Iranian Red Crescent Medical Journal
Volume:25 Issue: 10, Oct 2023

This study aimed to investigate the therapeutic effect of trigger point (TrP) injection of paravertebral muscle to control postoperative lumbar pain.

The medical records of 46 patients who underwent lumbar surgery in our hospital between January 2013 and January 2020 were retrospectively analysed. The patients included in the study were divided into an observation group (n=26) and a control group (n=20) based on the certainty of their myofascial pain TrP diagnosis. The TrPs were found and injected with a 1:5 mixture of compound betamethasone/lidocaine (2 mL). The Visual Analogue Scale (VAS) scores and Patient Satisfaction Index (PSI) scores of the two groups were recorded before injection, on the day after injection, and one and two weeks after injection. The two groups’ postoperative bedridden time and analgesic medication treatment duration were calculated. All the scores were then compared.

The VAS scores of the observation group and the control group before injection were 7.00 ± 0.63 and 6.85 ± 0.59, respectively, and no significant difference was observed between the two groups (P>0.05). The VAS scores on the day and one and two weeks after injection were 2.65 ± 0.63, 3.46 ± 0.51, and 2.62 ± 0.50 in the observation group and 3.75 ± 0.44, 4.70 ± 0.47 and 4.95 ± 0.51 in the control group. Within the same group, the difference in patients at different time points was statistically significant (P<0.01), and the difference between the two groups at the same time point after injection was also statistically significant (P<0.01). The PSI score of the observation group was significantly lower than that of the control group (P<0.01). The bedridden time of the observation group was 2.71 ± 0.45 d, which was shorter than the bedridden time of the control group (4.42 ± 0.49 d; P<0.01). The duration of non-s teroidal drug use was also shorter in the observation group than in the control group (P<0.01).

Accurate injection of compound betamethasone/lidocaine mixture at the pain TrP can effectively control the early pain response after lumbar surgery. It is also beneficial to the early recovery of postoperative function and improves the patient’s satisfaction with the surgery.

Floods are among the most destructive crises in various countries, including Iran, and are considered a national issue. To reduce flood damages, the flood management process must be regularly reviewed and its problems be identified.

Therefore, the present study aimed to focus on flood management in April 2019 in Khuzestan province, Iran, to investigate the flood disaster management in Iran based on the experiences of policymakers, identify problems, improve the process of flood disaster management, and reduce damage in the future.

This study was designed based on qualitative content analysis. Data was collected using one-on-one, semi-structured interviews with open-ended questions. According to the targeted sampling method, six policymakers related to the Khuzestan flood disaster management in April 2019 were selected as interviewees. Interviews continued until data saturation.

After data analysis, three main themes were identified, namely 1) actions before the flood disaster, such as provision ofinfrastructure and public awareness, 2) actions during the flood disaster, such as flood disaster level assessment and coordination of actions, and 3) actions after the flood disaster, such as damage assessment. It should be mentioned that each theme included sub-themes and categories.

Increased effectiveness of disaster management requires integration and centralization of disaster management and coordination between organizations involved in the disaster at all stages of disaster management, including before, during, and after thedisaster. It is also necessary to pay attention to research and successful models and implement preparedness programs along with disaster drills to prevent disaster damage. Engagement of the participation of people should be considered as well.

Cancer is a common and fatal disease that affects family members, especially adolescents, and causes changes in family communication patterns

To investigate the impact of parental cancer on family communication patterns from the adolescents' perspective.

The present study was a descriptive correlational study conducted on one hundred adolescents with parents with cancer who were selected by available sampling method. The research instruments were a demographic questionnaire and a revised standard questionnaire of the Ritchie and Fitzpatrick family communication model. The information was analysed using S.P.S.S. version 16 software and descriptive statistics, analysis of variance, and correlation coefficient.

The proportion of consensual communication in the family was lowest (3%) and the proportion of laissez-faire communication in the family was highest (58%). The correlation is inverse in the number of children and in the range of treatment level, and a significant direct correlation is observed in the range of family communication pattern and child rank, but in other cases, the correlation coefficient shows no significant communication (p< 0/05).

From the adolescents' perspective, most families whose parents have cancer move toward a laissez-faire family. In these families, there is a low level of conversation and harmony, there is little interaction between family members, and usually only a limited number of topics are discussed. Therefore, the importance of family communication during this time, especially with adolescents, should be emphasized through appropriate education of families whose parents have cancer.

