فهرست مطالب

Analytical Research in Clinical Medicine - Volume:6 Issue: 2, 2018
  • Volume:6 Issue: 2, 2018
  • تاریخ انتشار: 1397/03/31
  • تعداد عناوین: 7
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  • Fatemeh Pournaghi-Azar, Naser Asl-Aminabadi, Zahra Jamali, Akbar Azami, Kameliya Hazem, Saber Azami-Aghdash, Mohammad Naghavi-Behzad*, Sina Ghertasi-Oskouei, Sajjadi Shirazi, Reza Piri Pages 55-66
    Introduction
    Oral health status is one of the health-related priorities in Iran. The present study was conducted with the aim to systematically review the status of oral health in Iran using the decayed, missing, filled teeth (DMFT) index.
    Methods
    In this meta-analysis, all data available on DMFT were reviewed and 35 published studies were included in the study based on search strategy. To estimate overall DMFT and perform the meta-analyses, Comprehensive Meta-Analysis (CMA) software was used.
    Results
    Of all 876 articles, 35 were included in the study. A total of 21849 individuals were included in the meta-analysis. The overall DMFT index was 3.65 [95% confidence interval (CI), 3.01-4.34]. In addition, this rate was 2.30, 8.60, and 3.85 among children, adults, and children with mental/physical disabilities with (CI 95%, 1.76-2.95), (CI 95%, 6.10-9.60), and (CI 95, 2.98-4.80), respectively.
    Conclusion
    Mean DMFT in the assessed published data was higher than that set forth by the World Health Organization (WHO). Further planning and taking effective preventive measures to improve the oral health status seems necessary.
    Keywords: Oral Health, Decayed-Missing-Filled-Teeth Index, Meta-analysis, Iran
  • Heydar Ali Esmaeili, Tala Pourlak, Alireza Salehi, Farid Karkon Shayan, Zohreh Sanaat, Gilda Gazi Soltani, Sepideh Fattahi* Pages 66-71
    Background
    Cervical cancer is one of the most common malignancies worldwide and a major problem in the healthcare system. Nowadays, the importance of biomarkers in the diagnosis of malignancies is proven. Some studies have pointed to the role of P16 in the diagnosis of cervical cancer. The purpose of this study was to compare the nucleic reactivity with P16 antibody in atypical vs normal endocervical glands.
    Methods
    We enrolled 60 patients who had undergone the hysterectomy due to non-endocervical causes at Alzahra University Hospital of Tabriz University of Medical Sciences to a descriptive-analytical study. We selected 25 patients with atypical endocervical glands and 35 subjects with normal glands based on the pathologic examination using hematoxylin-eosin staining. Then, we assessed the frequency of nucleic reactivity of the tissues with P16 antibody in both groups.
    Results
    No P16 expression was observed in any of the samples from normal subjects. However, only 2 (8.0%) out of 25 samples from the atypical group, were not reactive to the P16 antibody. Also, 20 samples (80.0%) were diffusely stained continuous, whereas three samples (12.0%) were stained locally. Accordingly, in the group with atypical endocervical glands, the reaction with P16 antibody was significantly higher than that of normal endocervical glands (p= 0.001).
    Conclusion
    P16 biomarker may play a role in the pathogenesis and progression of cervical cancer and can be used as a diagnostic marker for this purpose.
    Keywords: cervical cancer, P16, normal glands, atypical glands
  • Frank Kiwanuka*, Ronald Masaba Pages 72-79
    Introduction
    Patients with cancer often experience mild to severe pain. Therefore, effective pain assessment and management is paramount to this patient sub-population. This study sought to assess the knowledge, attitude, and practices associated with pain assessment among nurses at Uganda Cancer Institute (UCI), Mulago National Referral Hospital, Kampala, Uganda.
    Methods
    This descriptive cross-sectional study was conducted at UCI among 67 randomly selected nurses. Statistical analysis was performed using SPSS software.
