مجله پزشکی بالینی ابن سینا
سال بیست و هشتم شماره 4 (پیاپی 102، زمستان 1400)

Tinnitus is hearing a sound without an external source, which occurs anywhere in the head and one or both ears. It is one of the most common symptoms associated with hearing loss due to chronic otitis media. This study aimed to determine the effect of autologous primary ossicular reconstruction on the recovery of tinnitus due to chronic otitis media.

This study was conducted based on a before-and-after design and included 25 patients aged 18-70 years with tinnitus and chronic otitis media. The participants had undergone initial reconstruction of the bone chain using an autologous graft in the Department of Ear, Nose, and Throat of the Hamadan Besat Hospital, Hamedan, Iran, in 2019. The Tinnitus Matching Test and the Tinnitus Handicap Inventory were used to assess patients' tinnitus.

A total of 25 patients participated in this study, including 13 (52%) men and 12 (48%) women. The mean scores of the age of the subjects, duration of tinnitus, frequency of tinnitus were obtained at 45.76±12.76 years, 53.25±37.25 months, and 5,000 Hz, respectively. The difference between the mean values of tinnitus loudness was significant before (8 dB) and after the surgery (4 dB) (P<0.001). Moreover, a significant difference (P<0.001) was observed between the scores of the Tinnitus Handicap Inventory before (39.48) and after the surgery (17.84).

Primary reconstruction of the middle ear bone chain using autologous graft improved tinnitus and its resulting disability in patients with chronic otitis media.

Deep vein thrombosis and pulmonary embolism are fatal problems following brain trauma that, if left untreated, can dramatically increase mortality. Therefore, the present study aimed to evaluate deep vein thrombosis, pulmonary embolism and related factors in patients with traumatic brain injury.

This cross-sectional study was performed on 38 patients with isolated brain trauma in the intensive care unit. The study tool was a checklist that was completed as a file reading. The information required for the study was also collected through Doppler ultrasound and computed tomography angiography reports. The obtained data were analyzed in SPSS software using Chi-square and Fisher tests. The significance level of the tests was considered 0.05.

The mean age of study participants was 51.5± 18.3 years. In this study, 5.3% and 2.6% of participants had deep vein thrombosis and pulmonary embolism, respectively. There was a significant difference between the group with deep vein thrombosis and without deep vein thrombosis in the length of hospital stay, the mean length of stay in the ICU and the mean time of complete bed rest (CBR).

According to the effective variables in the development of thrombosis in this study, the development of related interventions to reduce the incidence of deep vein thrombosis and pulmonary embolism can minimize disability and mortality due to these diseases.

Patients with Alzheimer's disease have impaired visual function even in the early stages of the disease. Therefore, the present study aimed to determine the visual signs and symptoms in patients with Alzheimer's disease and compare them with those in the control group.

This cross-sectional descriptive study was conducted on 19 Alzheimer patients and 19 cognitively healthy people referring to Farshchian Sina Hospital, Hamadan in 2020-2021. They underwent visual examinations, including visual acuity, slit lamp exam, fundoscopy,contrast sensitivity assessed by CVS-1000 test, color perception test, investigating eye movements, and pupillary light reflex. Moreover,  OCT images were taken from all patients and the control group to measure macular thickness and volume. The data were analyzed in SPSS software (version 16) using X2 statistical test.

A significant reduction in visual acuity (P=0.006 for the right eye and P=0.003 for left eye), contrast sensitivity (P˂ 0.001), impaired color vision (P=0.016), increased cup to disk ratio (P˂0.001 for both eyes), reduction in temporal vascular diameter of both eyes (P˂0.001), disturbed movement (P=0.001), and sluggish pupillary light reflex (P˂0.001) were observed in patients with Alzheimer disease. Moreover, a significant reduction was detected in macular thickness and volume, especially in the inferior quadrant, in patients with Alzheimer's, as compared to the healthy group (P˂0.001). Nonetheless, there was no significant difference between the two groups in the incidence of age-related macular degeneration, cataracts, and pseudoexfoliation.

Patients with Alzheimer's disease have abnormal results on eye examinations.

Accurate diagnosis of CAD using noninvasive procedures is of great importance. The aim of the study is to assess diagnostic accuracy of myocardial perfusion imaging and compare it with exercise stress test in order to decipher a more accurate and cost-effective method for CAD detection.

Of 430 consecutive patients suspected with CAD, 104 performed both MPI (with the method of exercise stress) and ICA (Invasive Coronary Angiography). Luminal stenosis > 70% read by ICA was defined as significant CAD. Considering ICA as the gold standard, we calculated sensitivity, specificity, NPV and PPV for both tests. Besides, the relationship between CAD risk factors and findings of the procedures was also computed, using chi-square and student t-tests.

Sensitivity, specificity, PPV and NPV of MPI and exercise test for detection of CAD were: 90.74%, 92%, 92.45%, 90.19%, and 57%, 82%, 77.5%, 63.1%, respectively. A significant relationship between diabetes and hyperlipidemia with abnormal perfusion MPI and positive exercise test was found (P<0.05).Relatively poor agreement was observed between results of MPI and exercise test (kappa statistic = 0.445).

