فهرست مطالب

Medical Council - Volume:3 Issue: 4, Autumn 2020

Journal of Iranian Medical Council
Volume:3 Issue: 4, Autumn 2020

  • تاریخ انتشار: 1399/12/24
  • تعداد عناوین: 9
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  • Ahmad Shamabadi, Shahin Akhondzadeh * Pages 175-176

    More than a year after the onset of the coronavirus outbreak, the number of worldwide daily deaths reported from coronavirus disease 2019 (COVID-19) has remained significant (1). From the outset, efforts have been made to find effective preventive measures, legislation, appropriate treatments, and vaccines. These days, despite improving discipline and protocols, the effectiveness of some treatments, and preventive measures, the number of reported confirmed deaths per day has reached about 15,000 (1). While the virus has so far infected all countries and caused great harms to all societies, sparks of hope have emerged with the limited start of vaccination (2).

  • Omid Dadras, Nazanin Shahrokhnia, Sarina Borran, Ali Asadollahi Amin, Seyed Ahmad Seyed Alinaghi * Pages 177-186

    Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has been declared as a pandemic on March 11th 2020 by the WHO. Morbidity and mortality of COVID-19 has been shown to be high among patients with underlying diseases. In this narrative review, searching a number of electronic databases (PubMed, Google Scholar, Scopus, and Science Direct), 127 related articles written in English were retrieved and of which 73 articles related to risk factors affecting morbidity and mortality of COVID-19 were extracted and summarized. Factors such as old age, male gender and working in health setting were associated with higher morbidity and mortality. Hypertension was the most frequent reported condition among those with severe disease. It also appeared to increase the mortality and duration of hospitalization. Diabetes, respiratory chronic illnesses (COPD, asthma), impaired liver and renal function, and malignancies were also mentioned as the risk factors for severe disease, longer hospitalization, poor prognosis and outcome. Some laboratory findings such as elevated D-dimer, CRP, and LDH as well as severe lymphopenia were associated with severity, mortality and poor outcomes in hospitalized patients. All in all, a considerable number of comorbidities and biomarkers are associated with severity and presentations of COVID-19 disease, affecting its morbidity and mortality rates.

    Keywords: COVID-19, Morbidity, mortality, risk factors, SARS-CoV-2
  • Omolbanin Paknejad, Akram Shiri, Zeinab Naderpour * Pages 187-192
    Background

    The purpose of this study was to evaluate the implementation of GOLD guideline in patients with an acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD). 

    Methods

    In a cross-sectional study, all patients with COPD exacerbation referred to Shariati hospital from January 2014 to March 2015 were investigated. The level of adherence to GOLD guideline in three areas of hospital admission, therapeutic components of inpatient management (pharmacologic treatments, respiratory support) and discharge plan was assessed via reviewing patients’ medical profile. Each subject was classified as complete, non-complete and not evaluated in terms of adherence to the guideline.

    Results

    In this study, 125 patients with mean age of 67.64±1.71 years including 100 (80%) males were studied. Also, 104 and 21 patients were hospitalized in pulmonology and general medicine wards, respectively. In the present study, the adherence to GOLD recommendations for hospital admission, pharmacologic treatment and non-pharmacologic management were 92, 97.6 and 44.2%, respectively. Despite the high level of adherence to pharmacologic management, total adherence to non-pharmacologic interventions was poor.

    Conclusion

    Although high level of adherence to pharmacological management of COPD was observed, there was overtreatment particularly in case of antibiotics prescription. In addition, non-pharmacological management was not considered in over half of the patients.

    Keywords: Anti-bacterial agents, Chronic Obstructive Pulmonary Disease, Hospitalization, Humans
  • Mehrnaz Rasoolinejad, Ali Asadollahi Amin, Omid Dadras *, Alieh Pourdast, Syyedmohamad Ghavam, Seyedahmad Seyedalinaghi, Masoud Jafari, Malihe Hasannejad, Banafsheh Moradmand-Badie Pages 193-199
    Background

    There has been a significant decrease in HIV-related mortality following the introduction of antiretroviral therapies. This increase in life expectancy has caused an increased risk of cardiovascular and metabolic diseases. Lipid metabolism could be affected by the virus itself or antiretroviral medications. In this study, an attempt was made to investigate the effect of first- and second-line HIV medications on lipid profile in HIV/AIDS patients.

    Methods

    The present study is a retrospective cohort study. The medical records of 66 AIDS patients older than 18 years, who referred to the Behavioral Counseling Center of Imam Khomeini Hospital during the years 2009 to 2014, were retrieved. The patients were assigned into two groups including first- (36 patients) and second-line (30 patients) treatment groups. To ensure that the patients’ baseline information was matched, demographic information and baseline lipid profile were compared between two groups and no significant difference was found between them. To examine and compare the effect of HIV medications on lipid metabolism, patients’ lipid profile at the baseline and 6 months after treatment was compared.

    Results

    The results showed that only triglyceride level was significantly affected by the type of HIV medication regimen (p <0.05). It was significantly higher in second-line medication group. Although the lipid profile (Cholesterol, HDL, and LDL levels) showed an overall increase over the course of treatment in both groups, it was not statistically significant.

