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Research in Medical Sciences - Volume:22 Issue: 3, 2017 Mar

Journal of Research in Medical Sciences
Volume:22 Issue: 3, 2017 Mar

  • تاریخ انتشار: 1396/03/08
  • تعداد عناوین: 11
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  • Hossein Abdali, Mohammad Bagher Heydari, Mahomod Omranifard, Majid Rasti Page 1
    Background
    One of the most common operations in the plastic surgery curse is abdominoplasty. Several methods were recommended for achieving better results. In the present study, efficacy of a new method compared with classical high lateral tension on preventing dog ear and elongation scar was evaluated.
    Materials And Methods
    in an open-label, randomized clinical trial, seventy patients who were candidates for abdominoplasty were selected and randomly divided into two groups. Te first group was operated by classic high lateral method and the second group was operated by a new method concentrating on changing incision line and angle. Dog ear prevention, length of scar, improvement, and postoperative complications were compared between the two groups.
    Results
    Te mean ± standard deviation (SD) length of scar in treated patients with classical and new abdominoplasty surgical methods was 53.68 ± 6.34 and 41.71 ± 1.78 cm, respectively, and the length of scar in the group treated with the new method was significantly shorter (P
    Conclusion
    Te new method is more likely to be successful in patients with high lateral tension abdominoplasty. However, according to the lack of similar studies in this regard and the fact that this method was introduced for the first time, it is recommended that further studies in this area are needed and patients in term of complications after surgery need a longer period of follow-up.
    Keywords: Abdominoplasty, dog ear, high lateral tension, scar length
  • Mohammad-Hasan Emami, Masoud Ataie-Khorasgani, Nasim Jafari-Pozve Page 2
    Background
    Early upper gastrointestinal (UGI) cancer detection had led to organ?preserving endoscopic therapy. Endoscopy is a suitable method of early diagnosis of UGI malignancies. In Iran, exclusion of malignancy is the most important indication for endoscopy. Tis study is designed to see whether using alarm symptoms can predict the risk of cancer in patients.
    Materials And Methods
    A total of 3414 patients referred to a tertiary gastrointestinal (GI) clinic in Isfahan, Iran, from 2009 to 2016 with dyspepsia, gastroesophageal re?ux disease (GERD), and alarm symptoms, such as weight loss, dysphagia, GI bleeding, vomiting, positive familial history for cancer, and anorexia. Each patient had been underwent UGI endoscopy and patient data, including histology results, had been collected in the computer. We used logistic regression models to estimate the diagnostic accuracy of each alarm symptoms.
    Results
    A total of 3414 patients with alarm symptoms entered in this study, of whom 72 (2.1%) had an UGI malignancy. According to the logistic regression model, dysphagia (P
    Conclusion
    We recommend to do an early endoscopy for any patient with UGI symptoms and to take multiple biopsies from any rudeness or suspicious lesion, especially for male gender older than 50, dysphagia, or weight loss.
    Keywords: Alarm symptom, diagnostic accuracy, upper gastrointestinal malignancy
  • Farzin Ghiasi, Babak Amra, Vahid Sebghatollahi, Fatemeh Azimian Page 3
    Background
    Irritable bowel syndrome (IBS) is assumed as one of the most frequent gastrointestinal disorders, which decreases the patient’s quality of life. IBS pathogenesis, however, is not clearly defined. It seems that sleep apnea induces or escalates IBS clinical symptoms. Tis study aims at evaluating of IBS prevalence in patients, who are afflicted or are not afflicted with sleep apnea.
    Materials And Methods
    Tis was a case–control study, which was implemented in a sleep laboratory located in Isfahan, Iran. We recruited 200 patients being more than 15 years from 2014 to 2015. Based on the apnea–hypopnea index (AHI), we recruited 100 patients in each of two groups: negative sleep apnea (NSA) (AHI ?4) and positive sleep apnea (PSA) (AHI >4). IBS was diagnosed through a Rome III diagnostic questionnaire.
    Results
    Overall, the prevalence of IBS among patients referred to sleep laboratory was 17.6%. Indeed, IBS prevalence in NSA and PSA groups were 8.2% and 27.1%, respectively. Furthermore, odds ratio of IBS in PSA group versus NSA was 3.92 (95% confidence interval = 1.58–9.77, P = 0.003). Our results showed that the prevalence of IBS did not differ significantly between various severity of sleep apnea (P = 0.452).
    Conclusion
    Tis study showed that there was a positive association between sleep apnea and IBS.
    Keywords: Irritable bowel syndrome, polysomnography, prevalence, sleep apnea syndrome
  • Zahra Shariaty, Gholam Reza Mahmoodi Shan, Mehran Farajollahi, Monireh Amerian, Naser Behnam Pour Page 4
    Background

    Chronic inflammation is one of the causes of anemia in chronic renal failure patients under hemodialysis. Probiotics probably establish a balance between pro- and anti-inflammatory cytokines. Te study was conducted to determine the effects of probiotic supplementation on hemoglobin (Hb) in hemodialysis patients.

