Shiraz E-Medical Journal
Year:2021 | Volume:22 | Issue:6|Papers Count:11

Background: Chronic obstructive pulmonary disease (COPD) is a major noncommunicable respiratory disease with diverse pulmonary and external pulmonary clinical manifestations. This disease is one of the leading causes of mortality in the world, and about 1% of the adult population suff ers from COPD. Objectives: The aim of this study was to assess the eff ect of Montelukast on the serum level of infl ammatory factors in patients with chronic obstructive pulmonary disease (COPD). Methods: In a randomized placebo-controlled trial, 74 patients with COPD with stable conditions were followed for two months after a random assignment to the placebo and montelukast (10 mg/d) groups. All patients continued their treatment protocol irrespective of their group to evaluate the eff ects of the addition of montelukast on serum levels of common infl ammatory factors, such as Tumor Necrosis Factor alpha (TNF- ), C-reactive protein (CRP), and Interleukin 18 (IL-18) in COPD patients. SPSS 18 software was used for data analysis. Results of quantitative data were reported as mean standard deviation or median (interquartile range) and qualitative data as frequency (percentage). If the data distribution was normal, the paired t-test was used to compare the mean before and after and using an independent t-test to compare the mean changes between the two groups. The Mann-Whitney U test and Wilcoxon signed-rank test were also used if the data were not assumed to be normal. A P < 0. 05 was considered as the level of signifi cance. Results: At baseline, there were no signifi cant diff erences in laboratory studies between the two groups. After two months of intervention, there was no evidence of decreased TNF- and CRP in the montelukast group. IL-18 levels were not signifi cantly diff erent at the end of the study between the two groups (P = 0. 23), but it had a decreasing trend in the montelukast group (from 20. 25  5. 98 ng/ml to 16. 19  4. 17 ng/ml, P < 0. 001). Conclusions: Montelukast complementary therapy in COPD patients only improve the serum IL-18 levels and has not a reducing eff ect on the level of TNF- and CRP evidenced by keeping their trend from baseline to the end of the study.

Background: During menopause, women undergo biological, social, and psychological changes and are sensitive to stressors, especially anxiety and depression. Decreased estrogen in postmenopausal women causes mood swings, especially depression and anxiety. Objectives: We aimed to determine the eff ect of the Vitex agnus-castus extract on depression in postmenopausal women referring to a bone density measurement center in Shiraz. Methods: In a randomized controlled tria1, 60 postmenopausal women were randomly divided into an intervention group and a control group. In the intervention group, the research units were assigned to two groups of Vitex agnus-castus tablets and placebo, using random permuted blocks with a block size from one to six for each eligible case. After three months, depression was evaluated by the Edinburg Postnatal Depression Scale (EPDS) in both groups. Then, the results were analyzed using the independent t-test for quantitative variables. The obtained data were analyzed by a statistician using SPSS21. Results: Based on the results, the two groups were homogeneous in terms of the level of education, occupation, and housing, and a signifi cant decrease was observed in the mean depression score in the Agnugolgroup (P < 0. 001). Conclusions: Because depression increases during menopause, it is recommended that it should be used as a supplement during menopause.

