مجله پزشکی دانشگاه علوم پزشکی تبریز
سال چهل و چهارم شماره 6 (پیاپی 162، بهمن و اسفند 1401)

Background:

 The high mortality and morbidity rate of COVID-19 turned this pandemic into the most challenging health issue. Here we systematically reviewed the consequences of COVID-19 in heart transplant recipients.

Methods:

 The terms “Coronavirus” or “COVID19”, “SARS-CoV-2”, “Heart Transplantation”, and “Cardiac Graft” were searched focusing on heart transplant patients with positive severe acute respiratory syndrome of coronavirus-2 (SARS-CoV-2) on June 22, 2022, in Web of Science / ISI, PubMed and Ovid ProQuest, Scopus.

Results:

 The results showed that of 14 eligible studies that were included in the systematic review, 8 were case reports, and 6 case series. Among 109 reported cases, 67 patients were male and 22 were female and about the rest, it was not reported. The minimum hospitalization day was one day and the maximum was 60 days. In three case reports, the studied patients died, and in one case series, 7 out of 28 patients died. The most reported symptoms were shortness of breath (85.7%), cough (76.2%), and myalgia/fatigue (76.2%), followed by rhinitis (66.7%) and fever (7.7%). 66 percent).

Conclusion: 

Although the symptoms of the disease in these patients are similar to other patients, the mortality rate is high. Considering that the studies conducted on heart transplant recipients with covid-19 have mostly been in the form of case studies, it is suggested that larger studies be conducted so that more accurate information can be obtained regarding the survival rate, symptoms of the disease, and the type of drugs used.

Practical Implications:

 The mortality rate of heart transplant cases affected by COVID-19 was 23.6% (21 patients).In four studies the duration of hospitalization was not mentioned, but the others varied from no hospitalization in one case to up to 60 days. The most reported symptoms were dyspnea (85.7%), cough (76.2%), and myalgia/fatigue (76.2%), followed by rhinitis (66.7%) and fever (66.7%). Treatment differed for each patient, but hydroxychloroquine, antibiotic therapy including Azithromycin, and lopinavir/ritonavir were the most commonly used drugs.

Background:

 The conditioned medium of stem cells plays an important role in the treatment of various diseases such as heart damage, but its molecular mechanisms are unknown. Therefore, this study aimed to investigate one of the mechanisms of the effect of this substance in the treatment of male rats with heart failure.

Methods:

 A total of 20 male rats were divided into four groups, control, heart failure, heart failure receiving culture medium, and medium condition groups. Heart failure was induced in all groups except the comtrol group with isoproterenol, then, culture medium and conditioned medium were injected into the related animals 28 days after HF induction. Afterward, the expressions of caspase 3 and 9 factors were examined.

Results:

 Changes in the expressions of caspase 3, caspase 9, and GAPDH genes in the four groups were evaluated real-time PCR. Furthermore, the average expressions of caspase 3 and 9 in four groups were compared using ELISA. All data revealed that the induction of heart failure increased the expression of apoptotic factors compared to the control group, and that the treatment with a conditioned medium caused a significant decrease in apoptotic factors compared to the heart failure group (P≤0.05).

Conclusion:

 It was concluded that the conditioned medium of human amniotic membrane mesenchymal stem cells was able to improve heart failure by targeting the apoptosis pathway.

Practical Implications:

 The findings of this study highlighted the importance of this compound as a suitable candidate for treating heart failure in the future.

 Depression is a common disorder in rheumatoid arthritis (RA) patients and can affect clinical outcomes. This study was conducted to determine the prevalence of depression and its relationship with disease activity in RA patients.

In this cross-sectional study, 144 patients with RA were recruited from the Rheumatology Outpatients Clinic, Mostafa Khomeini Hospital Ilam, and were examined for disease activity and depression symptoms. Disease activity was assessed by DAS28 using laboratory tests and physical examination. The Beck self-report questionnaire was used for measuring depression disorder. Data were analyzed using the linear regression models in STATA 14 software.