It is of prime importance to manage trauma patients in the early hours and use easy trauma severity scoring systems to make decisions and evaluate patient prognosis.

The present study aimed to design a predictive model of the mortality of multi-trauma patients due to traffic accidents.

This cross-sectional analytical study was performed on 600 patients who suffered from multi-trauma caused by traffic accidents from December 2019 to September 2021. Collected data included age, sex, vital signs, trauma mechanism, involved vehicle in the accident, accident location, and hospital outcome.

In this study, 600 multi-trauma cases caused by traffic accidents were evaluated. Among the significant variables included in the regression model, age, Mean Arterial Pressure (MAP), Glasgow Coma Scale (GCS), AVPU (Alert, Verbal response, Pain response, Unresponsive), and vehicle versus fixed objects (in Vehicle 2) in the presence of other variables in the model, significantly predictedpatient outcomes. Therefore, with the other variables being constant, one unit increase in the age variable increases the probability of death by 1.04 times, one unit increase in the score of the two variables of MAP and GCS, and also the transfer of trauma mechanism from the fixed object to the vehicle reduces death by 0.92, 0.62, and 0.10 times, respectively. In the AVPU variable, the transition from Alert to Verbal, the transition from Verbal to Pain, and the transition from Pain to Unresponsive increases the probability of death by 32, 104, and 567, respectively.

In this study, AVPU, age, MAP, primary GCS, and trauma mechanism due to hitting a vehicle with a fixed object had significantly the highest predictive power of hospital mortality in patients with multiple trauma due to traffic accidents, respectively. It is suggested that further studies be performed to replace the AVPU variable with GCS in the newly designed formulas for calculating the severity of trauma to simplify these scores.

Stroke is the leading cause of high mortality rates in the emergency department (ED). In this regard, early diagnosis and starting appropriate treatments are important.

We aimed to evaluate the efficiency of the optic nerve sheath diameter (ONSD) in the detection of ischemic cerebrovascular disease on initial brain computerized tomography (CT) images of patients presented with ischemic stroke clinic to ED.

In this study, 375 retrospectively-evaluated patients underwent brain CT with a pre-diagnosis of cerebrovascular events, following diffusion magnetic resonance imaging (MRI) due to suspicion of ischemic stroke. Demographic findings, vital signs, Glasgow Coma Scale, National Institute of Health Stroke Scale, Modified Rankin Scale. The results of brain CT as well as diffusion magnetic resonance imaging (MRI) were noted. The measurement of ONSD was done at 3 mm behind the optic disc from both eyes from the initial brain CT of the patients.

In this study, 198 out of 375 patients (52.8%) were women. The mean age of patients was obtained at 67.74±13.18 years. According to diffusion MRI, 143 (38.1%) patients experienced ischemic stroke. The mean age of patients with ischemic stroke was 68.75±12.26 years, and 80 (55.9%) patients were women. The mean scores of ONSD with ischemic stroke were 5.14±0.68 and 4.79±0.6 in the control group. In the diagnosis of ischemic stroke, there was a statistically significant difference between the patient and control groups in terms of ONSD.

In CT images of patients with ischemic stroke, ONSD values were found to increase. If ONSD measurement via brain CT correlates with physical examination and clinical signs, it can be used as an indicator in the diagnosis of early-term ischemic stroke.

Postoperative care after sleeve gastrectomy is critical to a successful outcome because of the increasing popularity of the procedure in the treatment of obesity and related conditions.

The purpose of this study was to evaluate the effectiveness of a health intervention plan for sleeve gastrectomy patients based on the Transitional Care Model (TCM).

This study was conducted from January 2021 to January 2022 at Mudanjiang Hospital. The study included a total of 72 patients who underwent sleeve gastric volume reduction. Patients were randomly divided into an intervention group (36 cases) and a control group (36 cases). The intervention group received care based on a health intervention plan, while the control group received routine care. Various assessments were performed on the first day of hospitalization and three months after surgery, such as questionnaires on general information, physical activity, eating behavior, quality of life, and adherence to implementation.

