number of patients in the study was 384 patients, of which 55.2% were male and 44.8% were female (P value = 0.2). The most common underlying disease was community-acquired pneumonia (35.9%). The most common symptom was productive cough, which was observed in 85.2% of the patients. The most common microorganisms isolated from culture were Staphylococcus aureus (9.1%) and Acinetobacter (8.9%). The most commonly used antibiotic in this study was ceftriaxone (43.3). In addition, Acinetobacter species were the most common pathogen in exudative pleural effusion (51.5%). Among the people with higher than normal ESR, 62.2% were male and 37.8% were female, which showed a significant difference (P = 0.03). Out of 89 deaths following pneumonia, 43.8% were under 65 and 56.2% were over 65 years of age, which was significant (P= 0.01).
Conclusion: Considering the high prevalence of Staphylococcus aureus and higher mortality in the elderly and patients with decreased level of consciousness or underlying obstructive pulmonary disease, it is necessary to conduct detailed examinations for sputum culture at the beginning and administer appropriate treatment, based on the identified pathogen as soon as possible in order to reduce drug resistance.
Dr. Mohsen Savaie, Dr. Zeinab Farhadi, Dr. Farhad Soltani, Fereshteh Amiri, Dr. Reza Baghbanian,
Volume 27, Issue 2 (5-2022)
Abstract
Background and Aim: Deep vein thrombosis, especially in the lower extremities, is one of the complications of immobility. Major surgeries, especially orthopedic surgeries and inpatient care in the intensive care unit, predispose the patients to such complications. The aim of this study was to compare the prevalence rats of venous thromboembolism between the patients treated with enoxaparin and subcutaneous heparin in the intensive care unit.
Materials and Methods: This was a retrospective cross-sectional study. Sampling method was census. All the patients who had been admitted to the intensive care units of Imam Khomeini Hospital in Ahvaz from the beginning of September 2017 to the end of December 2017, were entered into this study. Data were extracted from the patients' medical records and recorded in a checklist for every patient. Using SPSS20 software, data were analyzed by descriptive and analytical statistics.
Results: Out of 600 patients, 64 (10.66%) patients had venous thromboembolism, of which 35 patients (54.7%) were in the heparin group and 29 patients (45.3%) in the enoxaparin group (P >0.05). 18 patients had deep venous thrombosis (3%), among them 13 (72.22%) patients were in the heparin group and 5 (27.78%) patients in the enoxaparin group (P <0.05).
Conclusion: In this study, enoxaparin administration was more effective than heparin in the prevention of deep vein thrombosis but the effects of these two drugs were the same in the prevention of pulmonary thromboembolism. More concrete conclusions require further studies with control of underlying and confounding factors.
Dr Mohammad Saad Forghani, Dr Hormat Rahimzadeh, Dr Mahmoud Parvin, Dr Anvar Mohammadi,
Volume 27, Issue 6 (1-2023)
Abstract
Background and Aim: Membranous nephropathy (MN) is a podocytopathy characterized histologically by uniform thickening of the glomerular basement membrane due to the presence of subepithelial immune deposits. This disease can occur in a transplanted kidney as a recurrence of primary (Recurrent Membranous Nephropathy, RMN) or de novo disease.
Case report: A 40-year-old non-smoker man with a history of membranous nephropathy and resultant kidney failure, underwent a kidney biopsy 9 months after transplantation because of proteinuria of 4000 mg/day. Diagnosis of recurrence of membranous nephropathy in the transplanted kidney was made. The patient was given two doses of rituximab 1000 mg at a 15 day interval. Gradually, the amount of proteinuria decreased to 188 mg/day after 4 months, and his kidney function remained stable (creatinine 0.8 mg/dl) during the treatment.
Conclusion: Membranous nephropathy can recur after kidney transplantation, and in cases of proteinuria more than one gram per day, we can use rituximab.
Dr Nasrin Moghimi, Dr Ezzat Rahimi, Jamil Eslamipour, Naser Reshadmanesh, Afshin Saeidi,
Volume 28, Issue 1 (3-2023)
Abstract
Background and Aim: Hydroxychloroquine is used to treat many rheumatic diseases. This drug has been widely used, especially in the treatment of rheumatoid arthritis and lupus. One of the most important side effects of these drugs is retinopathy and changes in the visual field. This study aimed to determine the incidence of ocular complications caused by hydroxychloroquine and its related factors.
