فهرست مطالب

Kerman University of Medical Sciences - Volume:29 Issue: 3, May-Jun 2022

Journal of Kerman University of Medical Sciences
Volume:29 Issue: 3, May-Jun 2022

  • تاریخ انتشار: 1401/04/12
  • تعداد عناوین: 13
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  • Poupak Rahimzadeh, Mohammad Reza Ghodraty, Seyed Hamid Reza Faiz, Elham Pardis, Toktam Yavari, Alireza Pournajafian * Pages 218-225
    Background
    Previous studies have suggested the use of ultrasonography for more success in spinal anesthesia. The purpose of this study was to compare the effect of ultrasonography and traditional method on the success rate of spinal anesthesia by an anesthesia resident.
    Methods
    In this clinical trial study, patients who were candidate for leg or lower abdominal surgery under spinal anesthesia and referred to Firoozgar and Rasoul-e-Akram hospitals in 2019 were randomly assigned to techniques: 1) common surface marking techniques and 2) the use of ultrasonography to find the spinal canal. The dural puncture success rate at the first needle entry attempt, time required for determining the needle entry site, time required for needle entry until CSF exit, number of needle redirection without complete skin exit, and needle entry after complete needle withdrawal in each group were measured and recorded.
    Results
    The success rate of dural puncture at the first attempt of entry and the time required to determine the needle entry site in the ultrasonography group (55.2%) was significantly higher than that in Landmark group (21.4%) (P<0.05). The time required for needle entrance to CSF exit, the total procedure time for patients, the number of needles redirection without complete removal of the skin, and the number of needle entry after complete removal of the skin in the ultrasonography group was significantly lower than that in Landmark group (P<0.05).
    Conclusion
    The use of ultrasonography in comparison with the traditional method has been effective on the success rate of spinal anesthesia by an anesthesia resident.
    Keywords: Ultrasonography, Landmark, Spinal anesthesia, Surgery
  • Behshid Garrusi *, Saideh Garrusi, Ali Amirkafi, Mohammad Moqaddasi Amiri, Mohammad Reza Baneshi Pages 226-236
    Background
    There are many mental health challenges associated with immigration. Culture has a notable impact on the mental health of immigrants. The inability to adapt to the new culture is effective in developing mental health problems. Acculturation is a dynamic process that involves multiple aspects of adjustment to a new environment. Various acculturation levels and processes are associated with mental health problems. However, this association is complex and can vary for different groups of migrants. The primary goal of the present study was to study the relationship between acculturation and mental health among Afghan immigrant women compared to Iranian women.
    Methods
    The study included about 400 immigrant Iranian and Afghan women. Participants answered questions regarding age, marital status, education, occupation, religion, length of stay in Iran (in the Afghan participants), study in Iranian schools (in the Afghan participants) and the neighborhood characteristics where you live (with a majority of Iranian neighbors, a majority of Afghan neighbors and an equal population of both) and economic status. Information about mental health status and acculturation was also obtained through a self-administered questionnaire.
    Results
    The severity of mental illness among the three groups of Iranians, Afghans with low acculturation, and Afghans with high acculturation was significantly different (0 < 0.001). While mental disorders among Afghan women with high and low acculturation differed, this difference was not statistically significant. Some of the demographic features, such as widowhood, neighborhood features, socioeconomic status, and religion, had affected mental disorders in the two acculturated groups.
    Conclusion
    In societies with strong cultural similarities, individual factors and ethnic solidarity seem to be more crucial to the mental health of immigrants.
    Keywords: Immigrant, Afghan, Iranian, Women, Mental disorder, Acculturation
  • Mohammad Mirdoraghi, Vahid Changizi, Seyed Abolghasem Haeri, Zahra Rajabi, Peyman Amini, Sakineh Abassi * Pages 237-245
    Background
    Radioprotectors are used to neutralize the effects of free radicals caused by ionization radiation. In this study, the radioprotective effects of magnesium sulfate and vitamin A on bone marrow cells of mice were evaluated by micronucleus assay and changes in the expression of NOX4 gene.
    Methods
    The mice were randomly divided into 12 groups. The mixture of drugs was injected into mice by intraperitoneal injection 2 hours before the irradiation. The dose rate was 50 cGy/min at SSD (source to surface distance) 100 cm and field size of 10×10cm2. Twenty four hours after 2 Gy irradiation by LINAC, the mice were sacrificed by cervical dislocation. Then, several microscopic slides were prepared for each sample to evaluate the number of micronucleus in polychromatic erythrocytes (PCEs). In addition, the expression of NOX4 was evaluated by Real-time PCR. Data were analyzed through SPSS 19 and the mean of groups was compared to each other using one-way ANOVA.
    Results
    There was a significant difference between mean mnPCEs in the treatment (drugs + radiation) groups compared to the 2 Gy group (P=0.01). The expression level of NOX4 gene was significantly lower in groups receiving the combinations of vitamin A and magnesium sulfate compared to the 2 Gy group (P =0.01). The calculated dose reduction factor (DRF) demonstrated DRF=2.58 for 2Gy.
    Conclusion
    The results of this study indicated that the combination of vitamin A and magnesium sulfate, possibly with an antioxidant mechanism, removes the deleterious effects of free radicals caused by ionizing radiation on bone marrow cells.
    Keywords: Micronucleus assay, magnesium sulfate, NOX4, Radiation-protective agents, Vitamin A
  • Ali Alirezaie Alavijeh, Masoomeh Dadpay, Mohammad Barati * Pages 246-253
    Background
    Surgical sutures are sterile filaments to support the healing process. Also Suture as a major part of surgical site management can challenge surgical wound healing. The objective of the current study was to prevent surgical site infection by creating a new antibacterial silk-nano cefixime suture.
    Methods
    The silk suture became silk-nano cefixime suture by immersing in the 1, 2, and 3 wt % cefixime solutions. The antibacterial activity of silk-nano cefixime suture was tested on E. coli (ATCC25922). The healing effect of silk-nano cefixime suture was evaluated by H&E staining sections and compared between the control and treated groups on days 3, 8 and 14. The obtained quantitative data were presented as mean ± standard deviation. In order to compare the mean of quantitative variables between the studied groups, general linear model of statistical analysis test and 3-D SPSS charts were used (P ≤ 0.05).