After the intervention, the intervention group showed significant improvements in total duration of physical activity, moderate-intensity activity, restrained eating, emotional eating, physical pain, mental health, and social functioning (p<0.05). However, there were no significant differences between groups in activity intensity, walking, external diet, physical functioning, physical role, general health, or vitality (p>0.05). Adherence to the health management protocol was significantly higher in the intervention group (p<0.05).

The health intervention plan based on the transitional care model improves physical activity, eating behaviors, quality of life, and compliance in sleeve gastrectomy patients.

The identification of genetic abnormalities in multiple myeloma (MM) patients is of particular importance in designing their treatment. Therefore, it is necessary to use diagnostic methods with high sensitivity to detect abnormalities. Conventional cytogenetic and fluorescent in situ hybridization (FISH) methods are commonly used to identify genetic abnormalities. So far, studies have been conducted to investigate the sensitivity of each of these methods alone; nonetheless, the present research aimed to assess and compare the sensitivity of two methods in identifying genetic abnormalities.

in this study, the sensitivity of Conventional cytogenetic and FISH methods for identifying genetic abnormalities in MM patients has been investigated and compared.

This retrospective study included 246 patients who were referred to Kariminejhad Center for the diagnosis of genetic abnormalities from 2009-2019. All patients were diagnosed based on diagnostic tests, as well as the approval of the relevant physician. The diagnosis of cytogenetic abnormality was made based on the two methods of conventional cytogenetic and FISH.

As evidenced by the obtained results, out of 246 patients examined by conventional cytogenetics, only 17.8% had abnormal karyotypes. While out of 67 patients examined by FISH, 64.1% had abnormal results. The results also pointed out that out of 50 patients with normal karyotypes, 31 cases had abnormal FISH results. Moreover, 25% of patients had hyperdiploidy (pseudodiploid or structural abnormality in 23 pairs of chromosomes), which was diagnosed by conventional cytogenetics. Furthermore, 40.90% of subjects had diploid abnormalities (pseudodiploid or structural abnormalities). In addition, FISH detected del 13q in 27.9% and t(11;14) IGH-CCND1 in 18.6% of patients, the most frequently observed compared to other abnormalities.

Considering that the variety of mutations and translocations is high in different parts of the world and new mutations are detected every day, the use of both methods together can help identify genetic disorders.

One major drawback of using ultrasound for diagnosing thyroid nodules is its limited ability to distinguish between benign and malignant nodules. In China, the common methods for risk stratification and guiding fine needle aspiration (FNA) in diagnosing thyroid nodules are the Chinese Thyroid Imaging Reports and Data Systems (C-TIRADS) and American College of Radiology-Thyroid Imaging Reporting and Data System (ACR-TIRADS).

This review seeks to assess the effectiveness of C-TIRADS and ACR-TIRADS in accurately identifying the risk of malignancy in Chinese patients suspected of thyroid cancer.

A detailed search was conducted in PubMed, Google Scholar, Medline, Embase, Web of Science, Cochrane, and China National Knowledge Infrastructure (CNKI) databases from January 2018 to December 2022. The analysis only considered original articles from China reporting the use of C-TIRADS and ACR-TIRADS confirmed by histology and FNA.

This review analyzed 26 studies with a total of 23,064 thyroid nodules from 19,114 patients to compare the diagnostic performance of C-TIRADS and ACR-TIRADS in predicting malignancy risk in thyroid nodules. Although the malignancy rates in each risk category were similar between the two systems, the TIRADS showed better diagnostic performance than C-TIRADS in terms of pooled specificity (95.0 % vs. 66.8 % of C-TIRADS). However, the pooled analysis showed that C-TIRADS had a better pooled sensitivity (94.6 % vs. 76.5% of ACR-T IRADS). The diagnostic odds ratio was 1.37 (95 % CI: 0.75-2.51) for ACR-TIRADS and 0.89 (95 % CI: 0.36-2.16) for C-TIRADS.

Based onthe results, both C-TIRADS and ACR-TIRADS are effective in predicting the risk of malignancy in thyroid nodules with similar overall diagnostic accuracy. The combination of both systems can be beneficial in enhancing accuracy in suspicious or uncertain cases. The long-term experience of the trained radiologists can readily help in concluding the diagnosis. As no single system or combination of systems can provide a 100% accurate prediction of the malignancy of thyroid nodules, the ultimate diagnosis relies on the concluding assessment of experienced radiologists and the medical team.