Background: Primary ciliary dyskinesia (PCD) is a rare genetic disorder with signs and symptoms of recurrent chronic sinusitis, otitis media, pneumonia, bronchiectasis, male infertility, and situs inversus. The diagnosis of PCD has always been one of the challenging issues that is mostly made through screening tests. These include the saccharin test and measurements of exhaled and nasal nitric oxide (NO) level, transmission electron microscopy (TEM) for evaluating ultrastructure of the cilia, high-speed video microscopy for evaluating ciliary beat patterns, immunofl uorescent staining of the cilia in the biopsies, and genetic studies. As there had not been any epidemiological studies in Iran to detect the prevalence of PCD in the general population, the current research has been undertaken for the fi rst time using screening tests of saccharin and measurement of the level of exhaled NO (fractional exhaled NO) to investigate the prevalence of PCD. Objectives: Primary ciliary dyskinesia (PCD) is a rare genetic disorder with the basis of an abnormal ciliary movement that causes chronic respiratory infections, bronchiectasis, infertility in males, and situs inversus. The signifi cance of earlier diagnosis is for better care and prevention of complications. In this regard, we studied the PCD in children with bronchiectasis by saccharin test and measurement of exhaled nitric oxide. Methods: In this cross-sectional study, 31 patients with a defi nite diagnosis of bronchiectasis were evaluated regarding nitric oxide exhalatory measurement (FeNO) and a saccharin test for the confi rmation of PCD diagnosis. The cut-off point of 20 ppb was considered as the normal level for FeNO test and the sensation of fewer than 60 minutes for the normal range of the saccharin test. Age, gender, and cardioposition were recorded for the patients. Results: Unlike the saccharine test, the measurement of exhaled nitric oxide had a high sensitivity (90. 3% versus 54. 8%) for the diagnosis of PCD. Cardioposition and gender did not have signifi cant eff ects on the outcomes of exhaled NO and saccharin test (Pvalue > 0. 05). Besides, the patients’ age did not aff ect FeNO measurement but was signifi cantly higher among those with abnormal saccharin test (P-value = 0. 028). Conclusions: The FeNO test had a remarkable sensitivity of 90. 3% for the diagnosis of PCD, and its outcomes were not aff ected by age, gender, and cardioposition. The saccharin test had a sensitivity of 54. 8% and was infl uenced by age, while not by gender or cardioposition. Although there are more accurate tests for diagnosis of PCD such as TEM and genetic studies, we decided to investigate PCD in children with bronchiectasis by performing two screening tests, NO and saccharin, because of several issues.

Background: Osteoarthritis (OA) is a progressive degenerative disease. Previous treatment strategies have tried to slow the progress of OA. Objectives: The present study aimed to stop and reverse the progressive nature of OA by the paracrine eff ects of synovial stem cells. Methods: Fifty male Sprague Dawley rats were randomly allocated to fi ve equal groups (n = 10). The control group received no treatment. The second group received an intra-articular Hyalgan injection. The third group received an intra-articular injection of secreta. The fourth group received an intra-articular injection of synovial-derived stem cells (5  10 ). The last group received an intra-articular injection of secreta combined with synovial-derived stem cells (5  10 6 ). Three months after treatment, the samples were harvested and evaluated by histopathological and radiological analyses. Results: Histopathological and radiological fi ndings demonstrated signifi cant diff erences between the synovial stem cell combined with the secreta group and the control and Hyalgan groups. Signifi cant diff erences were observed in the subchondral bone and matrix scores between the secreta group and the synovial stem cell and Hyalgan groups (P-value = 0. 042 and P-value = 0. 0001, respectively). Both secreta and synovial stem cell groups showed better healing in terms of cell population viability index than the Hyalgan group (P-value = 0. 015 and P-value = 0. 005, respectively). The synovial stem cell combined with secreta group showed a signifi cant diff erence from the synovia stem cell group in both medial femoral condyle and fabella osteophyte indices (P-value = 0. 004 and P-value = 0. 011, respectively). Conclusions: The group treated with synovial stem cells combined with secreta showed better outcomes than other groups in histopathological and radiological evaluations.