    Results
    The inhibition zone diameter of E. coli (ATCC25922) was 25 mm and no statistically significant difference was found between the healing properties (P≥.05). There was a significant difference in the mean of Polymorphonuclear leukocytes (PMN) and macrophage infiltration between the control and treated groups on day 8 (p≤ 0.05).
    Conclusion
    Our data indicate that silk-nano cefixime suture has the potential to reduce the risk of surgical site infections. Finally, it is strongly recommended to introduce silk-nano cefixime suture as a reliable substitute for current surgical sutures.
    Keywords: Silk suture, Nano-Cefixime trihydrate, Antibacterial Activity, Healing properties
  • Mehrnaz Karimi Afshar, Hossein Hojat Farsangi, Marzieh Karimiafshar *, Ali Eskandarizadeh Pages 254-261
    Background
    Dental caries is a common diseases that imposes a big economic burden on individuals and the health care system. The aim of this study was to assess oral health status and its related factors in adults who referred to Kerman (Iran) health centers.
    Methods
    This descriptive cross-sectional study was performed on 195 patients who referred to Kerman health centers and selected by two-stage sampling method. Data were collected through a questionnaire consisted of demographic information and oral health behavior status, and assessment of DMFT index based on the criteria of the World Health Organization and dental plaque index. Data were analyzed using SPSS version 21 by ANOVA and t-test at a significant level of 0.05.
    Results
    In this study, 104 (52.8%) patients were male and 93 (47.2%) were female. The mean age was 36.99 ± 10.68 years. Dental plaque index was moderate in 94 patients (47.7%). The mean DMFT index was 7.27 ± 4.88. There was a statistically significant relationship between age and self-reported oral health, and general health with DMFT index. Older people and those who described their oral health status poor had higher DMFT.
    Conclusion
    The findings of the present study indicate the poor status of DMFT in the adult population of Kerman. It is recommended to hold training classes and oral health promotion programs.
    Keywords: Dental Caries, Adults, Oral Health, Oral Health Behavior, DMFT
  • Leili Rouhi, Hossein Mousavi Nasab *, Mahshid Tajrobehkar Pages 262-273
    Background
    This study aimed to investigate the validity and reliability of the updating component tasks of executive functions in normal individuals and to compare their performance with patients with clinical disorders, including schizophrenia (SC), traumatic brain injury (TBI), Alzheimer’s disease (AD), and major depressive disorder (MDD).
    Methods
    In this causal-comparative study, all normal individuals aged 16-70 years and patients with SC, TBI, AD, and MDD in Kerman city, were included. The study population included 406 normal individuals who were selected through convenience sampling and 74 patients (24 SC, 11 TBI, 15 AD, and 24 MDD) who were selected by purposive sampling. Participants completed updating tasks, including letter memory, keep track, spatial 2-back, and spatial 3-back. Data were analyzed using descriptive statistics, Cronbach’s alpha, test-retest reliability, and multivariate analysis of variance.
    Results
    The results showed that the validity and reliability of the updating tasks are acceptable, and there is a significant difference between the scores of normal individuals and those of patients with SC, TBI, AD, and MDD.
    Conclusion
    According to the results, it can be concluded that this set of tasks can well assess the updating-specific ability and distinguish between the performance of normal individuals and patients with clinical disorders.
    Keywords: Validity, Reliability, Executive Function, Updating tasks, Clinical Disorders
  • Mohammad Mehdi Bagheri *, Fahimeh Sadegh Zarandi, Zahra Kamiab, Armita Shahesmaeili Pages 274-280
    Background
    Early diagnosis of congenital heart disease (CHD) has a significant impact on the prognosis of the patient. This study aimed to determine the sensitivity and specificity of cardiomegaly according to Chest X-ray (CXR) indices in comparison with echocardiography in the diagnosis of CHD in infants.
    Methods
    In this cross-sectional study, the clinical status of 166 infants aged 2 to 24 months who referred to the Pediatric Ward of Afzalipour Hospital in Kerman and needed CXR for any reason, was evaluated from November 2019 to November 2020. CXR and echocardiography were performed for all infants by a pediatric cardiologist and the probability of CHD was confirmed or ruled out. Therefore, the sensitivity and explicitness of CXR were determined. Data were analyzed using SPSS version 20.
    Results
    The most common anomalies observed in infants were Patent ductus arteriosus (PDA), atrial septal defect (ASD), ventricular septal defect (VSD) and pulmonary stenosis (PS), respectively. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CXR, for determining cardiomegaly in these infants were 65.7%, 51.1%, 26.4%, and 84.8%, respectively.
    Conclusion
    The results of this study showed that the sensitivity and specificity of CXR for determining cardiomegaly were 65.7% and 51.1%, respectively. Therefore, when echocardiography is not available, the chances of finding congenital heart abnormalities with the help of CXR will be quite high.
    Keywords: Sensitivity, Specificity, Cardiomegaly, Congenital heart disease, echocardiography, Infants
  • Nasrin Saberi, Behnam Dalfardi, Mitra Samareh Fekri, Meysam Yousefi, Mehrdad Farrokhnia, Mohammad Reza Shakibi, Mohamad Hasan Tajadini, Mohsen Shafiepour * Pages 281-287
    Background
    COVID-19 is a widespread viral disease that has severely affected our world. Although beneficial effects of vitamin D on immune system are well known, there are ongoing discussions about its role in patients suffering from SARS-CoV-2 infection. In this study, we examined the relationship between risk of COVID-19 infection and plasma vitamin D level.
    Methods
    This case-control study was conducted on 133 participants in Kerman city, Iran. SARS-CoV-2 infection was confirmed by positive RT-Real time PCR test in 69 cases and another 64 participants were considered as - non-infected - control group. Plasma vitamin D levels were measured among all, and compared.
    Results
    Sub-normal plasma vitamin D level were reported in about 51% of participants; however, there was no significant difference in the mean plasma vitamin D levels between COVID-19 and control groups. Mean plasma levels of vitamin D were significantly higher in females than males (P-value: 0.017).
    Conclusion
    According to our results, risk of COVID-19 infection does not correlate with plasma level of vitamin D.
    Keywords: COVID-19, Disease Severity, Pneumonia, SARS-CoV-2, Vitamin D Deficiency
  • Mina Moridi, Shirin Jafari, Arezoo Saberi, Khadije Mohammadi * Pages 288-291

