مجله پزشکی بالینی ابن سینا
سال بیست و نهم شماره 2 (پیاپی 104، تابستان 1401)

Hump reduction is performed by different instruments with inherent drawbacks. The present study was conducted to compare the frequency of complications in the nasal bridge area after hump reduction with piezosurgery and a conventional instrument (Rasp).

This clinical trial was carried out on 20 primary rhinoplasty patients. The patients were randomly assigned to two groups. In one group, nasal dorsum height reduction was performed with a rasp, and in the other group, hump reduction was fulfilled with piezosurgery. The patients in both groups were examined after 10, 30, and 90 days of surgery to detect palpebral ecchymosis, asymmetry, bony form, and cartilaginous irregularities of the dorsum.

In the rasp group, two patients with ecchymosis were observed on the 10th day after surgery. Moreover, one patient with dorsal asymmetry, two patients with bony form, and one patient with cartilaginous irregularity in the dorsum were observed in the 3rd month after surgery. In the piezosurgery group, no patient had any complications. However, these differences between the two groups were not statistically significant (P>0.05).

As evidenced by the obtained results, piezosurgery can be used safely for hump reduction.

A definitive diagnosis of tuberculosis is based on the identification of tubercle bacilli in sputum using microscopy and culture. Although direct smear microscopy is the most common diagnostic method, the Petroff method is recommended for a better diagnosis of tuberculosis. This study aimed to evaluate the Petroff method for a more accurate diagnosis of tuberculosis in health centers of Hamadan province, Iran, during the COVID-19 pandemic.

In this descriptive cross-sectional study, 210 sputum specimens from patients who were referred to the tuberculosis reference laboratory in Hamadan province were collected in health centers. All of the samples were processed for the presence of mycobacteria using the Petroff method and the direct smear technique, and the results of both techniques were compared afterward.

Among 210 samples, 9 (4.28%) and 12 (5.71%) cases were reported as smear-positive samples by direct smear method and Petroff method, respectively. A comparison of the results showed that the sensitivity for acid-fast bacilli (AFB) smears was increased using the Petroff method.

Petroff method improved the sensitivity of AFB identification. It was methodologically simpler and less expensive and can be used as a promising candidate in primary TB control programs. Therefore, we recommend the Petroff method for the improvement of the sensitivity of AFB microscopy.

There is some degree of hypoxia in many cyanotic heart diseases that cannot be diagnosed with the naked eye. The measurement of arterial blood oxygen saturation at birth is a convenient and valuable procedure. Therefore, the present study aimed to investigate the arterial blood oxygen saturation of healthy newborns and its relationship with the family history of congenital heart disease and maternal demographic variables.

In this cross-sectional descriptive study, 120 healthy neonates were selected via the convenience sampling method. Upon discharge, right-hand pulse oximetry was performed on the subjects. In the case of 90%-95% arterial blood oxygen saturation, one hour later, control was performed again. With a similar result, a referral to a cardiologist was made. Data were analyzed in SPSS software using descriptive and inferential (linear and multivariate regression) tests.

The mean arterial oxygen saturation of neonates was 98.13±1.95%. The number of deliveries and the history of heart disease in first-degree relatives had a significant relationship with the saturation results (P<0.05). For each increase in delivery, the mean saturation increased by 0.591 units, while it decreased by 1.948 units with a positive history of the disease. Gestational age, gender, maternal age, and type of delivery had no significant effect on saturation (P<0.05).

Apart from physical examination, pulse oximetry is helpful for the early detection of congenital heart diseases that are asymptomatic at birth. Due to the importance of diagnosing these diseases, it is recommended to be routinely examined at birth.

Due to the prevalence of myocardial dysfunction and Patent Ductus Arteriosus (PDA) in a large number of preterm neonates, the prognosis of these infants is highly related to their early diagnosis and treatment. In this regard, the present study aimed to determine the relationship between troponin T level and the prognosis of premature neonates admitted to the Neonatal Intensive Care Unit (NICU) of Fatemieh Hospital in Hamadan.

In this cross-sectional study, a certain number of infants who underwent serum levels of troponin T from 72 hours to one week after birth were assessed for demographic information, length of hospital stay, complications during hospitalization, acidosis, inotropic agents, recovery, and mortality, as well as their relationship with troponin level.

Out of 61 neonates, 22 patients had large PDA with a troponin level of 436±50.2 pg/ml, 14 patients had a small PDA with a troponin level of 260.5±89.8 pg/ml, and 25 patients were without PDA with a troponin level of 277.1±229.7 pg /ml (P = 0.203). There was no statistically significant difference between the three groups. The mean levels of troponin were 423±521 and 274±154 pg/ml in deceased and surviving neonates, respectively (P=0.194). Inotropic was significantly higher in deceased patients (P=0.003), and troponin T level was statistically significant (P=0.008). The relationship between troponin level and severe acidosis (P=0.051) was not significant, with a small difference that could be clinically valuable.

Serum troponin T level was higher in preterm neonates with large PDA and deceased ones who received inotropic agents due to hemodynamic disorders and severe acidosis.