    Results
    The mean age of the respondents was 26 years with the standard deviation (SD) of 2.46. The average knowledge scale score was 12 (range: 0-16), indicating good knowledge of pain assessment. Nurses’ average attitude scale score was 9 out of a total score of 12, indicating a positive attitude towards pain assessment. Practices included use of standardized pain assessment tools (61.2%), patient observation (41.8%), documentation (94.0%), and administration of analgesics (56.7%). Most common assessment tool used was the verbal rating scale (32.8%). Pain assessment findings were rarely discussed (52.2%) during nurses’ reports.
    Conclusion
    Nurses’ knowledge, attitude, and practices of pain assessment and intervention are essential components in promoting patient comfort; continuous professional development and research in this area is needed.
    Keywords: Knowledge, Attitude, Professional Practice, Neoplasms, Pain Measurement, Nurses
  • Mohammad Reza Ghaffari, Seyyed Ali Asadi Tahaa, Behnaz Ghamari, Sepideh Karkon Shayan, Roya Feizollahi, Farid Karkon Shayan* Pages 80-85
    Introduction
    Central venous (CV) line is one of the most common methods of central venous pressure (CVP) measurement and hemodynamic monitoring among patients admitted to the intensive care unit (ICU). However, its complications are not rare and are life-threatening in some cases. Recently, transesophageal duplex is frequently used to monitor the cardiac output (CO) and intravascular fluid volume of patients admitted to ICU. The present study was conducted aiming to assess noninvasive hemodynamic monitoring and hypotension management with transesophageal doppler among mechanically-ventilated patients.
    Methods
    In this descriptive cross-sectional study, 25 patients admitted to the ICU of Imam Reza Hospital, Tabriz, Iran, were studied. CV line had been inserted into the body of the patients prior to the study for various reasons. CO was measured using esophageal duplex and also transthoracic echocardiography (TTE), and CVP was determined via esophageal duplex and CV line findings.
    Results
    Mean CO of the patients was 4.88 ± 0.61 and 4.86 ± 0.59 l/minute measured by esophageal duplex and TTE, respectively. Hence, the difference was not statistically significant between the two methods. The mean CVPs of the patients measured by esophageal duplex and CV line were 4.94 ± 1.15 and 4.54 ± 1.04 mmHg, respectively. In addition, the left ventricular (LV) filling pressure measured by Oesophageal Doppler Monitoring (ODM) and by TTE was 9.28 ± 2.66 and 9.28 ± 2.66 mmHg, respectively. The difference for both of the mentioned variables was statistically significant but clinically negligible.
    Conclusion
    Based on the results of this study, esophageal duplex as a less invasive, safe and precise method can replace the use of CV line among patients undergoing mechanical ventilation. This will help clinicians to obtain accurate haemodynamic data from critically ill patients and avoid unexpected complications imposed by CV line insertion.
    Keywords: Doppler Echocardiography, Monitoring, Haemodynamics, Central Venous Pressure
  • Ronak Benisi, Zhinous Bayat-Makoo*, Haedeh Mobaiyen Pages 86-92
    Introduction
    Community acquired Pneumonia (CAP) is a common respiratory disease and a common health problem that causes many deaths annually and has burden of costs on health care system. Prognostic factors can be used for assessing and treating patients with CAP. The aim of the present study was to evaluate prognostic factors and outcome of patients hospitalized with CAP in infectious diseases centers.
    Methods
    In a retrospective-descriptive study, 236 patients with CAP who referred to Imam-Reza and Sina hospitals of Tabriz University of Medical Sciences, Tabriz, Iran, during 2011-2013, were studied. Age, sex, comorbidities, rate of mortality, and laboratory results of patients were evaluated. P value considered statistically significant when ≤ 0.05 for statistical analysis.
