مجله مطالعات علوم پزشکی
سال سی و ششم شماره 1 (فروردین 1404)

 Bullous pemphigoid is the most common autoimmune blistering skin disease, primarily affecting the elderly, and has been associated with neurological and psychological comorbidities. This study aimed to investigate the prevalence of these disorders in patients with bullous pemphigoid and explore the potential relationship between bullous pemphigoid and neurological/psychological diseases.

 This was a retrospective cross-sectional analytical study involving 100 patients with bullous pemphigoid admitted to Sinai Hospital in Tabriz over a ten-year period (2012–2022). Data were extracted from patient records and analyzed using SPSS software.

The mean age of the patients was 73.12 years. Forty-two percent (42%) were male, and 58% were female. Sixty-seven percent (67%) had at least one neurological or psychological disorder. The most common neurological disease was stroke (26%), while the least common was Parkinson’s disease (1%). Depression was observed in 15% of patients.

The findings indicate a high prevalence of neurological and psychological disorders in patients with bullous pemphigoid. Early diagnosis and management of these comorbidities may improve patients’ quality of life

Colorectal cancer is one of the most common cancers in the world. A review of cancer incidence and prevalence data in Iran in recent years has shown an increase in colorectal cancer. The aim of this study is to investigate the epidemiology and trend of colorectal cancer in West Azerbaijan Province. 

 In this registry-based trend analysis, data collected by the Cancer Registry Center from the beginning of 2015 to the end of 2019 were included in the study. All cases of colorectal cancer registered in the Cancer Registry Center of Urmia University of Medical Sciences during this period were included in the study. Finally, the collected data were analyzed using Minitab version 18 and MicroFit 4.1 software..

In this 5-year study, 2,767 cases of colorectal cancer were recorded, and the average incidence of colorectal cancer in West Azerbaijan Province was 12.46 ± 1.80 cases per month. No upward or downward trend in the incidence of colorectal cancer was confirmed according to the results of the ACF and PACF graphs, and no seasonal changes were observed. According to the results of the regression analysis, it was shown that increasing age and male gender are significantly associated with an increase in the number of cases of colorectal cancer (P < 0.05). Please clarify whether this P-value was significant for both variables (age and gender) separately or represents the overall result of the model.

The results of our study showed that the number of people with colorectal cancer has remained stable, and that increasing age and being male increase the risk of developing the disease as well as the number of people with colorectal cancer.

 Vitamin D can play a vital role in fetal heart development. This study investigated serum vitamin D levels in mothers of infants with congenital heart diseases. 

This study was a case-control study in which 50 mothers of infants with congenital heart defects (case group) and 50 mothers of healthy infants (control group) were examined. The required information for the study included maternal age, vitamin D supplementation, duration of supplementation, family history of congenital heart disease, and serum vitamin D levels. The collected information was then analyzed..

The mean serum vitamin D level in the case group was higher than the control group, but there was no statistically significant difference (P = 0.182). There was no significant relationship between the severity of vitamin D deficiency and the presence of congenital heart disease. (P = 0.695). The mean serum vitamin D level in the cyanotic group was higher than the asiatic group, but there was no significant difference according to the independent t-test (P = 0.42). Also, there was no significant relationship between the severity of vitamin D deficiency in the mother and cyanotic or asiatic status of the newborn (P = 0.102). The duration of vitamin D supplementation in the case group was slightly longer than in the control group and was significantly associated with the presence of heart defects in the newborn (P = 0.026). In the case group, there were more people with a history of congenital heart disease in their first-degree relatives than in the control group and was significantly associated with the presence of congenital heart disease in the newborn (P < 0.001).

In this study, significant relationship was found between vitamin D supplementation and its blood level in the mother with congenital heart disease in the newborn. However, since vitamin D deficiency in the body can cause serious complications in the individual, it is recommended that pregnant women, especially in the first trimester of pregnancy, consume sufficient vitamin D supplements.

Schwannoma, also known asneurilemmoma or neurinoma, is generally a benign, slow-growing neoplasm that originates from any nerve containing a Schwann cell sheath. These neoplasms are rare among spindle cell mesenchymal tumors of the gastrointestinal tract but most commonly occur in the stomach, accounting for 0.2% of gastric tumors. Gastric schwannoma is a rare tumor, and its presentation with severe gastrointestinal bleeding is even rarer. Diagnosing gastric schwannoma with severe gastrointestinal bleeding poses several challenges, as this tumor is uncommon and its symptoms are often mistaken for other gastrointestinal disorders. In this report, we present a case that highlights the importance of differential diagnosis of such lesions when dealing with gastrointestinal bleeding. The patient was amale 44-year-old with a large gastric schwannoma in the distal stomach. The patient was admitted with severe gastrointestinal bleeding, presenting with Hb = 9 and Hct = 25.3. The patient underwent resuscitation, fluid therapy, and received a total of eight units of blood in two sessions.After stabilization; the patient underwent endoscopy, which revealed a large submucosal lesion and an ulcer with blood in the gastric antrum, though no active bleeding site or vessel was identified. The patient subsequently underwent distal gastrectomy with Billroth I reconstruction. Postoperative immunohistochemical staining of the mass was positive for S100, KI67, and SMA but negative for CD34 and CD117. The patient was discharged five days postoperatively in satisfactory condition, and the final pathology report confirmed the diagnosis of gastric schwannoma.