The prevalence of depression in the sample was 61%. Multivariate analyses showed that patients with severe disease activity faced a significantly greater risk of depression compared to those with mild disease activity. Average levels increased by about 12.43 points in depression for patients with severe disease activity compared to those with mild disease activity. This association was statistically significant after adjusting for the model's other predictors (P<0.001). Furthermore, predicted models showed that the probability of depression increased with age and disease duration in patients with severe activity.

Considering the relationship between depression and severe RA disease activity, the need to screen RA patients in terms of depression disorder and pay attention to comprehensive mental and physical care and cure for better clinical outcomes seems necessary.

 Severe disease activity in RA may have been influenced by a psychological phenomenon such as depression; therefore, it was suggested that depression, as one of the diseases worsening the RA symptoms, should be screened and evaluated. It was also recommended that a comprehensive and multidisciplinary approach should be adopted by seeking assistance from psychiatric and psychological specialists in RA disease management.

 Due to the high lethality of aluminum phosphide as well as the lack of antidote for its treatment, this study aimed to determine the effect of intravenous lipid emulsion on the outcome of hospitalization in the patients poisoned by rice pill .

 In this cross-sectional study, 19 patients aged over 18 years and poisoned by rice pill were investigated to determine the characteristics and outcomes of the patients as well as to detect the effect of intravenous lipid emulsion on the patients’ outcome in a six-year period. A data collection form was used to collect research data. Patients were treated with two types of standard treatment regimen (first group) and standard regimen+intravenous fat (second group). ECG changes, heart ejection fraction (EF), and the patients’ outcomes (death or discharge) were evaluated.

 In the first group, 16 patients and 3 patients received treatment regimen in second group. Also, 89.5% of the patients had sinus tachycardia in ECG. There was no significant difference between two groups except in terms of diastolic blood pressure (P=0.012). All cases of ECG changes were sinus tachycardia in the second group, while sinus tachycardia (87.4%), V-tach (6.3%), and PAC (6.3%) were observed in the first group. The mortality rate in first and second groups were 87.5% and 100%, respectively.

 Application of lipid emulsion was a relatively new therapeutic approach to clinical treatment of rice pill poisoning, and the studies on given issue were limited. Therefore, it was recommended that prospective studies should be carried out based on clinical trials to further investigate its application.

 It was necessary to develop an effective antidote for Aluminum phosphide Poisoning since it had a high mortality rate as well as a high prevalence in Iran. Unfortunately, there was no antidote for dealing with this poison. Application of intravenous lipid emulsion may have been effective in reducing the hospital mortality.

Preterm infants’ mothers experience higher level of anxiety and depression, and are more prone to postpartum depression compared to the mothers of term infants. This anxiety at the beginning of and during the breastfeeding process causes serious disorders. Given the fact that psychological interventions can reduce individuals’ problems, the present study aimed to investigate the effect of acceptance and commitment therapy on mental health and breastfeeding self-efficacy of the preterm infants’ mothers.

In this randomized controlled trial, 90 mothers of preterm infants admitted to the neonatal ward and neonatal intensive care unit (NICU) of two university-affiliated hospitals in Tabriz in 2021 were examined. Participants were assigned to the intervention and control groups adopting stratified block randomization method. The intervention group received group counseling on ACT in eight 60-minute sessions, and the control group received routine care. The Depression Anxiety Stress Scale-21 (DASS-21) and the Breastfeeding Self-Efficacy Scale (BSES) were completed by the participants before and immediately after the intervention. ANCOVA test with adjustment of confounding variables was used to compare two groups regarding the outcomes.

 The total mean score of BSE in the intervention group was significantly higher than that in the control group (Mean difference (MD): 5.7; 95% CI: 4.6 to 6.8, P<0.001). Furthermore, the mean score of all subscales of mental health, including anxiety, stress, and depression in the intervention group was significantly lower than that in the control group (P<0.001).

 The mental health and BSE of preterm infants’ mothers may have been improved using ACT. It was recommended that counselling sessions (e.g., ACT) should be offered for preterm infants’ mothers during postpartum period.

