Shiraz E-Medical Journal
Year:2020 | Volume:21 | Issue:11|Papers Count:8

Context: Considering the pivotal role of telemedicine in providing healthcare services for remote areas, some of the military medical centers, especially in developed countries, use diff erent types of telemedicine programs. Objectives: The present study aimed at identifying the implemented telemedicine projects in military medicine worldwide and introducing their features. Evidence Acquisition: The current systematic review was performed in 2018. PubMed, Scopus, Embase, and Web of Science databases were searched for articles published from 2014 to 2018 by a combination of related keywords, and the related original articles were then selected based on the inclusion and exclusion criteria. Data were collected by a data extraction form, and then the data were summarized and reported based on the study objectives. Results: Of the 173 articles retrieved from the fi rst round of search, 12 were included in the study; fi ve (41. 66%) studies had used the synchronous (real-time telemedicine) method. The United States, with nine studies, had the highest number of projects in military telemedicine. Most studies (n = 7) were performed on tele-psychology and the application of telemedicine in psychology. All selected studies reported the positive eff ects of telemedicine on providing healthcare for military forces. Conclusions: The proper utilization of telemedicine equipment is eff ective in saving time for both patients and healthcare providers, reducing costs, supporting in natural disasters, and satisfying patients with military medicine. To achieve telemedicine program objectives, they should be set precisely. Considering the importance of timely healthcare services, it is suggested to utilize synchronous methods and tools such as video conferencing.

Background: Subarachnoid hemorrhage (SAH) is one of the most costly and important causes of death and disability worldwide. Aneurysmal type of this hemorrhage has high fatality and permanent disability rates. Objectives: In the present study, demographic and clinical characteristics of SAH with and without an aneurysm were compared. Methods: In this cross-sectional study, via the census method, all patients diagnosed with subarachnoid hemorrhage who were admitted to Farshchian Hospital in Hamadan during 2015-2016 were assessed. For SAH patients, both with and without an aneurysm, we used medical records to obtain demographic and clinical information. Data was analyzed using SPSS software version 21, at a 95% confi dence level. Results: Overall, the medical records of 69 patients were investigated in this study. Among them, 17 (24. 63%) had an aneurysm. There was a signifi cant diff erence between the age of SAH patients and aneurysm (P = 0. 003). Concerning patient risk factors, 59. 4% had a history of hypertension, 29% had a history of smoking, and 17. 4% had a history of diabetes. These risk factors and patient aneurysm status were not signifi cantly correlated (P > 0. 05). The proportion of death, persistent defect, hydrocephaly, and re-bleeding in investigated patients was 36. 23%, 43. 48%, 26. 09%, and 17. 39%, respectively. Conclusions: According to the fi ndings, hypertension and smoking were two of the common modifi able risk factors in aneurysmal and non-aneurysmal SAH patients. Unlike non-aneurysmal SAH, aneurysmal SAH was more common in younger patients.

Background: The family has an important role in shaping the children’ s behaviors. Today, along with social change, the family, as a major social institution, is also undergoing some signifi cant changes. Social behaviors are learned in the family, and the behaviors of family members are considered as examples by children. Objectives: This study aimed to determine the relationship between children’ s social skills and developmental function of the family in Iran. Methods: A descriptive-analytical correlation study was conducted in Iran in 2018. The subjects included 309 primary school students in four districts of the city (north, south, east, and west). The data collection tools were a demographic questionnaire, the Developmental Family Functioning Assessment Scale (DFFAQ), and the Matson Evaluation of Social Skills with Youngsters (MESSY), which were completed by the researcher and children’ s mothers. SPSS 16 was used for statistical analysis. The chi-square test and Pearson’ s correlation coeffi cient were applied for data analysis. The P values of less than 0. 05 were considered signifi cant. Results: The results showed that the developmental function of the family was at an intermediate level in 72. 2% and a good level in 27. 8% of the research units. The social skills of the children were at an intermediate level in 39. 5% and a good level in 60. 5% of the subjects. There was a signifi cant positive correlation between children’ s social skills and developmental family function (r = 0. 2, P = 0. 03). The result of multiple regression analysis showed that care and regulation were better predictors of social skills in children ( = 0. 25, P = 0. 001), and 30% of the variance in social skills could be predicted by the function of the family. Conclusions: It is suggested that parents, nurses, psychologists, and other health providers design appropriate interventions to promote the developmental functions of the family to improve the social skills of children.