Not only dose MPI benefits from higher diagnostic value for diagnosis of CAD, but it also can be used in patient risk stratification and applying more appropriate therapeutic strategies.

Cardiovascular diseases are a common disorder, and some patients undergo open heart surgery due to the severity of the disease and lack of response to drug treatment. Following surgery, these patients require adequate health literacy to make informed decisions and perform self-care behaviors. This study aimed to determine the health literacy and its related factors in patients with a history of open heart surgery in Farshchian Cardiology Hospital in Hamadan, Iran, during 2020.

This cross-sectional study selected 278 patients by available sampling method from those who were referred to a Cardiology Hospital in Hamadan and underwent open heart surgery. The patients were evaluated in terms of health literacy using a standard questionnaire, which assessed patients' health literacy in 5 areas of access, reading skills, comprehension, evaluation/decision-making, and the use of health information. Data were analyzed in SPSS software at a 95% confidence level.

The mean age of the patients was 48.62±14.04 years, and the majority of them were female (52.90%). Furthermore, 64.39% of the participants had poor or moderate health literacy. The Internet (49.60%) and health workers (32.40%) were the most important sources of receiving health information. Health literacy showed a significant relationship with patients' gender and education level (P<0.05).

Patients with a history of open heart surgery do not have good health literacy, and it is necessary to plan for the promotion of health literacy in them. In this regard, health workers have an important role in increasing the level of health literacy; moreover, they should spend more time educating patients appropriate to their age and education level.

Hydatidosis is one of the most important zoonotic infections that is a health-economic concern in endemic areas. This study aimed to determine the seroprevalence of hydatidosis in Arak, Iran.

This descriptive cross-sectional study was conducted on 456 individuals attending health centers in Arak in 2020. Blood samples were taken from the subjects and tested for anti-Echinococcus antibodies by the enzyme-linked immunosorbent assay-immunoglobulin G test. The collected data were then analyzed.

It was revealed that 6 out of 456 subjects had anti-Echinococcus antibodies (1.3%, 95% confidence interval: 0.3-2.3) The mean age of the participants was 58.8±19.9 years, and frequencies of seropositive individuals were 1.6% and 1% in men and women, respectively. Moreover, 5 (1.4%) and 1 (1%) urban and rural residents were found seropositive, respectively. According to the results, 93.4% of the participants were unaware of hydatid cyst disease and 21.5% of the cases had contact with dogs (P<0.05). It was found that 213 (46.7%) individuals used only water or saltwater to wash vegetables, and all seropositive subjects were observed in this group (P=0.01).

The results of this study showed that the seroprevalence of hydatidosis was significant in Arak. Therefore, due to the health importance of hydatidosis and its endemicity in this area, it is necessary to adopt health measures to control and prevent this parasitic infection.

Fibromyalgia syndrome is associated with major psychiatric disorders, such as anxiety and debilitating fatigue. This study aimed to determine the effect of Acceptance and Commitment Therapy on anxiety, chronic fatigue, and pain intensity in women with fibromyalgia with the effect of waiting.

This quasi-experimental study with a pretest-posttest design was conducted on 40 patients of Bouali Hospital in Tehran, Iran, in 2019. The samples were selected by the available sampling method and randomly assigned to the experimental and control groups. The subjects completed Beck Anxiety, McGill Pain, and Krupp Fatigue questionnaires before and after Acceptance and Commitment Therapy training. The collected data were analyzed in SPSS software (version 22) using analysis of covariance and repeated measures.

The results of analysis of covariance showed that Acceptance and Commitment Therapy reduced anxiety ( F=20.92, P<0.001), fatigue (F=13.66, P=0.001), and pain intensity (F=6.17, P=0.019) in patients with fibromyalgia, which was significant (P<0.001).

Acceptance and Commitment Therapy through the creation and development of psychological acceptance and flexibility, can reduce patients' psychological damage and lead to a decrease in anxiety, pain intensity, and fatigue in women with fibromyalgia.

Enterobius vermicularis (pinworm) is one of the most common intestinal nematodes in the world and is found in all developed and developing communities. Children are the most vulnerable group in this regard. This study aimed to determine the prevalence of E. vermicularis infection amongst kindergartens in Hamadan, Iran, in 2019.

This descriptive cross-sectional study was conducted on 98 active kindergartens in Hamadan, Iran. A total of 18 kindergartens were selected, followed by the random selection of a number of children from each kindergarten. The adhesive cello-tape is a standard method for examining this disease, and mothers were trained to use this method. Subsequently, the sampling was conducted by this method.

Out of 451 children from 18 kindergartens, the overall prevalence of E. vermicularis infection was obtained at 0.4% (n=2). The mean age of the children in this study was 5.45±0.93 years. Since the prevalence of the disease was not significant, the results were not analyzed.

The results of this study show that the prevalence of this disease has decreased over a decade in Hamadan, Iran; however, this infection still exists. Therefore, specific measures should be taken to control the transmission cycle of E. vermicularis