مجله مطالعات علوم پزشکی
سال سی و چهارم شماره 8 (آبان 1402)

Anal sphincter damage is a clinical condition that causes fecal incontinence and can severely disrupt a person's quality of life. Overlap sphincteroplasty is the most commonly referred surgical procedure for ASI repair. The aim of this study was to investigate the etiology and surgical outcomes of the patients with complete anal sphincter injury (ASI) in Imam Khomeini Medical Training Center, Urmia, Iran.

In this descriptive-analytical study, the study population included all cases of ASI surgery in the surgery department of Imam Khomeini Hospital in Urmia from March 2018 to March 2022 were investigated. Data has been analyzed by SPSS version 20 software using analysis of variance (ANOVA) and chi-square tests. A significance level of 0.05 was considered significant.

A total of 45 patients with ASI were selected. The results showed that there was a significant difference between severity and type of fecal incontinence (gas, liquid, solid) before and after the surgery in the patients with ASI (P<0.001). Also, according to the Wexner score, the severity of fecal incontinence before surgery (16.9 ± 3.7) was higher than it after surgery (4.1 ± 3.6), which indicates its reduction after surgery (P>0.05). Also, according to the Wexner score, the average improvement in incontinence was 14 ± 3.6 in women and 11.8 ± 4.2 in men no significant relationship, indicating that gender had no effect on the improvement of incontinence (P>0.05). Also, the results showed that the age of the patients had no effect on the recovery of fecal incontinence (P>0.05). However, the recovery rate of fecal incontinence in trauma patients was higher than the patients who underwent surgery (P<0.05).

The severity of fecal incontinence after surgery has decreased compared to it before the surgery, and the recovery rate of incontinence in childbirth and trauma patients was higher than it in surgical patients.

Pronation of foot is one of the most common abnormalities of the lower limb; so the purpose of this study was to compare the immediate and long-term effects of arch support on the electrical activity of muscles during landing in the three-step shot technique in handball players with pronation foot.

The present study was semi-experimental with a pre-test and post-test design with a control group. The statistical population of this research was male handball players with pronated foot. Sampling was done using convenient sampling method, and 10 people with pronated foot along with 10 healthy people were selected. The sole of the shoe used in this study had a protrusion on the inner edge of the foot (Arch support). To measure the electrical activity of the muscles of the lower limbs, it was recorded by an electromyography device and analyzed by the biometric datalite program. ANOVA test with repeated measurements was used to analyze the data, and the independent t-test was used to check the sameness of the initial conditions.

The results showed that there were significant increases in gastrocnemius muscles (P=0.04), vastus medialis (p=0.001), and biceps femoris muscles (p=0.089) in the pronation foot group after 4 weeks of using arch support insoles compared to the pre-test stage. Also, there was a significant increase in the vastus medialis muscle (p=0.06) in the pronation group in the immediate stage compared to the pre-test stage. In addition, the semitendinosus muscle in the pronation group had a significant increase after 4 weeks compared to the immediate phase (p=0.035).

It seems that in addition to improving the electrical activity of the lower limb muscles during jumping and landing, the immediate and long-term use of Arch Support insoles can lead to improved balance, absorption of landing shocks, and stability of the ankle joint in handball players with pronation foot.

Fatigue is one of the effective factors in changing the electrical activity of muscles, so that this index is directly related to the increase in the potential of muscle injuries and performance loss in various sports stages. Therefore, the aim of the present study was to compare the electrical activity values of the lower limb muscles before and after fatigue in the people with a history of Covid-19 compared to healthy people during walking.

The present research was of semi-experimental and laboratory one. The statistical population of the present study included women with a history of Covid-19 and healthy women in Ardabil province. A statistical sample of 28 people with an age range of 18-30 years was selected by purposive sampling. The statistical samples included two groups of 14 healthy people and 14 people with covid-19. The method of asking people for their history of contracting the Covid-19 disease was in such a way that at least two months had passed from their infection and their PCR test results were already positive. healthy people didn't have any symptoms and had negative PCR results. Electromyography data were analyzed using Datalite Biometric program before and after the fatigue protocol. Two-way analysis of variance (ANOVA) with repeated measures was used for statistical analysis, and bonferroni post hoc test was used at the significance level of P<0.05.

