Shiraz E-Medical Journal
Year:2021 | Volume:22 | Issue:4|Papers Count:10

Background: Constipation is a common disorder, and its management imposes a signifi cant health burden. Integration of complementary and alternative medicine into the current health system may result in benefi cial outcomes. Objective: This study aimed to evaluate the effi cacy and safety of a Persian medicine preparation (Jalinous capsule) on functional constipation. Jalinous capsule is a combination of Rose (Rosa damascena), mastic (Pistacia lentiscus), Aloe vera (Aloe barbadensis), and turpeth (Ipomoea turpethum). Methods: From January to December 2019, 126 patients aged 18-50 with functional constipation according to Rome IV criteria referred to Imam Khomeini hospital’ s gastrointestinal disease clinic were blindly randomized into "Jalinous" capsule group and placebo group for four weeks. Both groups received psyllium indeed. The patients were followed up at weeks two and four of the treatment and four weeks after the termination of the intervention. Results: Although the frequency of defecation, percentage of incomplete defecation and evacuation, straining during defecation, using manual maneuver to facilitate evacuation and defecation time showed signifi cant improvement in both groups (P < 0. 001), improvements in the intervention group were signifi cantly more than in control group (P < 0. 001). At the end of the second and fourth weeks of taking the drug and four weeks after stopping the drugs, the patients in the intervention group reported less frequent hard stool form in comparison to the patients in the control group (P < 0. 001). Their overall self-reported improvement in symptoms after the treatment was signifi cantly higher than the patients in the placebo group (P < 0. 001). Adverse eff ects were not serious and mostly were transient. Conclusion: "Jalinous" capsule is an eff ective and safe treatment for functional constipation in adults, but more studies are needed to make confi dent conclusions.

Objectives: Several studies have reported a correlation between the POLR2E rs3787016 polymorphism and cancer development, but fi ndings are inconsistent. Therefore, we designed the current study to understand how rs3787016 polymorphism impacts cancer susceptibility. Methods: We searched the Scopus, Web of Science, and PubMed databases for studies related to the topic of interest published up to March 2019. A total of 11 relevant studies, encompassing 8, 761 cancer cases and 10, 534 controls, were retrieved and subject to quantitative analysis. The strength of the relationship was evaluated using the pooled odds ratios (ORs) with 95% confi dence intervals (CIs). Results: Overall, the fi ndings proposed a positive association between rs189037 polymorphism and susceptibility to cancer in homozygous (OR = 1. 32, 95% CI = 1. 11-1. 57, P = 0. 002, TT vs. CC), recessive (OR = 1. 21, 95% CI = 1. 06-1. 39, P = 0. 005, TT vs. CT + CC), and allele (OR = 1. 12, 95% CI = 1. 02-1. 22, P = 0. 021, T vs. C) genetic models. Stratifi ed analysis showed that rs3787016 increased the risk of prostate and breast cancer. In addition, we found a signifi cant association between the variant and increased cancer risk in Asian and Caucasian populations. Conclusions: In summary, the fi ndings of the current meta-analysis suggest that the POLR2E rs3787016 polymorphism is an indicator of cancer susceptibility.

Background: Albumin is a colloidal protein medication in which has a limited availability in market and it has a high cost. Albumin must be used in such approved indications as, large volume paracentesis, plasmapheresis, spontaneous bacterial peritonitis and hepato-renal syndrome. Objectives: The aim of this study was to evaluate the appropriateness of albumin utilization in a teaching hospital in Iran before and after guideline implementation. Methods: In this prospective study, a total of 100 patients were enrolled into the study in Loghman Hakim Teaching Hospital. The medical records of patients were reviewed and some information such as demographic parameters, albumin indication, albumin therapy duration, appropriateness of indication, nutrition type were recorded in pre-intervention phase. Then in post-intervention phase, albumin was administered after clinical pharmacist teaching and guideline implementation. After post-intervention period, demographic parameters, albumin indication, albumin therapy duration, appropriateness of indication were recorded again. Results: In phase 1, albumin was mostly prescribed in inappropriate indications and internist physicians were the most physicians who ordered albumin and wound healing also was the most frequent indication for albumin therapy. This improvement also was signifi cant (P < 0. 05). Data showed that albumin indication in post-intervention was diff erent from that in the pre-intervention phase. After clinical pharmacist intervention most of indications were appropriately. Conclusions: This study demonstrated that in this hospital, albumin was prescribed inappropriately in most cases based on hospital guideline. This rate improved after clinical pharmacist intervention and resulted in signifi cant reduction in albumin irrational utilization. It is advisable that albumin prescription must be monitored carefully by clinical pharmacists.

