جستجوی مقالات مرتبط با کلیدواژه "treatment" در نشریات گروه "پزشکی"

Obsessive-Compulsive Disorder (OCD) is one of the most common mental disorders that causes many problems in the occupational and social functioning of the patient. In this review article, we have tried to provide a comprehensive study of various areas of this disease, including pathophysiology, diagnosis, and especially OCD treatment strategies. It seems that the optimal treatment option for this disease is drug therapy, and among these, selective serotonin reuptake inhibitors (SSRIs) are of special importance. However, when the severity of the disease is low or moderate, non-pharmacological strategies such as behavioral therapy and sports intervention therapy may be desirable.

Dengue (DEN) virus is a common arboviral infectious disease that poses a significant threat to global public health, putting nearly half of the world's population at risk of infection. It is transmitted by Aedes aegypti and Aedes albopictus mosquitoes. Dengue infection, caused by all four mosquito-borne serotypes (DEN-1 to DEN-4), is endemic in countries with tropical and subtropical climates worldwide. To date, there is no vaccine that provides effective immunity against all DENV serotypes. Additionally, there is limited information regarding the epidemiology and impact of this dangerous disease in regions with recent infection reports. In this study, we aimed to present a summary of the clinical symptoms, pathology, etiology, prevention, and treatment options based on previous studies, to facilitate a better understanding of dengue fever (DF). The results of this study show that the main effects of DF are on vital organs such as the liver (hepatocellular necrosis), lungs (pulmonary edema), kidneys (hematuria and proteinuria), heart (myocarditis), and brain (encephalopathy). These effects can be a major threat to a person's life if diagnosed incorrectly or late. Increasing public awareness through social networks, implementing appropriate waste management systems, removing breeding sites for Aedes aegypti and Aedes albopictus mosquitoes by government institutions, and providing proper laboratory diagnostic and treatment tools for patients with DF are essential solutions that should be prioritized globally.

Femoral artery pseudoaneurysm is a well-known complication after conventional angiography. Today, the treatment of choice for this condition is noninvasive repair using manual ultrasound-guided compression.

This study aimed to evaluate the efficacy of a novel compression device in improving angiography-induced pseudoaneurysm treatment compared to manual ultrasound-guided compression repair. Patients and

A double-blind, randomized clinical trial was performed on patients with femoral angiography-induced pseudoaneurysm in the Radiology Department of Ghaem Hospital, Mashhad, Iran. Based on color Doppler ultrasound exams, patients diagnosed with a pseudoaneurysm within 72 hours of angiography were included in the study. Patients were excluded if they had complete blockage, complete pseudoaneurysm thrombosis, abscess, surface tissue infection, or open wound in the area. The patients were allocated to a manual ultrasound-guided compression group or a device-assisted compression group using simple randomization with a sealed envelope method. After collecting demographic data, the patients underwent an ultrasound exam of the groin to determine and record the size of the pseudoaneurysm and the ratio of thrombosis to open lumen. The therapeutic success rate was defined as complete lumen thrombosis after conducting the compression procedure one to three times. Also, the pain score was measured during compression using the Visual Analog Scale based on a scale of 0 - 10. The duration of successful procedures was also documented. The patients were monitored for 6 hours for any side effects. The level of statistical significance was set at P < 0.05 for all tests.

The study was performed on 22 patients (13 males/9 females) with a mean age of 65.5 ± 3.5 years divided into two groups of device-assisted (n = 11) and manual ultrasound-guided (n = 11) compression repair. The two groups did not differ significantly in terms of demographic variables or initial ultrasound variables associated with the pseudoaneurysm. The device-assisted compression group was found to have lower pain intensity (5.0 ± 1.0 vs. 6.0 ± 0.8; P = 0.024) and a significantly higher success rate (100% vs. 45.5%; P = 0.004) compared to the manual compression group. None of the patients showed any side effects.

This preliminary study showed that the proposed device is completely safe and may improve the success rate while decreasing pain scores during ultrasound-guided compression procedures. Using a large multicenter study design, evaluating the efficacy of the novel device for hemostasis during sheath removal and adding new equipment to the device, such as manometers to apply controlled pressure, are suggested for future studies.

The primary caregivers of children with congenital heart disease (CHD) after cardiac surgery at home are often their mothers. Therefore, the quality of life (QoL) and treatment adherence (TA) of mothers are crucial for the prognosis of these children. This study evaluated the impact of a mobile educational application on the QoL and TA in mothers of children with CHD undergoing cardiac surgery.