Denture cleansing and disinfecting techniques include mechanical brushing and using ultrasonic units, as well as microwave radiation, in conjunction with various chemical cleansers. The present study investigated the effect of different ratios of vinegar and hydrogen peroxide on the color changes of hard heat acrylic resins.

This experimental study was conducted on 40 specimens with 3×20×20 mm dimensions. Samples were divided into four groups: one control group and three experimental groups with a combination of two types of hydrogen peroxide and vinegar with ratios of 1:1, 3:1, and 3:1. Samples were immersed in disinfectant solution for 8 h every day for one month. Afterward, they were subjected to spectrophotometry to evaluate their color properties based on a, b, and L color parameters. The color changes of each sample were then calculated using the ΔE00 and ΔW ID parameters. Data were analyzed using ANOVA and Tukey HSD tests at a significance level of 0.05.

The mean and standard deviation of ΔE00 parameter in vinegar and hydrogen peroxide groups with 3:1, 1:1, and 1:3 ratios, and the control were equal to 0.75±0.1, 0.5±0.2, 1.57±0.2, and 0.03±0.01, respectively. The mean and standard deviation of ΔW ID parameter in vinegar and hydrogen peroxide groups with 3:1, 1:1, and 1:3 ratios, and the control group were 0.7±0.96, 0.48±0.12, 1.51±0.47, and 0.09±0.07, respectively.

The highest color change and bleaching of base denture resin occurred in the group with the 3:1 ratio of hydrogen peroxide to the vinegar, which was significantly different from other groups (P<0.001) and also higher than the perceptibility threshold.

In recent years, resistance to antibiotics and the emergence of different strains of resistant bacteria have been of grave concern to the World Health Organization and all those working in the field of health. The aim of this study was to determine the frequency and pattern of bacterial antibiotic resistance in blood culture samples of hospitalized patients in Besat Hospital in Hamadan.

This descriptive cross-sectional study was conducted over a period of 10 years on all patients referred to Besat hospital in Hamadan with sepsis symptoms.

In this study, 1790 patients with positive blood culture were studied. The mean age of the patients was 24.81 years. 58.9% of the subjects with positive blood cultures were male. The majority of patients (38.4%) were hospitalized in the ICU. 48.8% of gram-negative bacteria and 49.1%-gram positive were reported. The most common isolated bacteria were staph aureus, Escherichia coli, Epidermidis staph. The highest resistance was to cefixime (70.6%) and cefpodoxime (67.5%) and the highest susceptibility to vancomycin (98.5%), piperacillin tazobactam (71.7%) and meropenem (70%).

The resistance of bacteria to available antibiotics in Besat Hospital in Hamadan is considerable and worrying and shows a serious risk of antibiotic resistance in Hamadan city, so it shows the necessity of serious interventions and reviewing the prescribing and consumption of antibiotics.

Adherence to the regular medication has an important role in controlling and treatment of AIDS. The aim of the present research was to develop, implement, and evaluation of an interventional program to promote medication adherence among AIDS patients referred to Behavioral Diseases Counseling Centers in Kermanshah by using the I-Change model.

The present research was a quasi-experimental interventional efficacy study among a total of 150 AIDS patients in Kermanshah, 2021 who were randomly selected and assigned to intervention and control (each, n = 75) groups. The intervention development was based on the I-Change model needs assessment and intervention mapping approach, the collected data was evaluated before and three months after the implementation intervention. Data were analyzed by SPSS-16.

The mean age of patients was 39.11 [SD: 6.07], ranging from 22 -51 years. After implementing the intervention in the intervention group, the mean score of regular medication adherence behaviors (P <0.001, d= 0.48) and knowledge (P = 0.028, d= 0.31) was significantly higher and the perceived barrier (P = 0.020, d= 0.35) was lower than in the control group.

I-Change model can be used as a basis for the development of interventional programs to improve medication adherence among AIDS patients.

Obstructive sleep apnea syndrome (OSA) is more common during pregnancy and is associated with adverse maternal and fetal outcomes, including hypertension, preeclampsia, and low birth weight, therefore screening of pregnant women is of particular importance. In this study, we intend to assess OSA risk in pregnancy using the STOP-BANG questionnaire.

In this cross-sectional study, 400 pregnant women who referred to Yazd health centers in 2020, were included in the study. Data collection tools included a questionnaire for demographic variables and STOP-BANG questionnaire to determine OSAS risk.

400 pregnant women with a mean age of 28.44 ±5.74 and a BMI of 27.31 ± 5.28 were present in the study. The frequency of diabetes and hypertension was 8% and 3.3%, respectively. 94.5% of women were at low risk of OSAS, 2.5% and 3% of them were at moderate and high risk, respectively. There was no association between diabetes and OSAS risk (P-Value > 0.05) but history of hypertension, BMI above 30 kg/m2 and age over 30 years were associated with increased OSA risk and higher STOP-BANG score (P-Value <0.05).

STOP-BANG questionnaire is a simple tool for screening OSA in pregnant women. Age over 30, BMI over 30 kg/m2, and history of hypertension are associated with higher STOP-BANG scores, therefore, pregnant women with these characteristics are at higher risk for developing OSA and screening is more important to them than other groups.