مجله پزشکی بالینی ابن سینا
سال بیست و نهم شماره 4 (پیاپی 106، زمستان 1401)

This study aimed to evaluate the changes in macular superficial and deep capillary plexus (SCP and DCP) density, Foveal Avascular Zone (FAZ) area, and visual acuity in patients with diabetic macular edema after anti-VEGF therapy.

This descriptive-analytical study utilized before and after treatment design. In total, 30 eyes of 30 patients with diabetic macular edema were investigated in this study. Optical Coherence Tomography Angiography (OCTA) images were taken at baseline (before injections) and at visits after injections (30 days after injections). The patients were treated with intravitreal injection of Avastin (Bevacizumab) with a dose of 2.5 mg per month. Macular vessel density of the SCP and DCP, as well as FAZ area were measured in each OCTA. Best corrected visual acuity (BCVA) was measured at baseline visit and at last visit (30 days after the third injection).

The mean age of patients was 57.33 years. Vessel density in SCP, DCP, and FAZ area were found to be significantly different before and after one, two, or three intravitreal injections (P<0.001). However, vessel density was not found to be significantly different in SCP, DCP, and FAZ area among one, two, or three intravitreal injections (P>0.05). Moreover, BCVA was not significantly different before and after intravitreal injections (P>0.05).

In this study, macular vessel density and FAZ area statistically changed following the intravitreal injections of Bevacizumab; however, they were unchanged among three injections. In addition, the BCVA remained unchanged before and after treatment. Anti-VEGF effect on macular perfusion may cause a direct change in the micro vascular flow.

Mycosis fungoides is a neoplastic skin disorder whose underlying cause is not yet fully understood. There are hypotheses about the possible effect of viral agents on the development of mycosis fungoids that have not yet been proven. The present study aimed to evaluate the lymphocyte variant in peripheral blood smear of patients with mycosis fungoides fungoids to determine the possible role of viral agents in the development of mycosis fungoids.

In this case-control study, 55 patients with a definite diagnosis of mycosis fungoides based on pathology, clinical and immunological findings (ISCL) were selected by convenience and consecutive sampling method from those referring to referred to Farshchian Hospital (Sina) in Hamadan in 2020 and compared with 55 healthy individuals regarding variant lymphocytes percent of peripheral blood smear.

Patients with mycosis fungoides and the control group were matched in terms of age and gender. In the study of peripheral blood smear in patients with mycosis fungoides and the control group, the mean percentage of eosinophils was 5.35±5.11 and 3.00±2.01 (P=0.043), monocytes were 8.27±4.08 and 3.17±1.57 (P<0.001), neutrophils were 53.38±12.97 and 61.64±13.00 (P=0.001), lymphocytes were 31.67±12.57 and 32.95±12.60 (P=0.597), variant lymphocytes was 24.69±15.58 and 3.60±4.66 (P<0.001), and band cells were 1.75±0.96 and 2.25±0.71 (P=0.368) respectively.

In patients with mycosis fungoides, the percentage of variant lymphocytes was significantly higher than that in the control group, suggesting the role of infectious agents, especially EBV & CMV, in this disease.

In order to determine the Hypoxemia and prognosis of patients with covid-19 hospitalized in the intensive care unit, reliable oxygen supply indicators are needed. In this situation, the examination of the percentage of arterial oxygen saturation (SaO2) and arterial oxygen pressure (PaO2), as well as their relationship, may be helpful.

This descriptive-cross-sectional study examined 1,121 patients with covid-19 hospitalized in the intensive care unit of hospitals affiliated with Hamadan University of Medical Sciences. Data were collected through a researcher-made checklist, including age, gender, history of smoking and drug use, underlying disease, duration of hospitalization, the outcome of hospitalization, and hemoglobin listed in the patient's medical records. Moreover, SaO2 and PaO2 were examined in the first arterial blood analysis report after admission to the hospital.

A positive and significant correlation was observed between SaO2 and PaO2 (r=0.733 and P<0.001). SaO2 significantly predicted Pao2 in COVID-19 patients (β=63.51, R2=0.630, P<0.001). Furthermore, the duration of hospitalization had a positive and significant correlation with PaO2 (r=0.112, P<0.001) and SaO2 (r=0.063, P=0.034).

The measurement of the percentage of oxygen saturation and arterial oxygen pressure through arterial blood gas analysis is more accurate in diagnosing Hypoxemia in covid-19 patients. They are better indicators to determine the prognosis of critically ill patients.

Depression in children is especially related to social anxiety. The present study aimed to investigate the effectiveness of emotion-focused cognitive-behavioral therapy (ECBT) in depression and its components in children with social anxiety.

This research was a quasi-experimental study with a pretest-posttest control group design. Among the primary school students of Qom in the 2019 academic year, 46 students whose score was higher than 29.5 on the Liebowitz Social Anxiety Scale for Children and Adolescents were selected and randomly assigned to experimental (n=23) and control (n=23) groups. Firstly, both groups responded to Children's Depression Inventory as the pre-test. Thereafter, the experimental group participated in the 16 sessions of ECBT, and the control group remained on the waiting list. Finally, the two groups were administered the post-test.

The results of Multivariate analysis of covariance (MANCOVA) demonstrated that after the control of pre-test effects, there was a significant difference in the linear combination of depression components of the two groups (Wilks' lambda= 0.065, F33,5= 94.662, P= 0.001). The results of univariate tests of ANCOVA also showed a significant decrease (P<0.01) in all depression components (and also the total score) in children of the experimental group after the ECBT sessions.