This randomized clinical trial was conducted on 72 mothers of children with CHD referred for cardiac surgery to Children’s Medical Center Hospital, Tehran, Iran, from September 2023 to May 2024. Mothers were randomly assigned to intervention (n=36) and control (n=36) groups. The intervention group received the educational app upon discharge and used it for four weeks, while the control group received standard discharge education, which consisted of face-to-face education. Data were collected using a demographic form, the 36-Item Short Form Health Survey (SF-36), and the Modanloo Treatment Adherence Questionnaire at baseline and one month post-intervention. Data were analyzed using SPSS software version 26, with independent t-test, chi-square, and analysis of covariance. A significance level of P<0.05 was considered.

At baseline, no significant differences were observed between the two groups in total score of QoL (P=0.18) and TA (P=0.70). One month post-intervention, the intervention group showed significantly higher total scores in QoL (P<0.001) and TA (P<0.001) compared to the control group.

Using mobile applications in home care education can significantly enhance the QoL and TA in mothers of children with CHD after surgery.Trial Registration Number: IRCT20230816059164N1.

The immunologic factors are the chief reason for recurrent pregnancy loss (RPL) and induction ofmaternal-fetal tolerance is the main treatment for this cause of RPL, but the effect of this method is uncertainly andneeds multiple doses and/or interventions. The aim of this study was to investigate whether a single administrationof transforming growth factor-β1 (TGF-β1) can improve the pregnancy outcomes of RPL mice and whether theimprovement is cause by TGF-β1 driving the expression of immune tolerance molecule indoleamine 2,3-dioxygenase(IDO). In this experimental study, 40 RPL model mice were equally divided into a control group,that received 0.01 M phosphate-buffered saline (PBS), and a treatment group, that received PBS containing 2, 20, and200 ng/ml TGF-β1 via tail vein injection. The mice were sacrificed at 13.5 days of pregnancy and the embryo resorptionrate was determined. The expression of IDO, TGF-β1, and TGF-β3 were detected in the placenta using westernblotting and immunohistochemistry techniques. The expression of IDO was positively correlated with TGF-β1 in the placental tissue of RPL mice (r=0.591,P<0.001). In all treatment groups, the embryo resorption rates were significantly lower than the control group andthe expression of IDO in the placental tissue of all treatment groups was significantly higher than the control group.The expression of TGF-β1 increased gradually from, 2, 20 to 200 ng/ml in treatment groups, and the concentrationof exogenous TGF-β1 positively correlated with the expression of TGF-β1, in placental tissues in treatment groups(r=0.372, P=0.018). Exogenous TGF-β1 improves pregnancy outcomes in RPL mice, and the possible therapeutic mechanismis that exogenous TGF-β1 induces the persistent expression of endogenous TGF-β1 and IDO due to mutuallyinduced expression of the other. This experiment may provide a new direction and idea for the future treatment ofRPL patients.

Pregnancy striae, or stretch marks, are highly prevalent and often a source of cosmetic concern for many women, presenting challenges in both prevention and treatment.

This study aimed to evaluate the effect of vitamin D cream on pregnancy striae in the thigh area of first-time pregnant women.

This triple-blind randomized clinical trial involved 60 primigravida women, aged 18 - 20 weeks, referred to Shahid Akbarabadi Hospital in Tehran, Iran, in 2022. Using blocked randomization, participants were assigned to two groups: The vitamin D cream intervention group (30 women) and the basic cream placebo group (30 women). Each cream was applied daily for 4 months, twice daily with a 12-hour interval. The severity of striae was assessed using the Atwal Scale before the intervention and at 4, 8, 12, and 16 weeks after the intervention commenced. Data analysis included descriptive statistics (frequency, minimum, maximum, mean, and standard deviation) and inferential statistics (chi-square, Fisher’s exact test, independent t -test, and Mann-Whitney test).

At the fourth, eighth, twelfth, and sixteenth weeks, the incidence of striae was as follows: Vitamin D group: 96.2%, 92.3%, 92.3%, and 88.5% without striae and 3.8%, 7.7%, 7.7%, and 11.5% with moderate erythema, respectively. Placebo group: 83.33%, 83.33%, 83.33%, and 66.67% without striae and 16.67%, 16.67%, 16.67%, and 33.33% with moderate erythema, respectively. No significant difference was found between the two groups regarding the severity of pregnancy striae at all follow-up times.

Over the 4-month follow-up period, vitamin D cream did not demonstrate greater effectiveness than placebo in preventing or reducing the severity of pregnancy striae in the thigh area.