Background: Infertility, as an individual and social problem, aff ects couples’ quality of life and family functioning, job relationships, sexual skills, and marital satisfaction. Objectives: The present study aimed to investigate the relationship between infertility and the quality of life in fertile and infertile women. Methods: In this cross-sectional study with a convenience purposive sampling method, 220 eligible women (110 fertile and 110 infertile) admitted to Shiraz’ s healthcare centers were selected. Data collection was conducted using a demographic information questionnaire and the World Health Organization Quality of Life questionnaire. Results: In this study, a total of 220 fertile and infertile women were studied. Our fi ndings showed that the quality of life WHOQOLBREF score was higher in the fertile group (72. 21 12. 74) than in the infertile group (69. 86 12. 58), although not signifi cant. However, the physical area of the quality of life was signifi cantly higher in the fertile group (17. 55  3. 62) than in the infertile group (16. 57  3. 55) (P = 0. 04). There was no statistically signifi cant diff erence between the groups concerning other quality of life areas (P > 0. 05). Conclusions: The results showed that infertility could reduce the quality of life of infertile women in all areas, and this reduction was signifi cant in the physical area. It appears that infertility diagnostic and therapeutic interventions can aff ect the quality of life of women in the physical area. Further research is recommended in this fi eld.

Background: Recently, therapeutic decision-making in oncology is changed to a big challenge for both patients and involved oncologists due to an increase in available treatment modalities with a variety of benefi ts or adverse eff ects. Objectives: The current study aimed at comparing the perception of treatment priorities regarding lengthening of survival time or maintenance of the quality of life (QoL) among patients with cancer by health care professionals (HCPs). Methods: The current cross-sectional study was conducted on patients with cancer, their relatives, and healthcare professionals in the referral cancer center of Omid affi liated to Isfahan University of Medical Sciences. To identify treatment choices, priority, and related variables infl uencing their opinions, all participants were interviewed using a standard and valid questionnaire in Persian. The collected data were analyzed using the SPSS software version 20, and the P-value less than 0. 05 was considered statistically signifi cant. Results: A total of 299 participants, including 100 patients, 109 relatives, and 90 HCPs (74. 2% nurses, 20. 2% physicians, 5. 6% others) participated in the study. The priority of treatment between survival time (66. 1% for relatives vs. 47. 9% for patients and 21. 3% for HCP) and QoL (33. 9% vs. 52. 1% and 78. 7%) was signifi cantly diff erent between the three groups (P < 0. 001). Most of the HCPs, patients, and their relatives believed that the physician is the only person who should accept the responsibility of treatment choices and process (98. 9% vs. 100% and 98%, respectively; P = 0. 002). Conclusions: Among the Iranian population, both the length of life and QoL were valuable; however, it was observed that patients with cancer and HCPs preferred mostly to expand the QoL, while the length of life was more valuable for relatives. Also, all patients, their relatives, and HCPs preferred to choose the physicians as the decision-makers. The results of the study can be helpful in choosing treatment regimens and designing clinical trials.

Objectives: This study aimed to evaluate the incidence of coronary artery ectasia (CAE) and its associated factors in the East of Iran. Methods: A cross-sectional study was conducted on 2, 795 patients undergoing coronary angiography between 2011 and 2017. Patients were categorized into three groups: Coronary artery ectasia, normal coronary artery, and coronary artery stenosis. Patients’ demographic data, cardiac risk factors, and angiographic results were extracted from medical records. Then, information on CAE patients was evaluated. Data were analyzed by the independent t-test, Mann-Whitney test, and chi-square test. Statistical signifi cance was defi ned by a P-value  0. 05. Results: The prevalence of CAE was 3. 04%. The mean age of CAE patients (59. 44  10. 15) was signifi cantly higher than that of normal coronary artery patients (53. 98 9. 97). The proportion of men was signifi cantly lower in the CAE group (48. 2%) than in the CAS group (62. 1%) but higher than in the normal group (32. 3). Body mass index (BMI) and low HDL (high-density lipoprotein) were higher in the CAE group, but diabetes mellitus was lower than in the CAS group. Conclusions: The prevalence of CAE was low in our study. Old age, male sex, obesity, and low HDL were CAE risk factors, but diabetes mellitus was a preventing factor in our study.

As a global pandemic, coronavirus disease 2019 (COVID-19) has so far posed countless challenges to healthcare systems. Indeed, the high transmissibility of this disease and the lack of eff ective treatments or vaccines have led to a case fatality rate of more than 1% worldwide (1). Despite declining demand for some services such as elective procedures following the COVID-19 pandemic, the drastic growth of the number of patients with COVID-19 has put signifi cant strain on hospitals and healthcare workers (HCWs), which can aff ect the safety and quality of services (2, 3). . .