Pelvic fractures require surgery to restore pelvic stability and ensure the restoration of normal physiological structure and function. In pelvic fracture surgery, the choice of surgical approach may have a significant impact on the postoperative recovery and prognosis of patients. This study compared the postoperative recovery effect, coagulation function, and inflammatory indicators of patients through two different surgical approaches: the pararectus abdominis approach and the traditional ilioinguinal approach, aiming to provide more evidence and guidance for clinical practice.

To observe the differences in fibrinogen (FIB), D-dimer (D-D), and inflammatory factor levels between patients undergoing pelvic fracture surgery through the Pararectus abdominis approach and traditional ilioinguinal approach.

A total of 86 patients with pelvic fractures were divided into a control group (n=43) and an observation group (n=43). The control group received traditional ilioinguinal approach surgery, while the observation group underwent surgery through the Pararectus abdominis approach. Comparisons were between the two groups for the postoperative coagulation function level, inflammatory factor level, and postoperative hip joint function scores.

Before surgery, there was no difference in FIB and D-D levels between the two groups (P>0.05). At 3 days and 7 days after the surgery, the levels of FIB and D-D in the two groups increased compared to before the surgery; however, the observation group was lower in this regard than the control group at the same time (P<0.05). The results of the repeated analysis of variance showed that there were group, time, and interaction effects between the two groups (P<0.05). One week after the operation, the scores of hip joint function were compared between the two groups (P>0.05). The hip joint function scores of the two groups were higher at 1 month and 3 months postoperatively than at 1 week, and the observation group was higher than the control group at the same time.

Compared with traditional ilioinguinal approach surgery, surgery through the Pararectus abdominis approach can reduce surgical stimulation, decrease coagulation factor secretion, and alleviate systemic inflammatory reactions after the surgery, promoting the recovery of hip joint function.

Pregnant women need correct information and skills for effective self-care and improved self-efficacy during pregnancy. Maternal training will raise women's awareness of pregnancy and childbirth, leading to higher self-efficacy.

The present study aimed to assess the impact of telehealth on pregnant women's self-care, self-efficacy, and satisfaction during the COVID-19 pandemic.

This quasi-experimental study involvedlow-riskpregnant women selected fromprenatal public clinics in Ahvaz, Iran. Eligible pregnant women (n=150) were assigned to three groups:WhatsApp training (n=50), phone call training (n=50), andcontrol(n=50).Women in the three groups received four face-to-face prenatal care sessions based on the content recommended by the Iranian Ministry of Health. In addition to these four face-to-face sessions, four more virtual training sessions were held for the WhatsApp and phone callgroups.

Raising the awareness of pregnant women through telephone counseling was found to not only increase their self-efficacy, self-care, and satisfaction but also reduce the need for in-person visits during the COVID-19 pandemic. Furthermore, a moderate positive correlation was observed between self-efficacy and self-care scores; moreover, they have a relatively negative weak correlation with face-to-face visits.

The results of this study suggested that most pregnant women were satisfied with telehealth during the COVID-19 pandemic, and thanks to this type of care provision, their self-efficacy and self-care levels were high. Reduced face-to-face visits during the pandemic are the main advantage of telehealth.

Hypertensive intracerebral hemorrhage (HICH) is a spontaneous cerebrovascular disease occuring in the brain parenchyma.

To characterize the predictive role of miR-155-5p and BDNF in the prognosis of HICH.

All patients with HICH who underwent CT-guided minimally invasive surgery were classified into the good and poor prognosis groups using the modified Rankin Scale (mRS). The level of miR-155-5p was determined by qRT-PCR, and the level of brain-derived neurotrophic factor (BDNF) in serum was determined by ELISA. The relationship between miR-155-5p and BDNF was tested by Pearson correlation and luciferase reporter assay. The logistic regression method was used to determine the risk factors. The ROC curve was drawn to explain the predictive role of miR-155-5p, BDNF, or their combination.

A high level of miR-155-5p and a lower level of BDNF were observed in the poor prognosis group. BDNF level was negatively related to the level of miR-155-5p. BDNF is a target of miR-155-5p. BDNF and miR-155-5p were associated with prognosis. BDNF, miR-155-5p or their combination were predictive biomarkers for the prognosis of HICH.

BDNF and miR-155-5p were associated with the outcome of HICH patients.