Background: As the pandemic of coronavirus disease 2019 (COVID-19) in Wuhan raised public health concerns, many studies were conducted to reveal the risk factors of the disease and predictive prognostic indicators to plan the treatment strategies and commence therapies earlier. Although specifi c parameters, including age, gender, chronic diseases, D-dimer, and neutrophillymphocyte-ratio play a curial role in COVID-19, the association between mortality and the extent of lung involvement in the initial computerized tomography (CT) scan of patients diagnosed with COVID-19 has not been well documented in the literature. Objectives: We compared two groups (CT-1 and CT-2) in terms of lung involvement in the initial CT of patients admitted to the emergency unit and then hospitallzed with COVID-19. Methods: Using the digital data system of ˙ Izmir Bozyaka Training and Research Hospital, Turkey, subjects diagnosed with COVID-19 in April 2020 were retrospectively screened. For each of the 90 patients, the initial CT scans on admission were evaluated for the extent of lung involvement and classifi ed as CT-1 ( 5% of lung involvement, n: 45) and CT-2 (> 5% of lung involvement, n: 45). Results: There was not any statistical signifi cance between two diff erent CT groups regarding mortality and length of stay of patients in hospital with COVID-19 (P = 0. 72 and P = 0. 51, respectively). Neutrophil counts were found to be statistically signifi cant and higher in CT-2 group than the CT-1 (P = 0. 02) group. The length of stay in hospital was correlated with age, neutrophil-lymphocyte ratio (NLR), neutrophils, lymphocyte, and only the correlation between length of stay in hospital and age was signifi cant (P = 0. 01). Conclusions: The size of involvement is not a predictive indicator for mortality and length of stay in hospital in patients with COVID-19.

ackground: Systemic corticosteroid use is undeniable for many patients, and many require long-term use of such drugs. Corticosteroids have adverse and irreversible eff ects on all organs of the body. One of these complications that have not been studied fully is the drug eff ect on salivary gland function and the quantity and quality of saliva. Some of the many properties of saliva aff ected by these drugs are saliva pH and viscosity changes and, therefore, its eff ect on oral health. Methods: This study was performed on 90 cumulative saliva samples containing three groups of corticosteroid users, including more than 15 mg/day, corticosteroid users less than 15 mg/day, and healthy and non-drug users. Each group contained 30 samples. The unstimulated cumulative saliva of volunteers was collected by spitting method for 5 minutes, and the pH of the samples were measured by digital pH meter, and the viscosity of the samples was calculated based on the comparison of the amount of movement of saliva in the capillary tube in millimeter per second with the control fl uids. Statistical analysis was performed by Statistical Package for Social Sciences (SPSS V. 18) software and the analysis of variances (ANOVA), Tukey’ s multiple comparisons, or their nonparametric equivalents tests were used. Results: The viscosity of saliva in patients with corticosteroid > 15 mg/day was higher than the healthy subjects (P = 0. 028). Also, salivary pH in patients taking corticosteroid < 15mg/day was lower than healthy ones (P = 0. 017). There was no signifi cant relationship between gender with pH and salivary viscosity (P = 0. 933). Conclusions: Long-term consumption of corticosteroids reduces the pH of saliva and increases its viscosity. Therefore Corticosteroids can cause quantitative and qualitative changes in saliva. It also can aff ect oral and dental health. Hence, the oral health of people taking corticosteroids should be more noticed.

Background: Insomnia is one of the most common sleep problems among children and is associated with a wide variety of impairments such as aggression, decreased attention and concentration, daytime sleepiness, hyperactivity, and irritability. A child with insomnia can aff ect the whole family. It is important to assess insomnia and sleep behaviors of children because insomnia is not a common diagnosis in them. Children’ s Sleep Comic is a questionnaire to diagnose insomnia in children aged 5-11 years, which can be completed within 20 minutes. Objectives: The aim of the present study was to translate and investigate the Persian form of Children’ s Sleep Comic’ s content validity and reliability. Methods: This cross-sectional study was carried out on 209 children aged 5-11 years in primary schools and preschools of Tehran who were selected by random cluster sampling in 2019. The translation was done with the forward-backward method. The content validity was evaluated by 10 occupational therapists, and quantitative content validity was determined by calculating the Content Validity Index (CVI) and Content Validity Ratio (CVR). Internal consistency was assessed through Cronbach’ s alpha and test-retest reliability via Intraclass Correlation Coeffi cient (ICC) among 30 children after one week as well as Standard Error of Measurement (SEM). Results: Overall, 220 children were entered into the study; however, 11 children were excluded because of missing data. The translation of Children’ s Sleep Comic was considered easy and acceptable. The content validity, which was assessed by CVR and CVI were desirable (0. 8 and 0. 8, respectively), and the internal consistency was 0. 76. ICC and SEM were 0. 97 and 0. 02, respectively. Conclusions: The fi ndings of this study showed that the Persian version of the Children’ s Sleep Comic questionnaire is a reliable and valid instrument that can be used for screening insomnia in Iranian children aged 5-11 years.