Materials and Methods: In this prospective study, 505 patients were investigated. These patients underwent complete ophthalmological examinations periodically every six months. If patients had impaired visual field in the perimeter, the visual field examination was repeated two weeks later. If there were specific findings, it was recorded as retinopathy and visual field defect. Optical Coherence Tomography (OCT) was performed for patients if the perimeter findings in the retest were nonspecific.
Results: Several of the 51 cases (10.09%) had eye problems, and 24 (4.75%) had problems other than retinopathy. Problems in perimetry or visual field defects were reported in 27 patients (5.34%) who had recurrent perimetry and 15 patients reported specific drug-related perimetry findings. The results showed that in terms of the underlying disease and its relationship with the incidence of ocular complications in patients, a significant relationship was observed between chronic renal failure and the incidence of complications (P=0.022).
Conclusion: The incidence of hydroxychloroquine-induced retinopathy appears to be relatively high in our region. Due to the significant association with chronic renal failure, screening should be done more carefully in these patients.
Sahar Rezaei Nejad, Hamid Bakhshi Aliabad, Hosein Basirat, Haniye Maleki, Fatemeh Amin, Mahdi Karimi,
Volume 28, Issue 6 (1-2024)
Abstract
Background and Aim: Chronic obstructive pulmonary disease (COPD) which is characterized by symptoms such as dyspnea and cough is the fourth leading cause of death worldwide. Limited studies have shown that vitamin D3 can have a positive impact on reducing the disease severity and preventing exacerbations in the patients with COPD. Therefore, in this study we evaluated the correlation of the serum vitamin D3 level with the severity of disease in COPD patients referring to the clinic of Ali-Ibn Abi Talib Hospital in Rafsanjan in 2015-2016.
Materials and Methods: This descriptive-correlational study included 70 patients with COPD. Diagnosis of COPD was confirmed by spirometry. In all patients, serum vitamin D3 level was measured then variables such as the severity of the disease (from spirometry score in GOLD criteria), the severity of dyspnea according to MRC dyspnea scale and the number of exacerbations were measured. Using software SPSS 20, data were analyzed by Spearman correlation.
Results: Among 70 COPD patients, 17 (24.2%) had severe vitamin D3 deficiency and 21 (30%) had insufficient vitamin D3 level. Significant moderate correlation was observed between the serum vitamin D3 level and severity of the disease based on the results of spirometry (r=0.587 and p=0.000). Also, vitamin D3 level showed significant inverse relationships with the frequency of exacerbations (p = 0.000) and the severity of dyspnea (p = 0.05).
Conclusion: The study findings indicated that vitamin D3 deficiency among COPD patients was prevalent. Moreover, there was a clear association between vitamin D3 deficiency and the severity of COPD. Therefore, treatment of vitamin D3 deficiency can potentially prevent the severity and frequency of exacerbations in these patients.
Dr Jalaleddin Naghshbandi, Dr Homayoon Vahedi, Dr Reza Malekzadeh, Asrin Babahajian,
Volume 30, Issue 2 (5-2025)
Abstract
Background and Aim: The inflammatory bowel diseases (IBD) affect young people of reproductive age. There is little knowledge about complications from IBD during pregnancy and delivery. Here, we aimed to evaluate the possible IBD effects on Fertility and pregnancy.
Materials and Methods: This observational study was conducted on female IBD patients aged between 15 and 50 years who were referred to the GI clinic of Shariati Hospital from 2013-2017. Details on disease activity, prenatal complications, delivery, and neonatal outcome were collected through the medical report.
Results: Among 1156 enrolled patients, 87.2% had UC and 12.8% had CD. About 40.2% of women had children. There was a history of infertility in 54 (7.4%) of subjects. No significant relation was found between the type of inflammatory bowel disease and the fertility status (P=0.47). However, the infertility rate in patients with Crohn's disease (9.5%) was significantly higher than in patients with ulcerative colitis (4%) (P = 0.006).
The low age of the diagnosis was associated with a reduction in fertility (having a child) (p<0.001, r = 0.30) and an increase in abortion (p<0.004, r = 0.80) in the study population.
Conclusion: The rate of infertility in people with Crohn's disease is higher than in people with ulcerative colitis, and the younger the age of onset of inflammatory bowel disease, the lower the fertility rate and the higher the risk of pregnancy complications, including miscarriage.
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