مجله پزشکی بالینی ابن سینا
سال بیست و هفتم شماره 2 (پیاپی 96، تابستان 1399)

Hypotension is a common complication of cesarean section with spinal anesthesia, which can be dangerous for both mother and neonatal. The aim of this clinical trial study was to investigate the effect of using bandaging on the lower limbs in preventing of post spinal hypotension in cesarean section.

This prospective clinical trial study was performed in 2019-2020 at Fatemieh Hospital in Hamadan. A total of 64 patients undergoing cesarean section with spinal anesthesia were randomly divided into two groups of with bandaging at the time of surgery and without bandaging. Demographic information, hemodynamic status in the first hour after spinal anesthesia, hypotension, nausea and vomiting, bradycardia, tachycardia, atropine levels, ephedrine consumed, was compared in both groups. The data were statistically analyzed by SPSS version 16 software and analyzed.

The mean age of both groups of patients was approximately 30 years (P = 0.958). Hypotension (25 vs. 78.1%), bradycardia (9.3 vs. 15.6%) and intraoperative nausea and vomiting (12.5 vs. 59.4%) in the intervention group with significantly less than the control group. The amount of ephedrine (4.1 3 3.1 vs. 20.6 13 13.2 mg) was lower in the intervention group than in the control group (P = 0.01). In the study of hemodynamic status of systolic and diastolic pressure from 2 to 6 minutes and mean arterial pressure from 2 to 10 minutes after spinal with a significant difference in the intervention group was more than the control group (P<0.05). In other minutes, there was no statistically significant difference in terms of hemodynamic status.

The findings of the present study show that bandaging of the lower extremities with bandaging in cesarean section with spinal anesthesia, which is a cheap and available non-invasive procedure, can be effective in preventing post-spinal hypotension and reducing the use of ephedrine.

Immune-mediated polyneuropathy is divided into acute and chronic categories named as Guillain Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy based on the course of the disease. Although the basic mechanism of these conditions has not been yet clarified, genes that regulate immune responses are putative contributors in their development. The aim of this study was to compare the blood expression level of IL-34 gene between patients with GBS and healthy individuals.

In this case-control study, blood samples were collected from 53 patients with GBS (i.e., 33 chronic patients and 20 acute patients) and 40 healthy individuals. Gene expression levels in the studied groups were measured using the real-time polymerase chain reaction technique. Finally, statistical analysis was performed using SPSS software (version 16) at a significance level of < 0.05 was.

The patient group consisted of 36 (67.93%) males and 17 (32.07%) females. In addition, the healthy control group included 27 (67.5%) males and 13 (32.5%) females. The results showed a significant increase in IL-34 expression in the GBS patients, compared to that in the control group.

The findings of the present study revealed an increase in IL-34 gene expression in patients with GBS. Accordingly, it seems that IL-34 gene has an important role in the pathogenesis of this disease.

 Unwanted pregnancy reduces maternal role and decreases maternal-fetal attachment. Maternal -fetal attachment is the thoughts, feelings, and behaviors that pregnant women express about their fetuses. The aim of this study was to determine the effect of midwifery counseling with cognitive-behavioral approach on maternal-fetal attachment in women with unwanted pregnancy.

This randomizes clinical trial was performed on 96 pregnant women with unwanted pregnancy referred to health centers of Kazerun, Shiraz, Iran, in 2019. The experimental group received 4 training sessions based on the cognitive behavioral counseling during 4 weeks. The control group received only the routine care program. At baseline and immediately after the intervention, both groups completed the demographic and maternal-fetal attachment questionnaire. Data were analyzed using descriptive and inferential statistics (independent t-test and Chi-square test) using SPSS 21.

The study showed no significant difference in total score of attachment (P=0.886) before intervention between the two groups; while after the intervention a significant difference was observed in the score of attachment (P=0.001) between the two groups; that is showed effectiveness of cognitive behavior therapy on promotes on maternal-fetal attachment

Considering the effect of cognitive-behavioral training in promoting of maternal- fetal attachment, it is recommended that this type of educational intervention be integrated into the womenchr('39')s care program with unwanted pregnancies.

One of the important steps in continuing the treatment of patients with mediastinal masses is definitive diagnosis using tissue sampling of the lesion within the mediastinum. One of the methods used for this purpose is mediastinoscopy. In this regard, this study was performed to determine the results of mediastinoscopic surgery in patients with mediastinal mass.

In this descriptive study, the files of all patients who underwent mediastinoscopic surgery in Besat Hospital of Hamadan from 2014 to 2019 were examined.    

Nineteen patients were examined. The mean age of the patients was 50.84 years. Sexual distribution was 11 men and 8 women. In the majority of patients mass was in the anterior mediastinum (16 patients) and in three cases mass was in the median mediastinum. Histopathological results were reported as inflammatory (4 cases), small cell carcinoma (3 cases), lymphoma (2 cases), squamous cell carcinoma (2 cases), metastatic (2 cases), adenocarcinoma (1case), hydatid cyst (1case), tuberculosis (1case), sarcoidosis (1case), anthracosis (1case), and nonspecific (1case) respectively.

In general, it can be concluded that in terms of age and sex variables and place of involvement in mediastinum and surgical complications, the results of this study are similar to other studies, but there are differences in terms of pathology results. It seems that the frequency of malignant masses in our study is higher than other studies.