    Hemodialysis catheter-related infections are associated with increased morbidity and mortality in end-stage renal disease patients. Here we present a case of an end-stage renal disease patient who presented with fever and weakness. During workup, we found a deeply inserted jugular vein double lumen catheter into the inferior vena cava that was complicated by infection.

    Keywords: Hemodialysis, Endocarditis, ESRD, Catheter infection, INFERIOR VENA CAVA
  • Zahra Kamiab, Mohammad Mehdi Bagheri, Maryam Ahmadipour, Reza Derakhshan * Pages 292-295

    Tricuspid valve atresia is a congenital heart defect and if left untreated, the lesion has a high mortality rate. This study aimed to report a case of tricuspid valve atresia in a low-birth-weight three-day-old infant, who was treated by intra-ductal stenting and established pulmonary blood flow instead of routine shunting.The patient was a three-day-old male infant, weighing 2800 grams with a gestational age of 38 weeks. He was admitted with symptoms of tachypnea, cyanosis, 45% saturation, and severe metabolic and respiratory acidosis. On echocardiography, tricuspid valve atresia was observed. The infant was treated with prostaglandin E1 immediately after admission to the NICU and necessary interventions were taken to keep the patent ductus arteriosus (PDA) open. Angiography was performed through the aortic artery. First, a balloon was inserted, and then a stent was successfully placed inside the PDA. Preoperative saturation increased from 45% to 93% after stenting, and the infant was extubated after 48 hours in a good general condition.As the results of the current case report showed, stent placement can effectively keep the PDA open and establish pulmonary blood flow in high-risk infants. It is suggested that ductal stenting should be considered as the first treatment selection in newborns with tricuspid valve atresia or as a good alternative method for Blalock-Taussig shunt.