Cold Ceramic (CC) is designed to meet the ideal criteria for root filling materials, offering effective sealing, biocompatibility, non-toxicity, dimensional stability, insolubility in tissue fluids, radiopacity, and ease of handling. It sets in the presence of moisture, making it suitable for various endodontic applications such as root-end filling, root perforation repair, apical barriers in teeth with open apices, and pulp capping. This study aims to evaluate cold ceramic’s clinical outcomes and applications as presented in case reports.

A comprehensive literature search was conducted to identify published case reports and case series on the clinical application of cold ceramics in endodontics from January 2000 to April 2024.  Databases searched included PubMed, MEDLINE, Scopus, Web of Science, Cochrane Library and Google Scholar. The search terms used were “cold ceramic,” “bio ceramic,” “endodontics,” “case report,” “clinical outcomes,” and “dental materials”. Articles in English and Persian were included. Patient demographics, cold ceramic brand, clinical procedures, outcomes, follow-up periods, and any complications were extracted. Quality assessment of the included case reports was performed using the CARE guidelines.

After removing duplicates and screening titles and abstracts, 7 case reports and 2 case series met the inclusion criteria. The reviewed case reports included 16 patients (9 female and 7 male) with a mean age of 29.25±1.2. Clinical outcomes were generally favorable, with high success rates and minimal complications reported.

All cases demonstrated radiographic and clinical healing and an absence of postoperative pain or infection during follow-up periods ranging from 3 months to 4 years. cold ceramics provide promising success rates and negligible complications in various clinical endodontic scenarios.

A tailored therapy for vitiligo is crucial in enhancing patients' quality of life and decreasing the associated dimensions. In addition, statins play a significant function in modulating the immune system.

This study investigated the efficacy of oral simvastatin in treating skin lesions in patients with vitiligo.

This interventional randomized clinical trial enrolled 50 vitiligo patients referred to Shahid Faghihi Hospital in Shiraz (Iran) in 2015. Participants were divided into control and intervention groups using block randomization. Participants in the control group received “NB-UVB phototherapy plus placebo,” and those in the intervention group received “NB-UVB phototherapy with 40, 60, and 80 mg simvastatin by a monthly increase in the drug dosage”. A reduction in the Vitiligo Area Scoring Index (VASI) score and side effects were measured for four months, and the results were compared between the two groups.

At the start of the study, the mean score for the disease severity was equal for both groups (P ˃ 0.05). However, the disease severity was significantly reduced in the following stages of the study in the simvastatin group compared to the placebo group (P = 0.0001).

Oral simvastatin enhances the photothermal outcomes while exerting trivial side effects. Thus, combining oral simvastatin with phototherapy is recommended as a potent strategy for treating patients with vitiligo.

Context: 

Acne is a common skin condition characterized by chronic inflammation of the pilosebaceous unit. Increased sebum production is a key component of acne pathogenesis. Various therapies are available for acne, including topical, systemic, and physical treatments. Botulinum toxin is increasingly used in facial cosmetic procedures. Observations suggest that botulinum toxin type A (BoNT-A) may reduce sebum levels in the face. This finding could potentially lead to the development of a new treatment for oily skin and acne.

Evidence Acquisition: 

A retrospective literature review was conducted by searching the PubMed, Web of Science, EMBASE, and SCOPUS databases using keywords such as "acne," "acne treatment," "oily skin," and "botulinum toxin type A." The review focused on studies that assessed the impact of BoNT-A on patients with acne vulgaris and oily skin, as well as studies that measured skin sebum levels and pore size following BoNT-A application.

Nine studies were reviewed. Of these, two evaluated the effects of BoNT-A on 30 and 35 patients with acne vulgaris. Four studies assessed sebum reduction in 20, 50, 42, and 20 patients. Three studies evaluated both sebum reduction and pore size tightening in 10, 25, and 20 patients. Eight studies demonstrated that the application of BoNT-A has a positive effect on patients with acne and reduces sebum production in facial skin. Only one study, which evaluated both sebum reduction and pore size tightening, found no significant effect. Overall, the studies indicate that BoNT-A application can positively impact acne and reduce facial sebum production. Specifically, intradermal application of BoNT-A at low dosages can help reduce acne, sebum production, and tighten pores.

BoNT-A shows promise as a treatment for acne and oily skin. While cost-effectiveness may be a challenge for some patients, the benefits of BoNT-A make it a treatment option worth considering. With further studies to optimize dosages and determine the longest duration of efficacy, BoNT-A has the potential to revolutionize the treatment of acne and oily skin.

To identify the effect of Iron as a preventive and therapeutic agent on depression and other hematological indices by a systematic review and meta-analysis.