Background: Oxidative stress as a major mediator of adverse outcomes in kidney transplant recipients who are prone to oxidative stress-mediated injury by pre-transplant and post-transplant conditions. Objectives: The purpose of this study was to assess the eff ects of Pioglitazone on oxidative stress biomarkers and blood glucose control in diabetic patients receiving insulin after kidney transplantation. Methods: In a triple-blind randomized placebo-controlled trial, sixty-two kidney transplanted diabetic patients (40 men and 24 women) were followed for 4 months after randomly assigned to the placebo group and Pioglitazone group (30 mg/d). All of the patients continued their insulin therapy irrespective of the group that they were assigned to evaluate the eff ects of the addition of pioglitazone on blood glucose and oxidative stress biomarkers, Malondialdehyde (MDA) and total protein carbonyls (TPC) serum levels. Results: At baseline, there were no statistically signifi cant diff erences in glycemic control levels and oxidative markers between the two groups. After 4 months of intervention, a signifi cant improvement occurred in Hemoglobin A1c (HBA1c) in the Pioglitazone group. The changes of HBA1c during 4 months of follow up in the Pioglitazone group show improvement in glucose control were as HBA1c in the placebo group increased by 0. 3% (P = 0. 0001). Moreover, at the end of the study, the MDA level was signifi cantly lower in the Pioglitazone group (P < 0. 0001, 1. 22-3. 90). Regarding the serum level of TPC, the changes were not statistically diff erent at baseline and also at the end of the study between two groups. Conclusions: Administration of Pioglitazone in addition to insulin in diabetic kidney transplant patients not only improved glycemic control (evidenced by HBA1c) but also signifi cantly decreased oxidative stress markers such as MDA.

Background: Today, the incidence of septic arthritis by Staphylococcus aureus has increased due to intra-articular injections, prosthetic joints, and underlying conditions such as rheumatoid arthritis and immunosuppression. Pistacia atlantica has signifi cant antioxidant, anti-infl ammatory, and antibacterial activities. Objectives: Considering S. aureus as the most important etiology of septic arthritis, this experimental study aimed to evaluate the eff ects of P. atlantica on septic arthritis. Methods: Septic arthritis was induced by intra-articular injection of S. aureus suspension in left stifl es of rats, which were divided randomly into eight groups, containing ten per group, including normal: no intervention; control: septic arthritis was induced but not treated; Oral Placebo (OP): 14 days daily P. O.; Local Injected Placebo (LIP): a single dose intra-articular (IA injection) of normal saline; Oral P. atlantica (OPa): 14 days daily P. O. P. atlantica extract; Local Injected P. atlantica (LIPa): a single-dose IA injection of P. atlantica extract; Prophylactic Oral P. atlantica (ProOPa): prophylactic P. O. P. atlantica extract daily one week before the induction for 21 days; Prophylactic Local Injected P. atlantica (ProLIPa): a prophylactic single-dose IA injection of P. atlantica extract one week before the induction. For further evaluations, blood and histopathological samples were obtained. Results: Pistacia atlantica oral medication reduced the physical symptoms of infl ammation. Although hematological analysis showed a fall in the control group compared to the normal group, all medicated groups increased. The OPa group showed the closest WBC count (9. 46  4. 12  10 /L) to the normal group (P = 0. 073). All histopathological parameters had signifi cantly higher scores in the control group compared to the normal group. Although the scores increased in the groups that received P. atlantica, they decreased in the groups that received placebo, except for synovitis degree. The OPa group demonstrated a lower degree of synovitis (1. 40  0. 51) than the control group; however, it was not signifi cant (P = 0. 690). Local injections revealed higher erosion scores (2. 80  0. 63 for the LIPa group and 2. 70  0. 48 for the ProLIPa group) than the control group (P < 0. 05). Conclusions: Oral administration of P. atlantica alleviated the clinical symptoms. Cellular immunity activation and systemic benefi ts of oral P. atlantica were assessed. Histopathology confi rmed the immune system involvement and antibacterial activity of P. atlantica. More erosion may be due to more bacterial debris with arthritogenic properties. Meanwhile, the probability of the stimulatory eff ect of P. atlantica extract for synovial content should not be ignored.

