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Analytical Research in Clinical Medicine - Volume:12 Issue: 1, Winter 2024

Journal of Analytical Research in Clinical Medicine
Volume:12 Issue: 1, Winter 2024

  • تاریخ انتشار: 1403/01/10
  • تعداد عناوین: 8
  • Rana Sorkhabi, Siamak Khavandi*, Hormoz Ayromlou, MohammadHosein Ahoor, Mehdi Mohammadkhani, Elsa Tabibzadeh Page 1

    Demyelination of the nerve fibers of the central nervous system is a main pathology of multiple sclerosis (MS), in which inflammation plays a major role. Studies have shown that inflammation is the leading cause of dry eye disorder. To investigate the association between inflammation and both diseases, we aimed to estimate the prevalence of dry eye syndrome (DES) in MS patients and its correlation with the severity of the disease and disability status.


    We enrolled 100 MS patients randomly and 100 healthy controls. DES was evaluated by Dry Eye questionnaire and Scoring System (DESS), tear break-up time (TBUT), tear meniscus height (TMH), and Schirmer 1 & 2 tests in subjects. Furthermore, the leading disability in MS was assessed by a clinician (neurology professor) using the related questionnaire (Expanded Disability Status Scale).


    According to the TBUT, THM, and Schirmer tests, the number of subjects with abnormal results was significantly higher in the MS group than in the control group. The severity of DES measured by the DESS was also higher in the MS group compared to control group. Also, there was a significant relationship between increasing disability and abnormal dry eye tests, especially in MS patients with EDSS scores>4.


    The present study highlights the importance of considering dry eye disorder in MS patients as a possible consequence of inflammation. Also, our results suggested a significant relationship between dry eye disorder and the EDSS scores.

    Keywords: Dry eye disorder, Multiple sclerosis, Inflammation, Schirmer
  • Tommy Alfandy Nazwar*, Farhad Bal’afif, Donny Wisnu Wardhana, Akhmad Ferro Avisena, Mustofa Mustofa Page 2

    Spontaneous intracerebral hemorrhage (sICH) is a common cause of morbidity and mortality in many countries. Hemorrhagic stroke occurs due to the internal hemorrhage inside the brain as a result of blood vessel rupture. Reversible cerebral vasoconstriction syndrome (RCVS) is multifocal arterial constriction and dilation in the cerebral vasculature and can cause subarachnoid hemorrhage and intracerebral hemorrhage (ICH). We present a case of diagnostic studies of sICH to RCVS in a patient with alcohol chronic consumption history.

    Keywords: Intracranial hypertensive hemorrhages, Nonepileptic seizures, CT angiography, Reversible cerebral vasoconstriction syndrome
  • Sanam Dolati, Morteza Ghojazadeh, Zahra Parsian, Mahsa Kangari, Nafiseh Vahed, Hadi Hamishehkar, Hassan Soleimanpour* Page 3

     Non-alcoholic fatty liver disease (NAFLD) is diagnosed when≥5–10% of hepatocytes display macroscopic steatosis in the absence of other etiologies of liver disease. Consumption of coffee or tea or both may decrease the risk of NAFLD, as recommended by studies of liver enzymes.


     The required data was collected from different databases such as EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and Web of Science as well as the database inception to July 2021. In addition, pooled mean difference and 95% confidence intervals (CIs) were considered in the random effects model.


     Of the total collected 218 articles, 8 met our inclusion criteria to be involved in the meta-analysis. Four studies assessed green tea and one study assessed sour tea consumption in NAFLD patients. Three studies assessed coffee use. All studies have shown an inverse correlation of coffee intake with elevated serum enzyme levels. Based on the meta-analysis outcome, the mean alanine aminotransferase (ALT) in the intervention group was measured as 12.50 points less than that of the control group. The mean aspartate aminotransferase (AST) of the intervention group was 9.23 points lower than that of the control group (P value<0.001).


     There is increasing evidence that steadily revealed an opposite relationship between the consumption amount of green tea and coffee and the risk of liver diseases. This meta-analysis supports the protective role of the mentioned beverages in patients suffering from NAFLD.

    Keywords: Coffee, Liver diseases, Meta-analysis, Non-alcoholic fatty liver disease, Tea
  • Seyed Pouya Paknezhad, Zahra Vand Rajabpour, HamidReza Morteza Bagi, Reza Shahryari Ghalehlar, Samira Pourtagi Anvarian* Page 4

     This study aimed to determine the predictive value of the reverse shock index (rSI) using the Glasgow Coma Score (GCS) to predict the outcome of traumatic patients.