    Keywords: Arterial duct stent, Infant, Tricuspid atresia, Congenital defect, Prostaglandin
  • I Ketut Arya Santosa *, Wati Evilia, I Wayan Yuna Ariawan, I Komang Ana Mahardika, Marianto Marianto Pages 296-300

    Coronavirus disease 2019 (COVID-19) has caused a huge burden across the world. COVID-19 affects not only physical health but also neuropsychiatric health. Reported neuropsychiatric presentations due to COVID-19 include encephalopathy, mood changes, and neuromuscular dysfunction, which may occur during the infection. There have been also reports showing that the COVID-19 could provoke psychosis during the infection. However, there is still no available evidence regarding this event. In this report, three uncommon cases of new-onset psychosis with mild symptoms of COVID-19 admitted to Bali Provincial Mental Hospital in Bangli, Indonesia are described. The patients had presented persecutory delusions and auditory hallucinations. None of the patients had suicidal ideation or behavior. Three of the cases met the criteria for brief psychosis according to Indonesia’s guidelines for mental health disorders and classification. This report showed brief psychosis without suicidal ideation. However, clinicians have to be more alert in treating this condition due to its potential emergency risk shown in previous reports.

    Keywords: COVID-19, Pandemic, Brief reactive, Psychosis
  • Simin Shamsi Meymand, Manzumeh- Shamsi Meymandi *, Shamim Afshinmehr, Mohammad Mehdi Lashkarizadeh, Mehrnoush Ranjbar Pages 301-306
    Background

    People with premature hair graying try to hide it because it makes them look older than their age. Hair graying is an esthetic problem that affects social life. This preliminary study aimed to investigate the influencing factors in premature hair graying.

    Methods

    One hundred twenty participants who were referred to a dermatology clinic were randomly selected and filled up an interview questionnaire. The questionnaire included demographic information such as age, sex, marital status, BMI, education level, and income. Also, queries on family history, cigarette smoking, and alcohol consumption were asked. The main question was the age of graying hair initiation which divided the participants into two groups; individuals with premature hair graying (PHG) under 30 and non-PHG individuals above 30 years old. Factors were compared and a logistic regression was used to identify the association.

    Results

    The mean age of participants was 42.2±1.2 and 49% of them were female. Cigarette smoking, alcohol consumption, educational level, marital status, and family history were significantly different between the two subgroups. But the marital status, family history, and alcohol consumption were significantly associated with premature hair graying.

    Conclusion

    Premature hair graying depends on family history and non-married people and alcohol users are more prone to it. More investigations are needed to identify the indicators.

    Keywords: Premature Hair Graying, influencing factors, smoking, marital status, Alcohol, Iran
  • Saied Abrishamkar, Mehdi Shafiei, Mehdi Mahmoodkhani, Ghasem Yadegarfar, Kamran Kaghazchi *, Donya Sheibani Tehrani Pages 307-312
    Background

    The adhesion between the dura and the muscle is one of the serious problems of patients who need delayed cranial bone replacement due to decompressive craniotomy after brain swelling, but there is no ideal solution to reduce this complication. This study aimed to determine the effect of implanting a silicone membrane between the muscle and the dura after craniotomy surgery in patients requiring delayed bone replacement at the craniotomy site.

    Methods

    In this clinical prospective cohort trial study with no evidence, all patients undergoing late cranial bone grafting after craniotomy were selected, and a total of 24 people were included in this study. During the craniotomy, a silicone mesh measuring 5 × 5 cm was placed between the dura and the muscle. Adhesion between the dura and the muscle and side effects associated with this procedure were examined during cranial bone grafting.

    Results

    Out of 24 patients requiring delayed cranial bone grafting, three individuals died and six individuals did not refer for cranioplasty; therefore, the operation was performed on 15 patients. During the operation, no cases of muscle-dura adhesion were observed, and in all 15 patients, the dura was completely detached from the muscle. Also, none of the patients presented side effects such as muscle bleeding at the surgery site, infection, and allergy to the mesh.

    Discussion

    Implantation of silicone layer between the dura and the muscle during craniotomy in patients suffering from cerebral edema can prevent muscle-dura adhesion without causing serious complications for the patients.

    Keywords: Cerebral edema, Craniotomy, Cranioplasty, Adhesion