International databases like Web of Science, PubMed, Cochrane,  International Clinical Trials Registry Platform, Clinicaltrials.gov, and Scopus were searched until 27 July 2024 to identify eligible articles with the appropriate Medical Subject Headings (MeSH).  The risk of bias tool for randomized trials (RoB 2) was used for precise assessment.  Heterogeneity was determined using Cochran’s Q-test and the I2 index. To assess source of heterogeneity, meta-regression was used. The pooled standardized mean difference (PSMD) was calculated by considering the random effects model.

of 2154 studies,14 studies were included in systematic review and 6 studies were excluded from analysis due to lack of data for calculating PSMD and finally, 8 studies were included in meta-analysis. Based on the results, iron therapy led to improvement in depression symptoms (PSMD = -0.18; 95% CI: -0.32 to -0.03). The iron therapy led to increasing the blood level of Iron (PSMD = 0.57; 95% CI: 0.19 to 0.95), Ferritin (PSMD = 0.55; 95% CI: 0.25 to 0.85), HCT (PSMD = 0.40; 95% CI: 0.18 to 0.61), MCV (SMD = 0.67; 95% CI: 0.18 to 1.15) and Transferrin saturation (PSMD:0.26; 95% CI: 0.02 to 0.50). Based on the meta-regression result, the sample size, participant age, and publication year had no significant role in heterogeneity between studies.

The use of iron supplements in patients with depression can be considered. However, there is a need to conduct further studies involving various kinds of depression.

Retinal artery occlusion (RAO) is a well-characterized ischemic ophthalmic event that may result in sudden and devastating vision loss. The etiology of RAO may vary including both arteritic and non-arteritic causes and the location of the lesion can extend from the ophthalmic artery to the branches of the central retinal artery. Given this variable causes of RAO, the clinical presentation and extent of vision loss may also differ from case to case, necessitating a prompt and thorough evaluation, including a full stroke work up. While there is currently no widely accepted standard for the treatment of RAO, there are several proposed methods that have been or are currently being investigated through retrospective studies and prospective trials. The current article aims to provide a review of the pathophysiology, clinical presentation, and management of RAO in addition to presenting a systematic review of recently published studies on treatment options for RAO.

The COVID-19 pandemic has significantly affected people's lives and healthcare systems worldwide. Therefore, it is important to determine its effects on the economic and health sectors. This study aimed to calculate and analyze the costs and outcomes of COVID-19 treatment, including mortality and recovery, to improve health system planning. This cross-sectional descriptive study analyzed the costs and consequences of COVID-19 treatment in one of the largest referral training centers for patients in Lorestan province, Iran. The study examined hospital documents from the beginning of January to the end of December 2022. The results showed that the recovery rate of patients was approximately 87%, and the average cost per patient was 161 USD. More than 70% of this cost was related to medication and hospital bed expenses. Lopinavir was the most prescribed medication, and Immunoglobulin and Remdesivir had the highest cost share among all medication expenses. Given the significant proportion of medication and hospitalization expenses, it is recommended that the new approach to prescribing medications and managing patient care should be centered around standardized treatment protocols and home-based care. This is particularly crucial in developing countries with limited resources and clinical evidence. It is important to note that the calculation of standard treatment costs has limitations and should be interpreted cautiously.

Context: 

Polycystic ovary syndrome (PCOS) is a neuroendocrine metabolic disorder, one of the symptoms of which is irregular menstrual cycles. Polycystic ovary syndrome treatment using chemical drugs has been effective, however, PCOS patients have received effective results from herbal treatment

Scopus, PubMed, Google Scholar, Crossref and Hinari databases were searched for the effect of medicinal plants in the treatment of polycystic syndrome.

The results showed that medicinal plants and their active substances are effective in the treatment of polycystic syndrome.

This study showed that the search and isolation of effective substances in plants can be a good treatment alternative for polycystic syndrome.

Artificial intelligence (AI) can play a significant role in the future of thyroidology. Thyroid nodules are common conditions that may benefit from AI through more accurate and efficient diagnosis, risk stratification, and medical or surgical management.

This paper aims to review the latest developments in AI applications for diagnosing and managing thyroid nodules and cancers.

English full-text articles published in the PubMed and Google Scholar databases from January 2014 to March 2024 were collected and reviewed to provide a comprehensive understanding of the topic. A total of 45 studies were selected based on relevance, robust methodology, statistical significance, and broader topic coverage.