    Materials And Methods

    A parallel clinical trial was conducted in which patients were randomly allocated into two groups. Te intervention group (n = 18) was given a 500 mg probiotic supplement (a capsule) every day whereas the control group (n = 18) received placebo (a capsule), both for 3 months. Hb levels and C-reactive protein (CRP) levels were measured for three periods. Te data were analyzed in SPSS-16 using statistical tests including the t-test and repeated-measures ANOVA.

    Results

    In the probiotic supplementation group, the mean Hb was 9.22 ± 1.04 mg/dl before the intervention and reached 10.85 ± 1.177 mg/dl afterward, while in the placebo group, the mean Hb level was 9.38 ± 0.97 mg/dl before the intervention and reached 10.03 ± 1.97 mg/dl afterward (P > 0.05). During the study, the placebo caused to increase of Hb temporary, but in longer term, the effect of probiotic was more manifested. Hb levels increased in both groups although the change was not statistically significant (P > 0.05). Te findings showed no significant differences between the two groups in either the pre- or post-intervention CRP levels (P = 0.239).

    Conclusions

    Probiotic supplementation decreased Hb fluctuations in hemodialysis patients but did not result in a significant increase in Hb levels. Similar studies are therefore recommended to be conducted with a prolonged duration of the study or an increased probiotic dose with larger sample size to complete the results of the present study.

