Iranian Red Crescent Medical Journal
Year:2022 | Volume:24 | Issue:3|Papers Count:10

Background: Hepsin is known as a cell-surface serine protease expressed predominantly in the liver. Hepsin-deficient mice show resistance to high-fat diet-induced obesity, hyperlipidemia, and hyperglycemia. Up to the present, the physiological function of hepsin has not been fully determined. Hepsin may play significant and specific roles in diabetes. Objectives: This study aimed to evaluate the relationship between hepsin protein concentrations in serum and type 2 diabetes mellitus (T2DM) and elucidate possible associations with disease activity andinflammatory and metabolic parameters. To the best of our knowledge, this is the first study evaluating the relationship between hepsin, lymphocyte-to-C-reactive protein ratio (LCR), and type 2 diabetes in humans in the existingliterature. Methods: This case-control study included 60 patients (30 males and 30 females) diagnosed with type 2 diabetes, according to American Diabetes Association's criteria, and 30 healthy controls (14 males and 16 females) with similar demographic characteristics. Several laboratory parameters were assessed including fasting glucose, total cholesterol, insulin, hemoglobin A1c, gamma-glutamyl transferase, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, uric acid, C-reactive protein, atherogenic index of plasma, LCR, monocyte-to-neutrophil ratio, neutrophil-to-lymphocyte ratio, and serum hepsin levels. Results: The type 2 diabetes group had significantly higher LCR than controls (P<0. 016). Correlation analysis in the patient group showed a statistically significant relationship between hepsin and LCR (rho=0. 296, P=0. 02). Hepsin was negatively correlated with CRP in the patient group (rho=-0. 333, P=0. 01). Correlation analysis in the patient group showed a statistically significant relationship between hepsin and cholesterol (rho= 0. 29, P= 0. 02). Age was positively correlated with hepsin in the patient group (rho= 0. 267, P=0. 04). There was no statistically significant difference in serum hepsin levels between the diabetes group and the control group (P=0. 157). Conclusion: To the best of our knowledge, this is the first study assessing the hepsin levels in patients with T2DM. Our results indicated that increased levels of hepsin could be associated with the inflammatory processes. Similar results were not found for diabetes. However, it is recommended that similar studies should be conducted in larger patient populations.

Background: Gene polymorphism of angiotensin-converting enzyme (ACE) may be associated with adverse prognosis and increased cardiovascular complications in hemodialysis patients. Objectives: This study aimed to compare the frequency of ACE gene polymorphism in both hemodialysis patients and normal individuals considering echocardiographic findings. Methods: This cross-sectional study included 110 hemodialysis patients (case) and 113 healthy subjects (control). Gene polymorphism of ACE was evaluated in both groups. ECG and echocardiography tests were performed for all patients. Correlations between gene polymorphisms and other variables were analyzed in this study. Polymerase chain reaction (PCR) was used to identify the short deletion allele (D with 190bp), large insertion allele (I with 490bp), and ID genotype which has both alleles. Results: Case and control groups included 46 and 54 female and 64 and 59 male patients, respectively. There were no significant differences between the prevalence of DD, II, and DI alleles of the ACE gene with DI as the most common allele in both groups. No significant differences were found between systolic and diastolic blood pressure and heart rate in DD, DI, and II alleles of the case group. Echocardiographic findings of the patients showed no significant differences between DD, DI, and II genotypes of the case group and intraventricular septal end-diastole (IVSd), MVE vel, MVA vel, MVE/A ratio, MV DT, and MV Dec slope. The mean±, SD left ventricular enddiastolic diameter (LVEDD) in II, ID, and DD patients were 4. 3±, 0. 72, 4. 52±, 0. 66, and 4. 89±, 0. 93 respectively (P=0. 046). Conclusion: The findings of the present study showed that there were no differences in the prevalence of alleles of an ACE gene in hemodialysis patients and control groups. Moreover, no significant associations were observed between alleles of an ACE gene in the patients' group and echocardiographic findings except in left ventricular end-diastolic diameter.

Background: Diabetes mellitus (DM) is one of the most common chronic non-communicable diseases (NCD). Objectives: The present study aimed to investigate the relationship between demographic and clinical data with balance impairments in people with diabetic peripheral neuropathy (DPN), considering the importance of early detection of balance impairments in this population. Methods: Forty-three patients with DPN were evaluated in this cross-sectional study. Age, disease duration, height, weight, and physical activity, along with blood sugar samples and neuropathy disability scores were collected to explore correlations with the balance evaluation system test (BESTest) in this population. Results: A significant weak to moderate correlations was found between physical activity (p-value=0. 046/ CC= 0. 286), severity of neuropathy (p-value=0. 025/ CC=-0. 317), and gender (p-value=0. 032/ CC=-0. 311) with BESTest, using multivariate linear regression analysis. Conclusion: It is recommended that diabetic patients with a sedentary lifestyle, more severe scores on neuropathy screening instruments, and female patients be referred for early screening of balance disorders regardless of age and disease duration. Also, increasing physical activity to prevent balance impairments in the future can be recommended.