 Hallux valgus is one of the most common foot deformities, with a reported prevalence of about 23% in the age group of 16 to 65 years. This deformity causes external deviation of the first toe and progressive subluxation of the first metatarsophalangeal joint. This condition can be associated with osteoarthritis of the joint and causes impairment in physical function, decreased general health, and decreased quality of life. The aim of the present study was to systematically investigate the effect of non-surgical techniques focusing on kinesiotape and corrective exercises in the management of hallux valgus. 

 Using domestic and foreign databases including Scopus, Google Scholar, PubMed, ISC, SID, Magiran, and Irandoc, articles published between January 2020 and January 2025 were searched with the keywords Rehabilitation, Hallux valgus Kinesiotype, Hallux valgus Corrective Exercises, Hallux valgus, kinesiotype, and corrective exercises. After searching and screening articles according to the inclusion criteria, including access to the full text of the article, articles in Persian and English, and articles that were randomized clinical trials, were selected. The quality of the included articles was assessed using the PEDro scale.

A total of 11 articles met the inclusion criteria. These studies mainly investigated the effect of kinesiology tape and corrective exercises on the big toe angle, pain, and balance. Studies that investigated combined interventions showed more significant improvements in the above indicators.

Evidence shows that the use of combined interventions, compared to the use of an intervention alone, has a greater effect on correcting the deformity, reducing pain, and improving balance in patients with hallux valgus.

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 1,4-Dioxane, a cyclic ether commonly employed in chemical and syntheses processes as a solvent, is now a probable human carcinogen. It is frequently found as a byproduct of detergents and personal care products, so reliable analytical methods to locate and quantify it in cosmetics are important for compliance, regulatory, and public health reasons. 

 We developed an optimized headspace solid-phase microextraction (HS-SPME) method that has the modified carbon fiber as the extraction phase when coupled with GC-FID. The analytical method also allows us to take the best of liquid-liquid extraction and HS-SPME together for better sensitivity in cosmetic matrices.

The method provided adequate sensitivity, detection limit (LOD) of 0.4 μg/kg and quantitation limit (LOQ) of 1.2 μg/kg. The linear dynamic range was 1.5-300 μg/kg, R² > 0.999, precision of 5.8% as RSD at 25 μg/kg, n=6. The carbon fiber modified with aniline/pyrrole/graphene oxide extraction phase had longer extraction times, but was more efficient than conventional fibers due to its π-π modified interactions as well as more areas of contact and surface hydrophobicity.

This method for the headspace solid-phase microextration-gas chromatography-flame ionization detection (HS-SPME-GC-FID) provides a sensitive, reliable, and solvent free method for monitoring, locating, and quantifying 1,4-dioxane in cosmetics to comply with regulatory standards of monitoring carcinogens. The modified carbon fiber exhibits exceptional performance for trace-level extraction of this challenging analyte.

 Brittle diabetes, associated with longstanding type 1 diabetes, is characterized by poor blood glucose control that fluctuates dramatically. Often, patients are defined as having brittle diabetes if they frequently experience episodes of hypoglycemia followed by episodes of hyperglycemia. Hypoglycemia can, in some cases, cause harmful complications such as altered levels of consciousness and seizures. In rare situations, seizures resistant to standard anti-epileptic drugs can prove difficult to manage. In this article, we examine the use of a ketogenic diet as a potential treatment for drug-resistant seizures associated with brittle diabetes.

A 39-year-old female with type 1 diabetes, known to have fluctuations in her glycemic control and seizures at least weekly prior to admission to the endocrinology service. During her admission, she began having 5–6 daily seizures, which were resistant to all anti-epileptic therapies (with supervision by neurology).

After consulting with the Nutrition team, a ketogenic diet was initiated. Over time, seizure frequency began to decrease and ceased entirely after 5 days. After meeting criteria for seizure freedom, we were able to gradually wean all anticonvulsant medications. The patient was discharged 30 days later on the ketogenic diet. Upon follow-up 30 days later, the patient and her family reported no further seizures.

The ketogenic diet may be an alternative treatment option in rare cases of drug-resistant seizures in brittle diabetes, even in the adult population. This promising approach warrants larger-scale studies to elucidate its precise mechanisms and long-term efficacy.

Enlarged adenoids are a common problem in childhood and the most common cause of upper airway obstruction and sleep apnea in children. If untreated, they can cause widespread cardiovascular complications. This study aimed to investigate the prevalence and severity of increased pulmonary artery pressure in children with enlarged adenoids who were referred to the Asthma and Allergy Clinic of Shahid Motahari Hospital in Urmia from 2022 to 2023.

In this descriptive-analytical study, all children referred to the Asthma and Allergy Clinic of Urmia University of Medical Sciences during 2022 with a diagnosis of enlarged adenoids, confirmed by a doctor using a special mirror or a flexible camera (nasal endoscopy), were evaluated. Information such as age, gender, place of residence, clinical symptoms of the patients (sleep disturbance, frequent colds, etc.), and previous medical history were collected in special data collection forms. The collected data were entered into SPSS version 22 software and statistically analyzed.

The mean age of the 19 patients in the study was 7.4 years, and 63.2% were girls. The mean pulmonary artery pressure was 11.36 mmHg, and the mean ANR among the patients was 0.78. Most patients had severe adenoid enlargement (63.2%). There was no significant difference in pulmonary artery pressure between patients with severe, moderate, and mild adenoid enlargement
(P = 0.53). There was no significant association between ANR and pulmonary artery pressure
(r = 0.02, p = 0.92).

The prevalence of increased pulmonary artery pressure in children with enlarged adenoids was 5.2%, and there was no significant relationship between the severity of enlarged adenoids and pulmonary artery pressure.