    Keywords: Chronic renal failure, hemodialysis, hemoglobin, probiotic
  • Mahdieh Akoochakian, Heidar Ali Davari, Mohammad Hossein Alizadeh, Nader Rahnama Page 5
    Background
    Muscle strength is necessary for upper body normal function. Upper extremity function impairments have been reported in breast cancer (BC) survivors. It is not possible to know precisely if cancer adjuvant therapy such as radiation and chemotherapy had any effect on the unaffected arm. Te aim of this study was to compare shoulder girdle strength among women with BC and similarly aged women without cancer.
    Materials And Methods
    Tirty-three postmenopausal women (51 ± 6.46 years) with BC who underwent surgery, chemotherapy, and radiation therapy and 30 healthy postmenopausal women (53.26 ± 5.05 years) were selected. Muscle strength was measured using a handheld dynamometer for flexion, horizontal adduction, internal and external rotation, scapular abduction and upward rotation, scapular depression, and adduction. Data were analyzed by multivariate analysis of variance (P
    Results
    Te findings indicated significant differences between groups of 6 of the shoulder girdle strength measure (flexion (P = 0.003), internal rotation (P = 0.001), external rotation (P = 0.040), scapular abduction and upward rotation (P = 0.001), scapular depression and adduction (P = 0.025), and shoulder horizontal adduction (P = 0.00)). Patients showed significantly lower strength compared with healthy controls (flexion = 34.3%, abd = 64.2%, int.rot = 51.2%, ext.rot = 32.4%, hor.add = 58.06, and depression = 35.2%).
    Conclusion
    Te results indicate that the shoulder girdle strength in women with BC decreased compared with healthy women without BC. Terefore, during the treatment of patients with BC, designing of training programs and rehabilitation programs need to be performed on shoulder girdle strength factors in patients undergoing mastectomy with axillary surgery and radiation therapy.
    Keywords: Breast neoplasm, chemotherapy, lymph nodes, menopause, radiotherapy, upper extremity function
  • Shervin Shokouhi, Ilad Alavi Darazam, Mohammad-Hossein Zamanian Page 6
    Background
    Tis study was aimed to determine frequency and antimicrobial susceptibility of Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) among colonized patients in outpatient status.
    Materials And Methods
    A total of 2000 nasal nares specimens were collected and inoculated on mannitol salt agar. MRSAs were identified based on mannitol positivity and coagulase test followed by cefoxitin disc diffusion test. Antimicrobial susceptibility of MRSA isolates was performed by E-test method for vancomycin and doxycycline as well as disc diffusion method for sulfamethoxazole-trimethoprim (SMX-TMP), erythromycin, linezolid, and clindamycin. D-test was performed for detection of inducible resistance to clindamycin.
    Results
    Overall, nasal carrier rate of S. aureus and CA-MRSA was estimated 22% and 1.25%, respectively. Out of the 440 S. aureus isolates, 25 isolates were MRSA. All were susceptible to vancomycin and linezolid, and susceptibility rates to SMX-TMP, erythromycin, levofloxacin, doxycycline, and clindamycin were 68%, 44%, 48%, 40% and 44%, respectively; furthermore, 28.5% of resistant isolates to erythromycin had inducible resistance to clindamycin.
    Conclusion
    It seems susceptibility to clindamycin and SMX-TMP, recommended agents for empirical treatment of suspected CA-MRSA, are not promising.Vancomycin and linezolid are effective and reliable antibiotics for the treatment of S. aureus infections.
    Keywords: Antimicrobial susceptibility, Community-acquired methicillin-resistant Staphylococcus aureus, nasal carrier
  • Zeinab Saremi, Mahboobe Rastgoo, Mahyar Mohammadifard, Bita Bijari, Ehsan Akbari Page 7
    Background
    Tere is interest about the role of platelet (PLT) number and function in nonalcoholic fatty liver disease (NAFLD). NAFLD patients have abnormalities of PLT number and function, especially mean platelet volume (MPV) which is known as a novel biomarker for atherosclerosis. We decided to compare PLT number and function between NAFLD and healthy participants.
    Materials And Methods
    In this case–control study, two groups of patients (65 cases with NAFLD and 65 cases without NAFLD) were included consecutively. Te diagnosis of NAFLD was made using ultrasound examination of the liver. Venous blood samples were taken, and the required laboratory markers including PLT number and function (MPV, platelet distribution width [PDW]), prothrombin time (PT), partial thromboplastin time (PTT), lipid profile, hepatic transaminases, ferritin, and fasting blood sugar were assayed.
    Results
    Mean (± standard deviation [SD]) MPV in NAFLD group (10.29 ± 0.95 fL) was significantly higher than in control group (9.56 ± 1.18 fL); P
    Conclusion
    Higher MPV was found to be significantly associated with NAFLD. However, such significant association was not detected regarding PLT count or PDW. As MPV is a reported risk factor for atherosclerosis, this marker may be useful in follow-up of patients with NAFLD. Tese findings provide basis for further studies to address this marker in long-term follow-up of NAFLD patients.
    Keywords: Blood platelets, mean platelet volume, nonalcoholic fatty liver disease
  • Kianoush Saberi, Mehrdad Salehi, Mehrzad Rahmanian, Ali Reza Bakhshandeh, Gholam Reza Massoumi Page 8
    Background
    Acute kidney injury (AKI) can happen due to different factors such as anemia. Packed cell (PC) transfusion is an important cause of AKI occurrence. Te aim of the study is to investigate whether appropriate blood component (BC) therapy can reduce blood transfusion and it would result in AKI decreasing.
    Materials And Methods
    We conducted a cohort study of 1388 patients who underwent cardiac surgery in one university hospital. A serum creatinine higher than 2 mg/dl, renal disease history, renal replacement therapy (chronic dialysis) were our exclusion criteria.
    Results
    from our 1088 samples, 701 (64.43%) patients had normal kidney function, 277 (25.45%) were in the AKI-1 group, 84 (7.72%) had an AKI-2 function, and the rest of patients were classified as end stage. A mean of more than three PC units were transfused for the second and third stage of AKI, which was significantly higher than other AKI groups (P = 0.009); this higher demand of blood product was also true about the fresh frozen plasma, platelet, and fibrinogen. However, there were no needs of fibrinogen in the patients with normal kidney function. Te cardiopulmonary bypass time had an average of 142 ± 24.12, which obviously was higher than other groups (P = 0.032). Total mortality rate was 14 out of 1088 (1.28%), and expiration among the AKI stages 2 and 3 was meaningfully (P = 0.001) more than the other groups.
    Conclusion
    A more occurrence of AKI reported for the patients who have taken more units of blood. However, BC indicated to be safer for compensating blood loss because of low AKI occurrence among our patients.
    Keywords: Anesthesia, creatinine, whey protein supplements
  • Seyed-Hossein Abtahi, Mohammad-Ali Abtahi, Seyed Ali Akbar Mortazavi, Hamidreza Jahanbani-Ardakani, Mehdi Mazloumi Page 9
  • Saurabh Rambiharilal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy Page 10
  • Ramachandran Vignesh, Chinnambedu Swathirajan, Sunil Solomon, Suniti Solomon, Pachamuthu Balakrishnan Page 11