The results showed significant group-by-fatigue interaction effect for frequency of the vastus latlarais (P=0.031), vastus medialis (P=0.029), and gluteus medius (P=0.035) muscles during loading response phase. The reduction of frequency content at post-test compared with pre-test in healthy group was greater than that Covid-19 group.

It seems that the difference in the frequency of electrical activity of the muscles of the lower limbs in different phases of walking after fatigue in people with Covid-19 compared to healthy ones can be a serious reason for the occurrence of injury and decrease in the stability of the joints during walking. However, more confirmatory researches in the future are needed to prove this relationship.

Bamlanivimab is a monoclonal antibody for the treatment of mild to moderate cases of Coronavirus disease 2019 (COVID-19). The aim of the current meta-analysis review study was to compare the efficacy of bamlanivimab and standard treatment in the treatment of patients with Covid-19.

PubMed, Scopus, Cochrane Library and Web of Science databases were searched to identify relevant articles from 2020 to 2023. Also, a manual search was performed in the sources of primary review and key studies. There were no restrictions on the language of the studies. Evaluation of the quality of studies was done with the Newcastle tool. Data analysis was done using Review Manager software version 5.4.

In total, 16 studies including 23166 covid-19 patients were included in the study. The results of the meta-analysis showed that a significant difference was observed between the bamlanivimab and standard care groups in terms of mortality rate (odds ratio [OR] = 0.26, confidence interval [CI]: 0.17 to 0.42, P>0.001), hospitalization rate (OR= 0.45; 95% CI: 0.31 to 0.66, P>0.001), and ICU admission (OR= 0.39; 95% CI: 0.21 to 0.72, P=0.003).

According to evidence from the current review, bamlanivimab reduces mortality, risk of hospitalization, and intensive care unit (ICU) admission in the patients with mild or moderate Covid-19. The results of this study can help health policy makers in choosing effective treatments for Covid-19 patients.

Increased intra-abdominal pressure, which is often hidden in the evaluating of patients, causes critical and complete-rest patients with irreparable consequences. Numerous and consecutive position changes can be effective in creating conditions to increase intra-abdominal pressure. The present study aimed to investigate the effect of position changes on intra-abdominal pressure in mechanically ventilated patients.

The present study was a clinical trial in which 68 patients were randomly selected and enrolled. Intra-abdominal pressure was measured by intrablader method using water manometer. Other hemodynamic and respiratory parameters were measured by BENNETT 840 ventilator and SAADAT hemodynamic monitoring device. Data were entered into a checklist and analyzed using SPSS software version 22 and parametric and non-parametric statistical tests. In this study, a significance level of P < 0.05 was considered significant.

The mean intra-abdominal pressure of patients in different conditions had statistically significant differences. Patients in the 15° and 45° positions had the lowest and in the 30° position to the right side, the patients had the highest intra-abdominal pressure (P<0.001). Mean arterial pressure and abdominal perfusion pressure were the lowest in the position of 30° to the right side, and the highest values were in the position of 15° and 45°. The highest values of airway pressure were observed in the position of 30° to the right side.

Changing of position for mechanically ventilated patients in Intensive Care Units can be associated with significant respiratory and hemodynamic consequences.

Escherichia albertii is a gram-negative and facultatively anaerobic bacterium that has been isolated as a causative agent of diarrhea in recent years. Due to the lack of sufficient information on the phenotypic and biochemical characteristics of this bacterium, it is difficult to distinguish it from other species of the Enterobacteriaceae, especially Escherichia coli pathotypes. So, the aim of this study was to evaluate the prevalence of E. albertii in the urine and stool samples of patients with urinary tract and gastrointestinal tract infection in Kermanshah hospitals using culture and molecular methods.

Four hundred samples consisted of 200 urine and 200 stool samples confirmed as Enterobacteriaceae phenotypically were collected. After subculture and biochemical tests, finally white colonies on XRM-McConkey agar (suspected to be E. albertii) were selected and subjected to PCR using specific primer for cdt gene (Eacdt). SPSS version 16 software was used for the statistical analysis of the data, and the p-value less than 0.05 was considered statistically significant.

Only 5 samples (1.25%) were positive in the final culture on XRM-MacConkey agar. None of them were then confirmed as E. albertii by the PCR.

According to the phenotypic isolation of this bacterium in present study and previous studies on the prevalence of it, it seems that the use of Eacdt specific primer is not efficient for the detection of this bacterium. However, further studies are recommended to confirm it.