Artificial intelligence has emerged as a powerful tool for managing thyroid nodules. First, several studies have demonstrated how AI-powered ultrasound interpretation enhances the diagnosis and classification of nodules while reducing the need for invasive fine-needle aspiration (FNA) biopsies. Second, AI significantly improves the cytopathological differentiation between benign and malignant thyroid nodules by minimizing reliance on pathologists' expertise and implementing standardized diagnostic criteria. When cytopathology is inconclusive, AI also aids in identifying molecular markers from omics data, distinguishing between normal and cancerous cells. Moreover, AI tools have been developed for prognosis assessment, predicting distant metastasis, recurrence, and surveillance by integrating medical imaging features with molecular and clinical factors. Additionally, some AI tools are designed for intraoperative evaluation, improving surgical techniques and reducing complications during thyroidectomy. In non-surgical treatments, several models have been developed to optimize therapeutic doses of radioactive iodine (RAI) and predict the outcomes of new drug formulations.

Artificial intelligence has the potential to assist physicians in accurate thyroid nodule diagnosis, classification, decision-making, optimizing treatment strategies, and improving patient outcomes. However, there are still limitations to this technology. Artificial intelligence-driven tools require further advancements before they can be fully integrated into clinical practice and replace specialists.

Schwannomas are typically benign tumors with a low likelihood of becoming malignant. Approximately 4% of schwannomas occur in the nasal passages, leading to gradual enlargement, cosmetic issues, and sensory disturbances. Common symptoms include nasal congestion and headaches. Nasal tip schwannomas are particularly rare, with only a few cases documented. This report presents a case of nasal tip schwannoma, detailing the symptoms, diagnostic process, and treatment provided.

A 14-year-old girl was referred for evaluation of a nasal lump that altered the appearance of her nose. She reported mild pain and numbness in the nasal area. Upon examination, a mobile lump was identified beneath the skin and inside the nasal cavity, with no other abnormalities noted. Preoperative imaging revealed a well-defined soft tissue mass without infiltration into surrounding structures. During an open rhinoplasty procedure, 17 nodules were excised to correct nasal deviation. Pathology confirmed a benign schwannoma. The surgery was successful, and after nine months, the patient maintained a stable nasal appearance and reported symptom relief. No complications or recurrences were observed, preserving the aesthetic outcome.

Nasal tip schwannoma is an uncommon condition that is diagnosed through imaging studies and confirmed by histopathology. Accurate diagnosis requires careful review of the patient’s medical history, a thorough physical examination, and relevant diagnostic tests. This comprehensive approach is essential for timely and precise diagnosis of rare nasal conditions, including differential diagnoses such as hemangioma.

Male breast cancer (MBC) is a rare type of cancer that affects men, accounting for only 1% of all cancers in men and all breast cancer cases worldwide. Its rarity is due to the differences in male endocrine function and the smaller amount of mammary tissue in males. Due to its infrequency, there is limited knowledge about the disease, and treatment recommendations are often based on extrapolation from clinical trial data involving female breast cancer patients. Men with MBC typically present in their 50s or older and may mistake a suspicious breast mass for a benign condition called gynecomastia. Various known risk factors contribute to breast cancer in men. Currently, there are no international randomized control trials (RCTs) specifically focused on MBC, and management guidelines are primarily derived from studies conducted among female patients. Localized and resectable cases of breast cancer typically require surgical intervention, followed by radiotherapy, chemotherapy, hormonal therapy, or potentially utilizing recent advancements in immune-oncology agents. A comprehensive approach that involves a multidisciplinary team ensures appropriate treatment and can lead to favorable outcomes. However, screening for MBC is limited due to the lack of large-scale international RCTs demonstrating its effectiveness in reducing MBC-related mortality.

Head and neck cancer treatment often leads to stomatitis, influenced by multiple factors. Mouthwashes, with diverse formulations, offer potential therapeutic benefits. This study examines the relationship between stomatitis severity improvement post-radiotherapy and mouthwash use, considering patient characteristics like gender, age, duration, and dosage.

A systematic review (2015–2023) evaluated mouthwash efficacy for radiotherapy-induced stomatitis. Searches in PubMed, Scopus, Web of Science, and Cochrane Library identified clinical trials, cohort, and case-control studies. Inclusion criteria focused on mouthwash effectiveness; quality was assessed using the Jadad scale.

Out of 480 screened studies, 16 met inclusion criteria. Traditional antiseptic mouthwashes (e.g., chlorhexidine) reduced infection risk but had mixed effects on pain and inflammation. Specialized formulations (e.g., aloe vera, honey, benzydamine) improved pain relief and mucosal healing. Combination therapies showed the best outcomes, though study variability limited conclusions.

Mouthwashes, from antiseptics to specialized formulations, show potential for managing stomatitis. Antiseptics reduce infection, while specialized products aid pain relief and healing. Personalized interventions and further research are needed to optimize formulations for diverse patients.