مجله دانشکده پزشکی اصفهان
پیاپی 456 (هفته چهارم دی 1396)

This study aimed to identify the efficacy and complications of premicath catheter in patients with renal failure and rejected renal transplant as well.
This descriptive-analytical study included 39 patients who had again undergone premicath catheter insertion due to rejection of renal transplant and 39 patients without renal transplant. Duration of premicath catheter performance and incidence of relevant complications in these two groups were assessed and compared using patients’ records.
Findings: The mean duration of catheter performance was 12.9 ± 9.5 and 13.9 ± 11.0 months in groups of with and without renal transplantation, respectively, and there was no significant difference between the two groups (P = 0.690). The mean survival time for the catheter was 25.04 ± 2.57 and 43.43 ± 3.04 months in renal transplant and hemodialysis groups, respectively; which was significantly higher in hemodialysis group, according to the log-rank test (P = 0.020).
Survival time of the catheter is less in patients with rejected renal transplant; and due to rejection of the transplant, they should continue hemodialysis in longer time compared to hemodialysis patients who have not received any transplant. Thus, it appears that it is associated with the patient's reactions and their immune system and lack of caring inserted catheter by patient and his/her relatives. Therefore, more care is required in patients undergoing catheter insertion again after renal transplantation. More researches are needed in this field to clarify the conclusion.

Vitamin D deficiency is common in pediatric intensive care unit (PICU) and is related with mortality. The aim of current study was evaluation of prevalence and correlation between vitamin D deficiency and mortality in pediatric intensive care unit.
In this cross-sectional study, 61 pediatrics patients admitted to pediatric intensive care unit were enrolled according to inclusion and exclusion criteria. Serum levels of vitamin D were measured in the patients at onset of study; then, patients were allocated into two groups of vitamin D deficiency (less than 20 ng/ml) and normal (vitamin D of more than 20 ng/ml). Mortality rate was evaluated in patients according to pediatric risk of mortality III (PRISM III) and pediatric index of mortality 2 (PIM 2).
Findings: Both the indexes (PIM 2 and PRISM III) were higher in vitamin D deficiency group (P = 0.020 and P According to our results, the prevalence of mortality was higher in vitamin D deficiency group compared to normal group; but there was no significant correlation between serum levels of vitamin D and mortality rate.

Mental disorders can have physical manifestation and are prevailed as psychosomatic signs. Studies about cognitive skills in psychosomatic patient are clinical trials in order to understand somatotization of mental disorder. This study aimed to compare problem-solving skills and cognitive emotion regulation strategies in patients with psychosomatic symptoms and control population.
This was a causal-comparative study during the third simester of 2016, and study sample included 68 people, 34 with and 34 without psychosomatic symptoms, in Isfahan City, Iran. They were selected via convenience sampling from the clients of Psychosomatic Research Center, Isfahan University of Medical Sciences, and their relatives. The research tools included the Problem-Solving Inventory (PSI) and the Cognitive Emotion Regulation Questionnaire (CERQ).
Findings: The Multivariant ANCOVA test showed that a significant difference between problem-solving skills (except avoid the tendency style) and cognitive emotion regulation strategies in patients with psychosomatic symptoms and control population (P We found that problem-solving skills (except avoid the tendency style) and cognitive emotion regulation strategies play a significant role in presence or absence of psychosomatic symptoms.