     This study included all patients with a traumatic injury aged≥18 years with ISS score≥16 and head Abbreviated Injury Scale (AIS)≥2 admitted to the Imam Reza hospital of Tabriz, Iran from 1 March, 2021 to 1 July, 2021. After excluding the patients with incomplete data, 216 patients were enrolled. In this study, the rSIG is the product of rSI multiplied by the GCS score. The patients’ symptoms were recorded routinely in the summary section of all patients’ records using the studied indexes. Data collection was performed using the researcher-made forms. The SPSS software v.21 was used to analyze the data. A P-value<0.05 was considered as statistically significant.


     The results of data analysis demonstrated that the regression model by two predicting variables of rSI and rSIG was statistically significant. Also, the model can distinguish between the patients who died and those who were discharged. In addition, the Hosmer-Lemeshow test confirmed the model’s advantage and its accuracy (χ2=14.12, df=8, P>0.05).


     So, the predictive value of rSI with GCS in predicting the outcome of traumatic patients was high.

    Keywords: Brain injuries, Outcome care, Trauma severity index
  • Ayushi Jorwal, Pallaavi Goel, Vishnu Kumar Garg*, Ekadashi Rajni Page 5

    Chryseobacterium indologenes is an uncommon human pathogen that is aerobic, non-fermentative, and oxidase and indole positive. Its clinical relevance has yet to be fully determined. An increase in deadly infectious cases has been recorded in recent years, mostly in patients of older age group and immunocompromised states as a result of C. indologenes infection of medical equipment involving fluids and implanted devices. Because C. indologenes is resistant to the majority of antibiotics, therapy is challenging and this bacterium is thought to be an emerging cause of high mortality in critically ill patients. In our study, we describe a case of C. indologenes producing bacteremia in an elderly female patient with a history of ovarian cancer and hepatitis B infection who had underwent a right hemicolectomy with end ileostomy and a distal mucus fistula and was effectively treated with levofloxacin.

    Keywords: Bacteremia, Chryseobacterium indologenes, Intensive care unit
  • Mohammad Delirrad, Habib Ahmadi, Nader Aghakhani* Page 6

    Donepezil [Aricept®] is a centrally acting reversible acetylcholinesterase inhibitor. We are reporting an unusual case of a 49-year-old male patient with a history of gastric bypass surgery who mistakenly ingested 200 mg of donepezil. During the hospital stay, atypical presentations such as tachycardia, disorientation, mydriasis, and ophthalmic myoclonus were diagnosed. He had experienced convulsions several times and developed rhabdomyolysis. The patient gradually improved under supportive management and was discharged from the hospital after seven days. The authors hope that reporting this case will provide both context for clinicians to be aware of its overdose that may be presented by atypical manifestations or side effects, along with the main muscarinic anticholinergic presentations.

    Keywords: Donepezil, Overdose, Atypical, Clinical presentations, Case report
  • Behnaz Sadeghzadeh Oskouei, Parviz Shahabi, Hossein Babaei, Azizeh Farshbaf-Khalili* Page 7

     Assisted reproductive technology (ART) is increasingly used to help infertile couples to have a child. However, less than one-third of transferred embryos result in successful implantation and live birth. Recurrent implantation failure (RIF) is an outstanding barrier to pregnancy achievement by this advanced technology. This study was conducted to evaluate the hypothesis that luteal phase prolongation would lead to endometrial thickening and decrease the RIF’s rate.


     This interventional study was conducted in the infertility clinic of the Alzahra Teaching Hospital and Asadabadi polyclinic, Tabriz, Iran. Sixty women, aged 20–40 years, with a history of RIF following several in vitro fertilization treatment cycles with mid-luteal progesterone levels less than 3 ng/mL, and endometrial thickness less than 8mm were recruited through the purposive sampling method. Participants were treated for six cycles with oral medroxyprogesterone acetate (MPA) tablet 5 mg/12 h initiated from the 16th day of their menstrual cycle for 20 days and evaluated for study outcomes during this course. Endometrial thickness was compared before and after MPA administration in the whole study population. The pregnancy rate was determined. Pregnancy complications and conditions were evaluated during the study.


     Endometrial thickness was increased in patients after MPA administration (mean difference [95% CI]: 2.66 [2.43 to 2.89]; P<0.001). Overall, 80% (n=48) of participants achieved biochemical pregnancy during a 6-month treatment. Four pregnancies out of 48, were lost in different stages of pregnancy. One participant experienced gestational diabetes in the 24th week of pregnancy. No embryo-fetal abnormality was present until delivery.


     Administration of MPA following RIF induces endometrial development and facilitates embryo implantation by luteal phase prolongation which results in natural pregnancy achievement followed by timed intercourse.

    Keywords: Endometrial thickness, Luteal phase, Recurrent implantation failure
  • Mehrnoush Toufan-Tabrizi* ORCID, Leila Ghahremani-Nasab, Mehran Rahimi Page 8