Medial Knee movement during exercise causes disorder of normal body alignment and import stress on the tissues. Increased knee valgus during exercise is one of the risk factors for lower extremity injuries. With this background in mind, the current study aimed to make a comparison between healthy women and women with dynamic knee valgus in terms of isometric strength of the muscles and the range of motion of the hip.

This case-control study was conducted on 20 healthy female athletes and 20 athletes with dynamic knee valgus who participated in regular exercise for at least 2 years. The maximum isometric strength of extensor, flexor, adductor, abductor, as well as external and internal hip rotators, was measured with a hand dynamometer (kg). Moreover, the active range of motion of extension, flexion, adduction, abduction, as well as hip external and internal rotation, was measured with a standard goniometer (degree). Independent t-test and Multivariate Analyses of Variance were used to determine differences in strength and range of motion between groups.

As illustrated by the obtained results, the group with dynamic knee valgus had less extensor (P=0.006), hip external rotator muscle strength (P=0.029), and hip external rotation range of motion (P=0.005), compared to the healthy group. Nonetheless, no significant difference was observed between other variables in the two groups.

Based on the results of the present study, training programs with a focus on the strength and range of motion of the hip joint can improve the kinematics of the knee joint in the frontal plane.

Dry eye syndrome is a multifactorial ocular surface disease characterized by visual disturbance, irritation, discomfort, and injury. Due to the impact of dry eye on vision function, daily activities, and quality of life, patients with dry eye may experience some levels of depression and anxiety. Therefore, the present study was carried out to investigate the prevalence of depression and anxiety in patients with dry eye syndrome.

This cross-sectional descriptive study was conducted on 113 female patients with the symptoms of dry eye referring to the Ophthalmology Clinic of Farshchian hospital in Hamadan, Iran, within 2018 to 2019. The subjects were evaluated by an ophthalmologist for the symptoms and signs of dry eye using the Schirmerʼs test and tear breakup time. Then, the patients with dry eye syndrome were assessed in terms of depression and anxiety by the Beckʼs Depression Inventory. The data were analyzed using SPSS software (version 16) at a 95% confidence interval.

In this study, the mean age of the patients was 42.90±13.50 years. The frequency rates of mild, moderate, and severe dry eye syndrome were reported as 8.8%, 64.6%, and 26.5%, respectively. The prevalence rates of depression and anxiety (i.e., mild, moderate, and severe) were 28.3% and 54.5%, respectively. There was a positive and significant correlation between the dry eye score with depression (r=0.210; P=0.026) and anxiety (r=0.324; P<0.001).

In patients with dry eye syndrome, a significant correlation was observed between the severity of dry eye and severity of depression and anxiety, requiring further investigation. The results of this study recommend to carry out psychological studies on this group of patients simultaneously with the treatment of dry eye.

Infertility and its treatment is one of the most important challenges that gynecology faced it. This study compares two methods of administration of GnRH agonists and GnRH antagonists on the occurrence of pregnancy.

 This study is a randomized controlled clinical trial. 84 infertile couples with male factor infertility problems referred to Fatemieh Hospital of Hamadan were enrolled in this study and randomly assigned to two groups of 42 cases, the first group treated with agonist GnRH (Bucereline) and the second one treated with GnRH antagonists (Cetrotide). Two groups regarding the incidence of pregnancy, number of oocytes obtained, the average days of induction and the number of fertilized oocytes, the incidence of OHSS syndrome and treatment costs were compared.

Findings showed that the clinical pregnancy rate in the agonist group, 19 cases (45.23%) and the antagonist group, 7 cases (16.67%) has been observed. The difference was statistically significant (P<0.009). Number of fertilized oocytes in agonist group was significantly higher than antagonist (P<0.004) and the average induction days in the antagonist group was significantly lower (P<0.001). The difference between incidence of OHSS syndrome and the overall cost of treatment in both groups was not significant.

We suggested  that the efficacy of agonist drugs in occurrence of pregnancy are much better than antagonist drugs even though the complications do not differ in both groups.

Today, the Internet and Internet addiction are among the most important issues involving the young generation. Regarding the spread of coronavirus disease-2019 (Covid-19) as a destructive factor, this problem has caused mood disorders, anxiety, and aggression, which need proper identification. Therefore, the present study aimed to predict the computer voyeurism and stigma of the first wave of the Covid-19 pandemic based on the dimensions of Internet addiction among young people.

This study was conducted based on a practical, descriptive, and correlational design. The study population included all undergraduate students in Tabriz Branch, Islamic Azad University, Tabriz, Iran. Out of all students, 252 cases were selected to participate in this study through an online voluntarily call due to traffic restrictions. The data were collected using the Yang Internet Addiction Assessment Questionnaire, a researcher-made computer voyeurism questionnaire, and a researcher-made corona stigma questionnaire. The data were then analyzed using Pearson statistical methods and multivariate regression.

According to the results, all dimensions of Internet addiction correlated significantly with the rate of computer voyeurism and Covid-19 stigma. Out of the dimensions of Internet addiction, lack of control, and negligence of professional and educational tasks can predict the extent of changes in computer voyeurism and Covid-19 stigma among young people.

There is a significant relationship between the increased level of Internet addiction and the power of direct prediction of computer voyeurism and youth stigma. With an increase in each of the dimensions of the mentioned variables, the amount of Covid-19 stigma increases, thereby promoting the mood-anxiety disorders among young people.