مجله پزشکی بالینی ابن سینا
سال سی‌ام شماره 3 (پیاپی 109، پاییز 1402)

As a global healthcare issue, Chronic Obstructive Pulmonary Disease (COPD) is mainly associated with smoking. Nonetheless, environmental and occupational issues are also linked to its development. The present study aimed to assess the urine albumin-to-creatinine ratio (ACR) and serum uric acid (SUA) levels as predictors of disease severity in COPD patients.

This cross-sectional study was conducted on 67 patients diagnosed with COPD using the Global Initiative for Obstructive Lung Disease diagnostic criteria. The participants were patients who were either referred to the subspecialty clinic of the pulmonology and spirometry unit of Hamadan Shahid Beheshti Hospital or were hospitalized in the pulmonology ward. Blood and urine samples were taken from the COPD patients, and the serum uric acid, urine albumin, and urine creatinine levels were assessed and recorded in a checklist. The data were analyzed in SPSS software (version 23) at a significance level of 0.05.

In terms of gender, 5.7% of the participants were male and 34.3% were female. The mean age of patients was 61.77 years. The stages of disease severity in the patients were as follows: 20.89%, 22.38%, 5.73%, and 2.98% of cases had very severe, severe, moderate, and mild COPD, respectively. The regression analysis results demonstrated that SUA levels could significantly predict the FEV1 in COPD patients; nonetheless, urine ACR could not predict the FEV1 scores.

As evidenced by the result of the present study, the FEV1 in COPD patients and disease severity could be predicted by the SUA levels. Therefore, it is recommended to consider monitoring and assessing non-pulmonary factors, especially SUA levels, in the treatment of COPD patients.

Based on previous studies, the clinical sensitivity of cardiac troponin I (cTnI) is higher than creatine kinase MB (CK-MB) in diagnosing acute coronary syndromes. The present study aimed to assess the diagnostic accuracy of cTnI and CK-MB biomarkers in diagnosing suspected myocardial infarction (MI).

In this descriptive study, 453 patients suspected of acute coronary syndrome who visited the emergency department of Farshchian Hospital in Hamadan in 2017 with chest pain were included. Of these, 360 patients had MI, and 93 patients did not have MI. In order to measure serum levels of CK-MB and cTnI, blood samples were taken from patients at the beginning and one and six hours later. The sensitivity and specificity of CK-MB and cTnI enzymes in MI were compared.

The sample size of this research was 453 cases, of which 66.45% were male and 33.55% were female. The mean age of subjects was 65.28±14.38 years. The sensitivity and specificity of cTnI in the diagnosis of MI were 96.67% and 100%, respectively. The sensitivity and specificity of CK-MB in diagnosing MI were 81.11% and 12.90%, respectively. The positive and negative predictive values of cTnI were 88.57 and 100, respectively, while the positive and negative predictive values of CK-MB were 78.28 and 15%, respectively. The accuracy of cTnI in differentiating cases of MI from non-MI (97.35%) was higher than that of CKMB (67.08%).

As evidenced by the obtained results, the sensitivity, specificity, and accuracy of cTnI detection in MI cases were higher than CK-MB. Therefore, troponin is a better marker than creatine kinase to identify patients with myocardial infarction.

Shoulder pain is one of the most common complaints of patients after laparoscopic cholecystectomy, which seems to be closely related to the residual volume of carbon dioxide gas used during surgery. Therefore, this study was conducted with the aim of investigating the effect of Trendelenburg positioning after surgery in reducing shoulder pain in patients.

This study was conducted as a randomized clinical trial in 58 patients who were eligible for laparoscopic cholecystectomy. Patients were enrolled in the study by simple random sampling and randomly assigned to supine (control) and Trendelenburg (intervention) positions. After complete awakening in the recovery room, the patients in the intervention group were placed in the Trendelenburg position (30 degrees), while the patients in the control group were placed in the supine position for 30 minutes. The level of pain was measured 6, 12, 24and 48 hours after completion of the procedure using the NRS scale. Data analysis was performed using SPSS version 24 software.

The results of this study show that there is a significant difference between the pain intensity 6, 12, 24and 48 hours after the end of the intervention between the two intervention and control groups (P >0.05). The pain in the intervention group is therefore lower than in the control group.

As a simpleeffective, and inexpensive technique, the Trendelenburg position can reduce shoulder pain in patients undergoing laparoscopic cholecystectomy

One of the most important stages of root canal treatment is the correct and complete preparation of the root canal. This study aimed to compare the amount of canal transportation in two nickel titanium files, OneShape and Neolix.

In this experimental study, 30 extracted mandibular first molar teeth with 25-35-degree curvature were selected for periodontal reasons and randomly divided into two groups (n=15 each). A cone beam computed tomography (CBCT) scan was obtained from the teeth before the intervention. Followingly, the teeth of each group were prepared by the desired file (OneShape and Neolix) according to the manufacturer's instructions. Another CBCT scan was obtained from the teeth at the same angle. The amount of transportation was analyzed from the mesiodistal aspect at two distances of 3 and 9 mm from the apex. The preparation time of each tooth was also recorded by a chronometer. Data were analyzed by independent t-tests (α=0.05).

The mean transport at a distance of 3 mm from the apex in the OneShape and Neolix groups was 0.19 and 0.1 mm, respectively. The mean transport at a distance of 9 mm from the apex was 0.2 and 0.1 mm in the OneShape and Neolix groups, respectively. Statistically, there was no significant difference in the amount of transportation between the two groups at the distance of 3 mm (P=0.055) and 9 mm (P=0.39). The mean preparation time was longer in the OneShape group than in the Neolix one; however, it did not show a statistically significant difference (P=0.73).