    Conclusion

    In both groups, following antiretroviral medications (the first-and second-line), lipid profiles increased. Moreover, the triglyceride level was higher in second-line medications. Therefore, early screening and lipid lowering agents should be considered in HIV/AIDS patients receiving the retroviral medications in long term to prevent further cardiovascular complications.

    Keywords: Acquired immunodeficiency syndrome, Anti-retroviral agents, Cholesterol, HDL, HIV infections, Triglycerides
  • Elham Shirali, Mitra Modarres Gilani, Fariba Yarandi, Omid Hemmatian, Azar Ahmadzadeh, Zohre Kazemi, Marjan Ghaemi * Pages 200-204
    Background

    Endometrial cancer usually occurs at postmenopause stage of life but its incidence in younger patients is increasing in the last decades. The objective of the study was to evaluate the ovarian preservation in the early stage of endometrial cancer.

    Methods

    In this cross-sectional study, 174 patients with endometrial cancer who underwent Total Abdominal Hysterectomy (TAH) and Bilateral Salpingo-oophorectomy in 5 years were included.

    Results

    The results showed that 51.1% of the patients were at stage IA, 28.7% at stage IB, 6.9% at stage II, 11.5% at stage III and 1.7% at stage IV of endometrial cancer when they underwent surgery. One patient (1.12%) at stage IA of endometrial cancer, one patient (2%) at stage IB and one patient (8.3%) at stage II had micrometastasis in ovaries, and 8 patients (40%) at stage III and 2 patients (66.6%) at stage IV had micrometastasis and co-existing tumor.

    Conclusion

    In conclusion, findings revealed the high safety of ovarian preservation in endometrial cancer at earlier stages of the endometrial cancer with low risk of ovarian involvement.

    Keywords: Endometrial neoplasms, Hysterectomy, Fertility preservation, Salpingo-oophorectomy
  • Hamideh Shajari, Ahmad Shajari *, Mohammad Golshan Tafti, Reza Samaninejad Pages 205-210
    Background

    Kidney stones are one of several serious health problems in childhood that cause nutritional and growth disorders, and may finally lead to chronic kidney failure in this group.

    Methods

    In this analytical study conducted through a case-control design, 30 children under the age of two with kidney stones, and 125 children of the same age and sex without stones were studied. Patient information including personal profile and the results of some necessary tests were extracted from patient records and listed in a checklist. The data was analyzed using SPSS (Version 17.0). Statistical significance was considered when p-value was <0.05.

    Results

    In terms of duration of breastfeeding, a significant difference was observed between the patients with stones and patients without stones; the duration of breastfeeding was longer in the control group (p=0.003). In addition, the duration of feeding with formula milk and cow milk was longer in the case group (p=0.038 and p=0.012, respectively).

    Conclusion

    Breastfeeding can serve as a nutritional factor that plays a preventive and protective role against the formation of kidney stones in infants.

    Keywords: Animals, Breast feeding, Child, Infant, Kidney stone, Milk
  • Rahim Badrfam, Atefeh Zandifar * Pages 211-213

    Since the identification and global spread of COVID-19 in Wuhan, China to date (1 September 2020), more than 26,506,670 people worldwide have been infected with the disease and more than 876,677 people have died of the disease (1). Observing what has happened during this period and paying attention to the way governments have dealt with this recent situation in the long run have raised serious concerns about slow and late steps of governments from the beginning of the spread of the disease (2).

  • MirFarhad Ghalehbandi, Fahimeh Saeed, Fatemeh Kashaninasab * Pages 214-215

    During COVID-19 pandemic, factors such as incidence of uncontrollable conditions, uncertainty of the future, and changes in daily life patterns affect the mental and physical health of individuals. Anxiety, depression, and stress caused by the pandemic can significantly change the quality of sleep in people. Some studies have shown that young women, individuals with high levels of fear of COVID-19, and people with a history of psychiatric problems are expected to experience sleep problems such as insomnia more severely. Poor sleep can weaken the immune system and make individuals more vulnerable to viral infections. Under these conditions, optimal sleep patterns can help regulate mood, improve brain function, and boost energy during the day. However, maintaining good health is not an easy task in quarantine conditions due to the limitations in social communication and sedentary lifestyle (1,2).The focus of this letter is on mental health of staff, general practitioners, and sleep specialists to educate their patients and people in the community about how to improve quality of sleep and deal with sleep problems during COVID-19 pandemic. The following are some typical suggestions to overcome the negative effects of the current pandemic:

  • AhmadAli Noorbala, Rahim Badrfam *, Atefeh Zandifar Pages 216-218

    During the relatively short period of COVID-19 pandemic, we have witnessed numerous psychiatric and psychosomatic problems among patients with this disease and different groups of people and health care staff (1). Growing concerns about the uncertainty of the situation, along with fear and changes in biological rhythm, have played an important role in the formation of psychosomatic symptoms associated with this disease (2). In addition, increased depression and anxiety and decreased quality of life and well-being in different parts of the world, compared to the time before the recent pandemic, have been reported (3).

    Keywords: COVID-19, psychosomatic care, General Hospital, bed side psychoeducation