Preterm birth was a stressful event for parents and may have aroused negative emotions in mothers. Our study results showed that counseling based on acceptance and commitment therapy may have improved the mental health and breastfeeding self-efficacy of mothers with preterm infants

 In 2019, a new disease called Covid-19 was identified in Wuhan, China. Anyone can get this disease at any age and become seriously ill, or even die from it. This study aimed to determine the factors affecting the re-admission of coronary patients.

 In this study, 2411 Covid-19 patients referring to Shahid Mostafa Khomeini Hospital in Ilam, Iran were included. Variables such as gender, age, death, body mass index, headache, vomiting, having cold, cough, muscle pain, underlying disease, fever, hemoglobin, blood platelets, glucose as well as ALT, AST, and LDH enzymes were examined. SPSS software was used to fit the model of multiple logistic regressions in soft.

 Majority of the patients (54.5%) were males. The average age of readmitted patients was 63 years, and 23% of these patients died. The results of logistic regression test showed the variables of age (OR=1.02, P=0.029), sex (OR=0.637, P=0.047), underlying disease (OR=2.36, P=<0.001), hemoglobin (OR=0.91, P=0.04), blood platelet count (OR=0.99, P<0.001), vomiting or nausea (OR=0.48, P=0.03), and muscle pain (OR=0.61, P=0.04). Effective factors were also identified.

 It was concluded that having a comorbid disease and old age increased the chances of re-admission. Moreover, it was scientifically confirmed that an increase in age along with having an underlying disease significantly contributed to re-admission of patients with Covid-19.

 The maximum effectiveness of the treatment of Covid-19 patients was confirmed by this study and, therefore, it was recommended that re-hospitalization should be avoided in order to avoid additional treatment costs and waste of resources.

The oral health of pregnant women affects the health of mother and child as much as the public health affects the health of people in a community. Dental treatment during this period should be performed in such a way that it has no side effects on the fetus. This study aimed to evaluate the knowledge and practice of general dentists and dental interns in Isfahan about dental measures in pregnancy period.

 In this study, a total of 232 general dentists and dental interns were investigated in Isfahan using a self-made questionnaire containing 26 questions (20 knowledge questions and 6 performance questions) about the measures necessary to employ during pregnancy. Then the validity and reliability of the questionnaire were calculated. The data were statistically analyzed using SPSS software version 22 and performing T-test and ANOVA test. Significant level for all calculations was set at 0.05.

According to the study result, the total knowledge score was 13.2±3/5. The question about "prescribing the required drugs" had a significant correlation with university of study (P=0.047) and type of employment (P=0.047). The question "if the pregnant woman had pyogenic granuloma (pregnancy tumor), what will you do?" had a significant correlation with gender (P=0.042).

The overall score of the dentist's knowledges of the necessary measures during pregnancy was 13.2±3.5 which was fairly acceptable; however, it was recommended that further studies should be carried out in order to eliminate the possible risks posed by dentists to dental treatments of these patients.

 The average knowledge score of dentists with less than 5 years of experience was 14.18, and the average knowledge score of dentists with more than 5 years of experience was 13.42, which highlighted the need for offering refresher courses for dentists.

Antibiotic resistance is a phenomenon that occurs in different areas of the world against pathogens that cause nosocomial infections. This study aimed to evaluate the antibiotic resistance of Staphylococcus aureus and Pseudomonas aeruginosa strains.

 In this study, 340 patients with positive blood cultures by these two bacteria were reviewed. The data were analyzed using SPSS software.

 For Staphylococcus aureus, the highest antibiotic resistance and sensitivity rates were 27/2 percent (25 cases) to vancomycin and 30/4 percent (28 cases) to gentamicin. In contrast, the resistance and sensitivity rates for pseudomonas aeruginosa were 11/7 percent (19 cases) to meropenem and 29/6 percent (48 cases) to gentamycin, respectively.

 Accurate evaluation of the antibiotic resistance pattern of these bacteria is necessary to select an effective antibiotic for the treatment of children.

We can provide beneficial and effective treatment using effective antibiotics on bacteria.