Knee joint is the most common site of injury in trauma and detection of its serious diseases with high precision is essential. The aim of this study was to compare clinical examination and magnetic resonance imaging (MRI) findings with arthroscopic findings in patients with meniscus and ligament damage.
This study included 100 patients with indication for knee arthroscopy. After obtaining informed consent from patients, and recording demographic data, patients underwent clinical examination and magnetic resonance imaging of the knee. The result of each method was compared with arthroscopy result (known as the gold standard) and sensitivity, specificity, and accuracy of each method were calculated and compared.
Findings: Sensitivity, specificity, positive and negative predictive values, and accuracy of clinical examination in the diagnosis of anterior cruciate ligament (ACL) rupture were 100%, 75.0%, 94.1%, 100%, and 95.0%, respectively; the values were 93.75%, 100%, 100%, 80.0%, and 95.0%, respectively, for magnetic resonance imaging. In addition, for physical examination, in the diagnosis of meniscus damage, pre-mentioned values were 74.1%, 100%, 100%, 73.7%, and 85.0%, respectively, and 93.1 %, 88.1%, 91.5%, 90.2%, and 91%, respectively, for magnetic resonance imaging. By means of significance, magnetic resonance imaging had higher specificity and lower sensitivity than physical examination for anterior cruciate ligament rupture, and had lower specificity and higher sensitivity and overall accuracy for meniscus damage.
Clinical examination and magnetic resonance imaging have close accuracy in diagnosis of anterior cruciate ligament rupture and meniscus damage.

The association between the speed of eating and gastroesophageal reflux disease (GERD) is less studied in Middle-Eastern countries. We aimed to find the relationship between the speed of eating and gastroesophageal reflux disease symptoms in a large sample of Iranian adults.
In this cross-sectional study, 4669 individuals fulfilled a questionnaire about their eating habits. Regarding the speed of eating, participants were asked: ‘How thoroughly do you chew foods? (not very well, well, very well)’, ‘How long does it take you to eat lunch? How long does it take you to eat dinner? ( 20 minutes). Gastroesophageal reflux disease was defined as having heartburn sometimes or more during the last three months. The severity of disease was assessed with a four-item scale rating (mild, moderate, severe, and very severe).
Findings: The prevalence of gastroesophageal reflux disease in study population was 23.7%. After adjustment of potential confounders, the association remained the same. Individuals who had “not very well” and ”well” chewed their food, had an increased risk of 94% and 38% to have gastroesophageal reflux disease with great frequency. When the mutual effect of other potential confounders were taken into account, association remained meaningful, those who had “not very well” and “well” chewed their food had an increased risk of 91% and 35% to have gastroesophageal reflux disease with great frequency. On the other hand, individuals who ate their lunch during more than 10 minutes had a reduced risk of 30% and 25% to have gastroesophageal reflux disease with great frequency.
We found a significant association between the speed of eating and gastroesophageal reflux disease symptoms and heartburn.

In this study, we compared the effects combinations of ketamine and paracetamol with ketamine and metoclopramide on postoperative pain and their effects on surgical complications. Then, better method for reducing pain and complications was referenced.
In a clinical trial study, 102 candidates for laparoscopic surgery under general anesthesia divided into three equal groups of ketamine and metoclopramide, ketamine and paracetamol, and control. In the first group, 0.5 mg/kg ketamine and 0.1 mg/kg metoclopramide, in the second group, 0.5 mg/kg ketamine and 1 g paracetamol, and in the third group, normal saline were injected. Patients’ systolic and diastolic blood pressures and heart rates in all three groups were measured and recorded every 15 minutes. Then, the effects of these two drug combinations on postoperative pain and some other complications were studied and compared between the three groups.
Findings: Average pain intensity was significantly different among the three treated groups (P Combination of ketamine and paracetamol is more favorable because of significant decrease in postoperative pain.

Saffron or Crocus sativus is a member of Iridacea which traditionally has been used as flavor and color in foods. Studies indicated that saffron has different pharmacological effects such as anti-inflammatory, antioxidant, antiproliferative, and apoptosis. Although, numerous in-vitro and in-vivo studies have been done to find the different effects of this herbal drug, however, clinical usage of it is very limited. Since using herbal drugs in treatment of disease is very popular, it should be more attention on the beneficial effects of saffron which lead to clinical usage of it. In this study, to understand more about the beneficial effects of this herbal drug, we reviewed clinical studies which have been done on saffron so far.