Background: The family, as the smallest and the most infl uential unit of society, plays a pivotal role in the development of personal, social, and human values. Objectives: The current study aimed at developing and psychometrically evaluating the successful marriage factors questionnaire in youth. Methods: The current methodological study was designed in two stages. In stage one, a qualitative conventional content analysis was conducted successful couples and experts in marriage-related fi elds. By using the obtained results, a 129-item instrument was designed. In stage two, the qualitative and quantitative face and content validity, as well as the convergent and construct validity, were measured, and the reliability of the instrument was assessed. Cronbach’ s alpha and test-retest reliability were employed to determine internal consistency and estimate the stability, respectively. Results: After assessing face and content validity, 129 items were reduced to 80; then the construct validity was performed using the exploratory factor analysis (EFA), and then a 62-item successful marriage factors questionnaire (SMFQ) was formed. The convergent validity of the tool was measured by the 47-item ENRICH marital satisfaction scale (EMS), and a signifi cant correlation was found between the total score of the 47-item EMS and its dimensions and those of constructs and entire SMFQ. In the third stage, the internal consistency reliability (Cronbach’ s alpha) and stability of the instrument were estimated, which were 0. 969 and 0. 962, respectively. The total minimum and maximum scores of the questionnaire are 62 and 310, respectively. Conclusions: A 62-item SMFQ was developed and psychometrically evaluated in the present cultural context of Iran, and it was a valid and reliable scale for the evaluation of factors aff ecting the successful marriage.

Context: Jaundice is a common gastrointestinal system disorder globally. Considering the potential of herbal remedies in traditional medical systems, this study was performed to explore medicinal plants used for the treatment of jaundice in the Canon of medicine. Evidence Acquisition: This narrative review was done on one of the most important textbooks in traditional Persian medicine. Diff erent keywords, like Yá rá gh ¯ an and Zá rd¯ ı , were searched in the book, and a list of plants used was prepared. We searched for recent literature to fi nd any supportive evidence to fi nd the established mechanism of action, as well. Results: At the end of the study, 32 plants were found in the Canon of medicine, which most of them had at least one experimental or clinical study clarifying their mechanism of action to treat jaundice or decrease bilirubin. Conclusions: There are potential remedies in traditional Persian medicine resources, which may be useful in future trials to treat jaundice.

Background: As the traditional indicators of the operative outcomes, including morbidity and mortality, cannot give suffi cient information on a patient’ s physical, mental, emotional, and functional well-being alone, we aimed to compare life quality in the patients under open vein harvesting (OVH) and endoscopic vein harvesting (EVH) techniques after four years of follow-up. Methods: This prospective cohort study followed all the patients who were scheduled for off-pump CABG in the Mashhad-based Imam Reza Hospital, in October 2013, for 4 years. Accordingly, data related to their quality of life were collected, and their life quality was then compared using the WHOQOL-BREF scale. T-test, chi-squared, Fisher exact test, and relative risk were also used. Results: This study was conducted on a total of 103 patients under the two techniques of OVH (n = 53) and EVH (n = 50). The diff erence between the EVH (4. 7%) and OVH (16. 3%) groups at the demographic characteristics was the Transient Ischemic Attack (P = 0. 023). After a 4-years follow-up period, no signifi cant diff erences were observed between the patients undergoing the two techniques of OVH and EVH in all the domains of life quality. Conclusions: According to the obtained results, there was no diff erence in the quality of life between the patients undergoing OVH and EVH techniques over a four-year period. In this regard, further investigations are recommended on the quality of life in patients under the two techniques of OVH and EVH with long-term follow-up periods.

Background: Iran has welcomed a large population of immigrants and refugees, which has led to new demands and priorities in many aspects of life, such as healthcare services. Objectives: For the fi rst time in Southern Iran, in Shiraz City, population-based research was conducted on the patterns of medication use in native non-Iranian residents. Methods: The present cross-sectional study was conducted amongst Shiraz citizens from 2017 to 2018. The population consisted of 43 migrants. Data were collected using a multipart data form. All statistical analyses were performed using SPSS. Results: A total of 43 Afghan migrants were included in the study. Most of them were female (72. 1%), aged under 40 years (67. 4%), and homemaker (62. 8%) with an education level of non-completed high school diploma (97. 7%). The majority of the subjects did not have insurance or family physician coverage (93%), and 85. 7% got medications without prescription. The three most common medications used by the subjects were iron supplements, acetaminophen, and cold medicines. Conclusions: Iran is now hosting Afghan nationals as one of the largest population of refugees in the world. The health conditions of the Afghan population need more attention in order to improve the health status of their community in Iran.