Both Neolix and OneShape files can maintain the curvature of the canal and are suitable for curved canals in terms of shaping ability.

Medical residents have a crucial role in the development of the healthcare system and medical services. This study aimed to determine the quality of life, job satisfaction, and sleep hygiene pattern of the medical residents of various specialties working in teaching centers affiliated with Shahid Beheshti University of Medical Sciences, Tehran, Iran, before and after the beginning of the residency period.

This cross-sectional and descriptive-analytical study with a convenience sampling method assessed 162 medical residents who filled out the research questionnaires twice during a six-month period from September 2018 to March 2018. The required data were collected using the World Health Organization Quality of Life Assessment, Job Satisfaction Questionnaire, and Sleep Hygiene Index.

The results of the study revealed that the quality of life (P=0.000), job satisfaction (P=0.000), and sleep hygiene pattern (P=0.000) significantly decreased in medical residents six months after starting the residency program. Quality of life was found to be lower in men than in women (P=0.000); however, in the field of specialty, no significant difference was found in terms of the relevant variables six months after starting the residency period (P>0.05). Furthermore, having more than 15 shifts per month was significantly related to decreased quality of life in medical residents (P=0.01).

Considering the results of the present study, there is a necessity to provide programs in medical universities to improve the quality of life, job satisfaction, and sleep hygiene pattern among medical residents during their academic period.

The prevalence of obesity has increased dramatically worldwide over the last 50 years. The results of some studies suggest that obesity and overweight are related to increased oxidative stress. The aim of this study is to investigate the effect of combined high-intensity interval training on serum levels of antioxidants and oxidative stress in obese and overweight girls.

Twenty-four obese and overweight girls volunteered to participate in this semi-experimental study. The subjects were randomly divided into two groups: the training group (n=12, age: 21.6±2.0, weight: 71.00 ± 4.13, BMI: 28.58 ± 1.68 and the control group (n=12, age: 20.1 ± 9.2, weight: 71.75 ± 5.40, BMI: 28.08 ± 1.59). The training group (4 weeks/4 sessions per week) performed combined high-intensity interval training, while the control group did not exercise during the intervention. Data were analyzed using repeated measures analysis at a significance level of 0.05.

Antioxidant capacity (TAC), glutathione (GSH) and blood lipid profiles (TC, TG, HDL-c, LDL-c) showed no insignificant changes compared to the control group after four weeks of combined high-intensity interval training (P>0.05). On the other hand, malondialdehyde (MDA) levels showed a significant decrease after the intervention compared to the control group (P<0.05).

8 weeks of combined high-intensity interval training significantly reduced MDA levels. According to the results, this type of training protocol can therefore be considered an effective method to reduce oxidative stress in obese and overweight girls.

COVID-19 disease has various manifestations, such as fever, sore throat, shortness of breath, body pain, and loss of consciousness. This disease may cause coagulation disorders and therefore an increase in thromboembolic events in these patients. This study examines the status of anti-phospholipid antibodies (aPL) in such patients, as one of the factors of increased coagulability.

This case-control study examined anti-phospholipid antibodies (including lupus anticoagulant, anti-cardiolipin antibody, and anti-beta-2 glycoprotein antibody) in 60 patients with definite mild COVID-19. Patients were included in the study if they met the inclusion criteria. The blood samples of the studied subjects were analyzed in the unit's laboratory. The patients' sample results were compared to those of 60 healthy individuals who were matched in terms of age and gender.

The mean age scores of the case and control groups were 48.54±15.29 and 46.91±16.71 years, respectively (P=0.57). In case group, the Anti-β2GPI (IgG and IgM) test was positive in two patients (P=0.578 and P=0.346). The LAC test was positive in 3 patients and 2 controls (P=0.57). Anti-cardiolipin antibodies was positive in 4 patients (IgG in 1 patient and IgM in 3 patients), compared to the control group in 1 patient (P=0.004).

According to the results of this study, the prevalence of aPL was higher in patients with mild COVID-19 than in healthy individuals. Considering the role of aPL in thrombosis, it may increase the coagulability conditions in these patients.

Pilonidal sinus of the sacrum is a relatively common chronic infectious disease. Surgical management of pilonidal sinus is a challenging matter, and despite the different surgical techniques, the recurrence rate is still high.

This double-blind clinical trial study was conducted on 60 patients with pilonidal sinus (2023). These patients underwent surgery randomly and based on the available sampling method in three

open, semi-closure, and primary closure. Recovery time and intraoperative bleeding were recorded. The McGill Pain Questionnaire was used to evaluate postoperative pain, and the Southampton scale was employed to assess infection and secretions.

The recovery time was longer in the open method than in the closure and semi-closure methods (P=0.001). However, this difference did not exist between the closure and semi-closure methods (P=0.402). There were two cases of recurrence in the closed method, while no recurrence was observed in the open and semi-closure methods. The patients undergoing the closure surgical method experienced less bleeding postoperatively (P=0.002). No significant relationship was found between surgical method and infection (P=0.189). There was no significant difference in the intensity of pain experienced by patients after the operation (P=0.789).

For the treatment of pilonidal sinus, primary surgical closure is not recommended due to recurrences, despite the shorter recovery time and less bleeding. The semi-closure surgical method seems to be safer than the open and primary closure methods.