Background: Multiple sclerosis (MS) is an acquired autoimmune disease of the brain and spinal cord, resulting in the loss of control, vision, balance, and senses. Among the most important complications of MS in the course of the disease are speech disorders, especially dysarthria, as well as impairment of diffi culty and language disorders. Objectives: Therefore, this research aimed to study the verbal fl uency of Persian patients on three types of MS (Relapsing-Remitting, Primary Progressive, and Secondary Progressive). Methods: The descriptive-analytical approach was employed in this cross-sectional research. Since three types of MS were analyzed in this study, the samples collected using the convenience non-probability sampling technique from the MS patients in Rofeideh Rehabilitation Hospital in Tehran. Based on the inclusion criteria, 24 patients were put in each subgroup, and a total of 72 patients were selected. Besides, the mini-mental state examination (MMSE) was carried out in this research to study the cognitive conditions of the patients. The verbal fl uency test has two subtests: semantic and phonological fl uency. These two components were analyzed for analyzing lexical knowledge and fl exibility. In the data analysis phase, the normal distribution of the data was examined by the Shapiro-Wilk test, and paired t-test, one-way analysis of variance, and Bonferroni non-parametric tests were used to compare the mean values of the variables and analyze the data. Results: Our fi ndings revealed a mean switching and total verbal fl uency of 11. 6 (SD = 4. 56) and 27. 3 (SD = 7), respectively. The diff erent forms of word switching and phonological fl uency had no signifi cant relationship with age and gender, but MMSE had a signifi cant positive relationship with all of them (P < 0. 05). The results from the analysis of variance and Bonferroni test also revealed no signifi cant diff erence between the mean values on the SP and PP types of MS, but there was a signifi cant diff erence between all mean values on the RR as well as the PP types (P < 0. 05). However, the types of PP, SP, and RR did not signifi cantly diff er in word switching. Besides, phonological switching and verbal switching varied signifi cantly in patients by academic degree (P < 0. 001). Conclusions: The fi ndings from this research revealed that the three types of MS diff ered signifi cantly at least in lexical switching, phonological fl uency, or semantic fl uency.

Dear editor: Workplace violence against healthcare workers is an increasing global problem (1, 2). Workplace violence against nursing students has been reported to be high in international studies, indicating that students are at a high risk of exposure to violence (3-5). Violence against nursing students may occur in both clinical and academic settings (6). Most studies on workplace violence have focused on healthcare workers and nurses, while there are limited studies on workplace violence against nursing students around the world. Nursing students spend most of their academic time in clinical settings. Therefore, they are at a high risk of workplace violence due to their younger age, lower clinical skills, and low communication skills (5, 7-10). Because of the importance and limited studies in this area, this study aimed to estimate the rate of violence against nursing students in Iran...

Background: Illness behavior refers to the ways of perceiving, assessing, and managing specifi c symptoms by an individual. Objectives: The present study aims to investigate illness behavior during the COVID-19 outbreak among Afghan people. Methods: The study is a thematic analysis conducted between May and September 2020. Data were collected purposefully through semi-structured telephone interviews with 17 infected people from the cities of Kabul, Bamian, and Balkh in Afghanistan. Results: As the participants believed, the COVID-19 outbreak in their country was a socio-political rather than a medical phenomenon. In this situation, the health system is unable to meet medical needs, and patients creatively take care of themselves at home with exercise, local soups, and oxygen therapy if needed. There were four themes explored, including de-hospitalization, healthcare-seeking behavior, social stigma, and the role of media. Conclusions: The illness behavior regarding disease outbreaks is a social rather than a clinical phenomenon. It includes depharmaceuticalization perceptions and activities. Therefore, healthcare systems are recommended to pay attention to the sociopolitical dimensions of illness behavior during such outbreaks.