Background: In our organ procurement unit, based on empirical evidence, the chance of turning a potential donor into an actual one is less than 30 percent and nursing plays a crucial role in this regard. Objectives: We aimed to clarify nursing viewpoints and probe limitations that affect the organ donation process. Methods: In this cross-sectional study, a self-constructed 28-item questionnaire including information regarding hospital characteristics, nursing attitudes, and level of knowledge was prepared. Our study population was all nurses who consented to fill in the questionnaire using the Quota sampling method. After content validity, the questionnaire was circulated in cyberspace and the nursing society was invited to complete it. After one month, the response rate was 46 percent and the completed forms were analyzed. Results: The majority of participants had not attended any organ donation training program (67%). Also, only 30% of nurses were aware of their crucial role in the donation process. In total, 61. 7% of the participants had a high level of knowledge regarding brain death definition and donor maintenance. A positive attitude was observed in 59. 1% of nurses with a significant difference in the high record of services (p=0. 04). It was also, significantly higher in whom with the experience of working in private hospital (64% vs. 54%, p=0. 05),hospitals with neurosurgery-ward (67. 7% vs. 54. 7%, p=0. 01), transplant ward (67. 4% vs. 54. 9%, p=0. 03). Attending training programs had a considerable impact (67. 7% vs. 50. 8%, p=0. 03) but, being in ICU didn't affect nursing attitudes. Conclusion: Hospital characteristics affect the nursing attitude toward organ donation and transplantation. It is recommended that all health staff obtain appropriate working experience in transplantation wards of the hospitals.

Background: Various techniques can be used for the closure of the appendiceal stump in laparoscopic appendectomy, although no consensus exists on the optimum approach. Objectives: The present study was conducted to compare three different stump closure techniques in cases of complicated appendicitis. Methods: A total of 172 patients who underwent laparoscopic appendectomy for complicated appendicitis were selected for conducting the present retrospective cohort study. The patients were divided into three groups according to the appendiceal stump closure technique: Hem-o-lok clips,extracorporeal knots which were pushed into the abdomen,and laparoscopic knots which were tied manually within the abdomen. The three groups of patients were compared for demographic and clinical characteristics as well as follow-up data. Results: A total of 85 patients were in Group 1, 43 patients in Group 2, and 44 patients in Group 3. The most common surgical finding was a necrotic appendix in all three groups (67. 1% vs. 81. 4% vs. 68. 2%,p: 0. 448). The rate of drain use (42. 4% vs. 34. 9% vs. 31. 8%,p: 0. 455) and the readmission rates (10. 6% vs. 14% vs. 11. 4%,p: 0. 178) were also similar in all groups. The median postoperative hospital stay was 2 days in all groups. Conclusion: No superiority was identified in any of the approaches to stump closure for the laparoscopic treatment of complicated appendicitis cases. All three techniques can be used safely. Accordingly, the technique should be selected based on the assessment of the surgeon, patient’, s characteristics, and cost.

Background: During the COVID-19 pandemic, telemedicine is applied for various purposes, such as reducing the time of diagnosis and initiating treatment, quarantining and stabilizing patients, enabling the system to closely monitor the citizens at home, and supporting health professionals. Objectives: The present study used Scientometrics analysis to comprehensively analyze the body of research conducted on telemedicine regarding COVID-19. Methods: By using a searching formula, 900 documents were retrieved from the Web of Science. Co-authorship networks were drawn by CiteSpace and Gephi software that are free and powerful illustrating networks. The selected co-authorship indicators were Degree Centrality, Betweenness Centrality, and Closeness Centrality. Results: Andrea M. Russo had by far a high degree of centrality, compared to other authors. Regarding the countries, Belgium and Portugal had a larger node, indicating that they had a higher degree of centrality. Neurosciences had a large node, showing the higher degree of centrality of this subject area. Psychology and Clinical Neurology were also the nodes with a higher degree of centrality. The degree of centrality was high for the University of Zurich, University of Barcelona, and King College London, and the connections of these nodes were more and even stronger, compared to other nodes. Conclusion: This study, which was based on 900 scientific credentials in the field of telemedicine during COVID-19, indicated the level of cooperation among authors, countries, and organizations in 2020. Moreover, by presenting different indicators in these networks' researchers, countries, and key organizations were introduced for each indicator.