    Results
    The mean age of patients was 68.7 ± 18.9 years, and male to female ratio was 1 to 1.02. The mean duration of hospitalization was 8.0 ± 4.6 days and mortality rate of patients was 11.9%. Increase in heart rate (r = 0.406, P = 0.001), and respiratory rate of patients (r = 0.154, P = 0.018), pleural effusion (r = 0.313, P = 0.001), increase in blood urea level (r = 0.271, P = 0.001), and increase in creatinine level (r = 0.226, P = 0.001), had significant correlation with mortality rate of patients.
    Conclusion
    Based on the findings of the present study, heart rate, respiratory rate, pleural effusion, blood urea level, and creatinine level had significant correlation with mortality rate of patients with CAP. Lung disease, heart disease, and diabetes were the most common comorbid conditions in these patients.
    Keywords: Community-Acquired Infections, Prognostic Factors, Mortality, Prognosis
  • Alireza Barband, Farzad Kakaei, Reza Javadrashid, Mehrangiz Ebrahimi-Mameghani, Mohammadreza Mafi* Pages 93-97
    Introduction
    Gastric cancer is one of the relatively common malignancies all over the world, and is one of major problems of health care system. Nowadays, importance of cachexia is demonstrated in prognosis of various malignancies. The aim of the present study was to evaluate frequency of cachexia index and its relationship with resection operability in patients with gastric adenocarcinoma.
    Methods
    In a descriptive-analytical study, 36 patients with gastric adenocarcinoma who referred to Imam Reza and Sina educational medical centers of Tabriz University of Medical Sciences, Tabriz, Iran, for surgery procedures, were included and evaluated in the study. Skeletal muscle index (SMI) was calculated using computed tomography (CT)-scan before performing surgery, patients’ cachexia index was calculated by the following formula: . Cachexia syndrome, patients’ weight loss, resection operability, and cachexia index were evaluated in patients. R
    esults: Among 36 patients whom were studied, 25 patients (69.4%) were men, and 11 patients (30.6%) were women. Cachexia was seen in 5 patients (13.9%). In terms of gastrostomy operability, 26 patients (72.2%) were operable, and 10 patients (27.8%) were non-operable. Gastrostomy operability in patients with cachexia were significantly less than patients without cachexia syndrome (P = 0.001). No significant differences were seen in cachexia index of operable and non-operable patients (P = 0.105).
    Conclusion
    Based on the findings of the present study, gastrostomy operability in patients with cachexia was significantly less than patients without cachexia syndrome; but operable and non-operable patients do not have significant differences in cachexia in comparison to each other.
    Keywords: Stomach Neoplasms, Adenocarcinoma, Cachexia
  • Nasser Malekpour, Sara Basharat*, Trife Bakhshi Pages 98-101
    Introduction
    Appendicitis is the most common emergency surgical admission regardless of the age group. In case of delay in diagnosis, serious complications may occur, needing immediate actions. Complications of acute appendicitis like perforation, peritonitis, and sepsis are to justify massive negative appendectomies. In this study, it has been tried to collect data about negative appendectomy during last 5 years in Modarres hospital, Shahid Beheshti University of Medical sciences, Tehran, Iran, based on demographics and correlation with diagnostic studies before operation. This study is important in terms of economy and health care aspects.
    Methods
    Data were collected about all patients appendectomized during 5 years between 2012 and 2017 at Modarres hospital. There were 1454 records, of which 108 records were excluded from the study due to the lack of enough data, interval appendectomy, and clean appendectomy. Finally, end 1346 appendectomies were assessed.
    Results
    There were 275 (20.4%) and 1071 (79.6%) negative appendectomy and suppurative appendicitis, respectively. Preoperative ultrasonography (US) was performed on 753 (56.0%) patients, of which 472 (62.7%) and 281 (37.3%) cases were coordinated with and different from pathologic records, respectively. Preoperative computed tomography (CT) scan was performed for 316 (23.5%) patients, which matched and differed pathologic records in 280 (88.6%) and 36 (11.4%) cases, respectively.
    Conclusion
    Diagnosis of appendicitis should still mainly be based on history, and clinical and laboratory data.
    Keywords: Appendectomy, Negative Rate, Medical Imaging