Background: Several studies reported that endometriosis is associated with an increased risk of ovarian cancer. Atypical endometriosis is common in patients with endometriosis-associated ovarian, which might be considered as a precancerous lesion. Objectives: This study aimed to assess ki67 and PTEN expression in endometriosis associated ovarian cancer (EAOC), atypical endometriosis, and typical endometriosis. Methods: In this study, all H & E slides of 260 ovarian endometriosis cases were reviewed. And 25 cases were diagnosed with atypical endometriosis. Forty-one typical endometrioses and 24 ovarian cancers with endometriosis were included. We assessed PTEN and Ki67 immunoexpression in epithelial and stromal cells. Results: The prevalence of atypical endometriosis was about 9%. PTEN loss was found in 12 (out of 24 or 50%) of EAOC, 2 (out of 25; 8%) of atypical endometriosis, and none of the typical endometriosis. In all 12 PTEN loss cases, the PTEN loss pattern in endometriosis adjacent to ovarian cancer was similar to that of ovarian cancer. A total of 7. 3% of typical endometriosis and 8% atypical endometriosis and 33. 3% of EAOC had Ki67 staining in more than 50% of the epithelial component. Both typical and atypical endometriosis showed similar PTEN loss and Ki 67 staining (in more than 50% of the epithelial component) (P value > 0. 05), and both of them were diff erent from EAOC (P value < 0. 05). Conclusions: The PTEN loss pattern in endometriosis adjacent to ovarian cancer was similar to that of ovarian cancer. The result indicated that PTEN loss could be an early event in the tumor development pathway from endometriosis to ovarian cancer.

Background: Following an earthquake with a magnitude of 7. 3 on the Richter scale took place in the west of Iran, on November 12th, 2017, numerous state and community response teams were dispatched for a variety of purposes. Objectives: This study aimed to describe the experiences of the medical team dispatched from Shiraz University of Medical Sciences (SUMS) in an emergency fi eld hospital in the city of Sarpol-e-Zahab following the Kermanshah earthquake. Methods: In this cross-sectional study, the data collected by SUMS’ s team were used. In this regard, the condition of the only local hospital in Sarpol-e-Zahab after the earthquake, the actions taken by SUMS’ s team, the existing problems, as well as characteristics of the visited patients, were described. Finally, the satisfaction of the medical staff at the hospital under the study with the performance of the SUMS’ s team was analyzed. Results: Following the earthquake, the only hospital in Sarpol-e-Zahab became semi-open. An emergency fi eld hospital was partially established in the hospital’ s parking lot. The SUMS’ s team changed the arrangement of the fi eld hospital, and during eight days, visited more than 9, 000 patients. The most frequent chief complaints of patients were signs of the fl u and respiratory infections, various types of trauma, and gastrointestinal problems. Conclusions: Our results indicated that the data were not adequate to cover all the aspects involved. This shows the necessity of developing a registry system for better management of healthcare at times of the crisis.

Objectives: This study was conducted to determine the relationship between Internet addiction and social adjustment, and test anxiety among the female students of Ardabil University of Medical Sciences. Methods: This descriptive correlational research was conducted on all female students of Ardabil University of Medical Sciences studying in the second semester of the academic year 2019. The sample consisted of 346 students who were selected by simple random sampling. Data were collected using three questionnaires assessing Internet addiction, social adjustment, and test anxiety. The obtained data were analyzed using Pearson correlation and regression analysis. Results: The results showed that there was a signifi cant positive correlation between Internet addiction and test anxiety. There is also an inverse correlation between social adjustment and test anxiety. The results of step-by-step regression analysis showed that among the variables under study, the Internet addiction variable predicts 0. 32 and along with the social adjustment variable 0. 37 variance of test anxiety. Conclusions: It can be concluded that the level of test anxiety in students can be controlled through the necessary training to make better use of the Internet and prevent its addiction.