Background: Sedentary lifestyle has been associated with many chronic conditions and is recognized as a leading cause of total mortality. Regular physical activity can reduce the risk of cardiovascular diseases, diabetes, and osteoporosis and increase fitness, balance, muscle strength, and improve psychological function and self-satisfaction. Objectives: Therefore, the present study aimed to determine the physical activity level among employees working at the Shahid Beheshti University of Medical Sciences, Tehran, Iran to find any relationship between physical activity level and job satisfaction, which is crucial for professional success and productivity. Methods: In this cross-sectional study, 300 administrative staff members were randomly selected in the proportion of their numbers from various deputies, faculties, hospitals, health networks, and centers of the Shahid Beheshti University of Medical Sciences using multistage sampling. The subjects were selected from both male and female employees. The data were collected through a demographic questionnaire, International Physical Activity Questionnaire (IPAQ), Visoki, and Chrome's Job Satisfaction Questionnaire. Results: Mean and standard deviation of physical activity of employees were 3021. 83 and 2688. 65 MET-minutes/week, respectively. The average was slightly higher than the moderate level of physical activity according to IPAQ. The average and standard deviation of job satisfaction of workers were 112. 36 and 26. 16, respectively, which were relatively good. Physical activity and job satisfaction of female workers were higher than those of their male colleagues (P= 0. 019, P= 0. 036 respectively). A significant difference was observed between the level of physical activity of workers and their job satisfaction as workers with higher levels of physical activity had more job satisfaction (P< 0. 001). Conclusion: Regarding the significant relationship between physical activity and job satisfaction, physical activity and exercise of employees in the workplace are crucial. Future prospective studies can validate this association.

Background: Both transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) can provide effective analgesia for abdominal surgery. Objectives: To explore whether there are differences in the effects of TAPB and QLB on the quality of postoperative recovery in patients undergoing laparoscopic radical resection for rectal cancer. Methods: In total, 102 patients undergoing laparoscopic radical resection for rectal cancer were randomly divided into two groups. Bilateral TAPB or QLB was performed using 0. 375% ropivacaine after the induction of anesthesia. The 15-item Quality of Recovery (QoR15) scale was used to assess the quality of recovery at 24 h postoperatively. Secondary indicators included 24-h postoperative fentanyl consumption, patient-controlled analgesia (PCA), incidence of adverse reactions, numerical rating scale (NRS) at rest and during exercise, and incidence of postoperative complications. Results: QoR-15 scores were higher in the QLB group than in the TAPB group (115. 6±, 11. 3 vs. 99. 7±, 14. 2, P<0. 05). Moreover, the 24-h sufentanil consumption was less in the QLB group than in the TAPB group (2. 4±, 0. 5 vs. 5. 5±, 0. 3 μ, g, P<0. 05) after surgery. Time durations to first postoperative PCA compression were 152. 1±, 28. 4 and 100. 3 ±,22. 9 min, respectively (P<0. 05). The numbers of PCA compressions within 24 h after surgery were 6. 0 (2. 0, 8. 0) and 9. 0 (3. 0, 12. 0) (P<0. 05). There were no differences in secondary outcomes, such as adverse reactions, NRS scores at rest and exercise at 24 h postoperatively, as well as complication rates. Conclusion: Patients undergoing laparoscopic radical resection for rectal cancer with QLB had a better quality of recovery and better analgesic effects at 24 h postoperatively, compared to TAPB.

Background: The surgical management of obstructive colon cancers especially those presenting with acute obstruction, is still challenging. Since, the emergent colectomy in cases of unresectable tumors or frozen abdomen, has been reported with high rates of mortality and morbidity. Application of a diverting stoma significantly alleviates the symptoms and prevents further intestinal necrosis and perforation. Case presentation: In this Report a case of unresectable obstructive colon cancer is presented. During the operation, an asymptomatic Meckel’, s Diverticulum (MD) was found which used to be formed as a diverting ileostomy. Conclusion: We advocate our experience of using incidental MD for constructing a diverting stoma for an obstructive colon cancer.

Background: The coronavirus disease 2019 (COVID-19) forced higher education to adopt e-learning and remote online tests as a kind of assessment that leads to new paradigms. Objectives: This study aimed to investigate the medical students' test anxiety toward remote online tests during the COVID-19 pandemic. Methods: The current cross-sectional study has been conducted in the 2020-2021 academic year. A self-reported online questionnaire was used to investigate the medical students' test anxiety at Mashhad University of Medical Sciences, Mashhad, Iran. The survey consisted of demographic characteristics, including gender, age, and curriculum phase, as well as the validated version of the Sarasons's test anxiety scale in Persian. Results: The findings indicated that the prevalence rates of mild, moderate, and severe test anxiety were 27. 9%, 36. 9%, and 35. 2%, respectively, toward remote online tests. Although the comparison of test anxiety levels showed a statistically significant difference due to gender and age (P<0. 05), the difference in test anxiety among the students of basic sciences and preclinical was not significant (P>0. 05). Furthermore, the female students' test anxiety was more than that of male students, and participants over 20 years old had higher test anxiety scores (P<0. 05). Conclusion: Moderate to severe test anxiety was more common in medical students, which can have devastating effects on the students' academic performance. There is a critical need to recommend anxiety management techniques and bring reforms in e-assessment systems to reduce test anxiety in medical students.