As evidenced by the results of this study, ECBT is an effective treatment for depression in children with social anxiety. It is suggested that mental health professionals prioritize this treatment in their therapeutic programs.

Anal fissure can be associated with trauma caused by passing hard stools or prolonged diarrhea. The present study aimed to determine the effectiveness of topical hydrocortisone in the treatment of anal fissures in patients under medical treatment referred to Fatemi Hospital and Kausar Clinic of Ardabil Medical Sciences, Ardabil, Iran, in 2019.

In this clinical trial study, 200 patients with anal fissures were randomly divided into two groups. The intervention group was treated with diltiazem gel, psyllium powder, lactulose syrup, and hydrocortisone topical ointment. Hydrocortisone ointment was not used in the control group.

The mean scores of initial pain were 8.06±0.7 and 7.79±1.02 in the intervention and control groups, respectively. The mean pain at the end of the first week was 2.5±1.06 in the intervention group and 3.34±0.89 in the control group. Pain reduction was significantly higher in the intervention group than in the control group in the first week of treatment. Two weeks later, the pain was 1.46±0.7 in the intervention group and 1.86±0.74 in the control group. There was a significant difference between the two groups in the first and second weeks of treatment.

The therapeutic combination of a topical corticosteroid with a calcium channel blocker at the beginning of treatment for chronic fissures during the first week of treatment led to a faster response in the form of pain reduction

In the last decade, cross-linking (CXL) has been widely used for treating people with progressive keratoconus. The present study aimed to compare corneal aberrometry parameters before and after CXL in patients with keratoconus.

In this cross-sectional study, 67 patients with keratoconus referred to Farshchian Sina Medical Education Center, Hamadan, Iran, who underwent CXL surgery at Mahdia Surgery Center, were selected. The results of refractometry and aberrometry before the surgery and six months after the CXL, were examined and compared. Data were extracted from patients’ medical records and analyzed in SPSS software (version 26). A P-valuec less than 0.05 was considered statistically significant.

The mean age of patients was 22.28 ± 5.03 years, and 65.7% were male. Mean aberrometry parameters before and six months after the treatment for K1: 44.33 and 44.04 (P=0.003), K2: 48.01 and 47.91 (P<0.001), Km: 46.27, and 45.86 (P<0.001), Kmax: 51.72 and 51.34 (P<0.001), astigmatism: 3.59 and 3.93 (P<0.001), Thanet Local: 472.76 and 462.37 (P<0.001) and CDVA: 6.41 and 8.25 (P<0.001). No significant difference was oberved between CCT, Rms Total, Rms LDA, Coma, and sphere parameters before and after the CXl.

Cross-linking is an effective method for treating keratoconus in adults, leading to the correction of most corneal aberrometry parameters, including K1, K2, Km, Kmax, astigmatism, thinnest location, and CDVA within six months.

Dysfunction in the autonomic nervous system can cause cardiovascular complications in patients with type 1 diabetes (T1D). The present study aimed to investigate the effect of combined exercise training on heart rate variability (HRV-5min), aerobic capacity (VO2max), and glycemic index in boys with T1D.

In this semi-experimental research, 24 adolescent boys with insulin-dependent T1D and 12 healthy boys of the same age with an age range of 12 to 18 years were selected and divided into three groups: healthy, control diabetic, and exercise diabetic. The exercise diabetic group performed combined exercises for 12 weeks, three sessions a week. Blood variables and cardiac variables were measured 48 h before and 72 h after the intervention. Dependent t-tests and one-way analysis of variance were used for statistical analysis.

After the intervention, a significant increase in VO2max variables, high frequency HRV (HF) and a significant decrease in Resting Heart Rate Variables (HRrest), the ratio of low frequency to high frequency HRV (LF.HF) and glycemic index were observed in the exercise diabetic group (P<0.05). In addition, in the inter-group analysis of the difference between the pre-test and post-test results, a significant difference was observed in VO2max, HRrest, HF, LF.HF, and blood glucose indices in the exercise diabetic group compared to the healthy and diabetic control groups (P<0.05).

Our results showed that combined exercise training along with insulin-dependent treatment could help to strengthen the cardiovascular system (HRV) in boys with T1D by improving the function of the parasympathetic branch of the autonomic nervous system.

Tooth decay and periodontal problems are among the most common human diseases which are considered unsolved health problems in most countries of the world. This study aimed to investigate and compare the shear bond strength of the fiber post with three different types of cement, including Glass ionomer, as well as Universal and Flowable composites.

This in-vitro study was conducted on 30 extracted anterior deciduous teeth with at least two-thirds of healthy roots. The teeth were randomly divided into three groups of 10. The teeth were mounted from the root part inside the self-curing acryl. Group 1 includes G-Premio Bond and Universal Composite, group 2 includes G-Premio Bond and flowable composite, and group 3 includes Glass ionomer without bond. Immediately, the fiber post was placed in the cemented material in the canal and was light-cured according to the manufacturer's instructions. Shear bond strength was performed by an electromechanical universal testing machine at a speed of 1 mm/min.

The shear bond strength mean values in the Universal composite, Glass ionomer, and Flowable composite groups were 15.29±4.82, 9.74±2.82, and 13.71±4.91 MPa, respectively, and the difference among them was significant (P=0.022). The shear bond strength mean value of the Universal composite was significantly higher than that of the Glass ionomer (P=0.020); however, this difference was not significant for comparing other groups (P<0.05).

The highest and lowest amount of shear bond strength values for cementing fiber post in the repair of anterior deciduous teeth were related to the Universal composite and Glass ionomer cement groups, respectively, which showed a significant difference but did not differ significantly from the Flowable composite group