Jundishapur Scientific Medical Journal
Year:2023 | Volume:22 | Issue:4|Papers Count:12

Background and Objectives Despite the significant role of brain magnetic resonance imaging (MRI) and computed tomography (CT) scans in diagnosing diseases, unnecessary prescriptions of these imaging techniques may lead to adverse consequences, imposing a heavy financial burden on patients and health systems. The present study aimed to assess the unnecessary use of imaging services for the evaluation of children suffering from headaches in Namazi Hospital in Shiraz in 2020.. Subjects and Methods The research population of this retrospective study included all children who were referred to Namazi Hospital with the chief complaint of headache in 2019. Since the research sample was equal to the research population, no sampling was performed, and all individuals were surveyed through the census method. The data were analyzed in SPSS software (version 19) using statistical methods. Results Of the 54 brain MRIs performed, 7.4% were necessary, and 92.5% were unnecessary. Moreover, regarding 81 brain CT scans performed, 8.6% were necessary and 91.3% were not. The indication and insurance status had a significant positive relationship with the necessity of brain MRI and CT scan prescriptions (P<0.05). The total financial burden imposed by unnecessary brain MRIs and brain CT scans of the studied patients in Shiraz Namazi Hospital was 158,298,588 Iranian Rials in 2020.Conclusion The results pointed out that over 90% of the brain MRIs and CT scans prescribed for children with headaches were unnecessary, which could impose unnecessary patient costs. Therefore, it seems essential to use effective clinical guidelines for the proper administration of brain MRI and CT scans.

Background and Objectives Knowing the location of mental foramen during common dental procedures such as local anesthesia, periapical and endodontic surgeries, extraction of impacted teeth and enucleation of cysts and tumors is important. Due to the limitations of available information about this anatomical structure, the aim of this study was to evaluate the relationship between root of mandibular premolar teeth and mental foramen. Subjects and Methods In this retrospective study, CBCT images of 94 patients (47 men and 47 women) who referred to the radiologic department of Ahvaz Jundishapur Dental School in 2020-2021 were recorded and evaluated. Finally, the data were analyzed to evaluate the difference in distance between mandibular premolar teeth root apex and the mental foramen in men and women, using SPSS software version 24 and t- test. Results There was no statistically significant difference for any of the roots of the second right mandibular premolar, first and second left mandibular premolars regarding the distance between the root apex and the mental foramen in men and women. But this distance in the root of the first right mandibular premolar was significantly greater in men than women (p = 0.008). Conclusion This study showed that except for the root of the first right mandibular premolar, there is no significant difference in the distance between the apex of the mandibular premolars to the mental foramen between men and women.

Background and Objectives Magnetic fields can be used in radiation therapy to reduce electron contamination and improve dose delivery accuracy. MRIgRT systems use magnetic fields to track the position of the tumor during treatment and precisely deliver the dose from electron beams to the tumor, which will lead to improved treatment outcomes and reduced side effects. Subjects and Methods The MCNP 6.1 Monte Carlo code was used to simulate the Varian 2100 C/D LINAC in both photon and electron modes. Percentage depth dose curves, dose profiles, and the fluence of contaminating electrons and photons were calculated. Dose profile penumbra and dose differences were calculated for different modes. In the second phase of the study, a constant 1.5 Tesla longitudinal magnetic field was applied to a water phantom that was aligned with the direction of the radiation beam. Results The MD reduced the surface dose by 8.3% and the dose profile penumbra by 5.6% at the surface of the water phantom. The MD removes all contaminating electrons from the radiation field without affecting the number of photons. The application of a 1.5 Tesla longitudinal magnetic field increased the dose by 4% in the maximum dose depth region and reduced the penumbra by 20% and the off-axis dose by 57% at the same depth. Conclusion The MD reduces surface dose, off-axis dose, and dose profile penumbra. The longitudinal magnetic field reduces penumbra and off-axis dose in electron beams.

Background and Objectives Exercise and L-arginine supplementation are known as effective strategies for treating hypertension. The aim of the present study was to determine the effect of aerobic exercise and L-arginine consumption on tissue inhibitor of metalloproteinase-1 (TIMP-1) and endothelin-1 (ET-1) levels in postmenopausal women with hypertension. Subjects and Methods In this quasi-experimental research, 40 postmenopausal women with hypertension were divided into four equal groups including exercise, exercise + L-arginine, L-arginine, and placebo groups. Interventions of aerobic exercise (60-75% of maximum heart rate) and L-arginine supplementation (6 g/day) were completed for 12 weeks. Forty-eight hours after the last intervention session, blood samples similar to the pre-test were collected to measure TIMP-1 and ET-1 levels using ELISA method. Results Plasma ET-1 levels in the training and training + L-arginine groups were significantly reduced compared to the placebo and L-arginine groups. In addition, plasma TIMP-1 increased significantly in the exercise group and exercise + L-arginine group compared to the placebo group. No synergistic effect was observed on TIMP-1 and ET-1 levels, despite the greater effect of exercise combined with L-arginine supplementation. Conclusion According to the results of the present research, improved blood pressure in adaptation to aerobic exercises is associated with reduced ET-1 and increased TIMP-1. L-arginine supplement, either alone or in combination with aerobic exercise, has no significant effect on TIMP-1 and ET-1 changes.

Background and Objectives Thalassemia is the most common genetic disease associated with the body's recurrent blood transfusions and iron overload. Iron chelators can reduce the adverse effects of iron overload through various mechanisms. However, concerns have recently been raised about their negative impact on renal function. The current study, therefore, examined the effect of different iron chelators on renal function in patients with thalassemia major. Subjects and Methods This cross-sectional descriptive study included primary thalassemia patients (5 - 25 years) referring to Ahwaz Thalassemia Center for regular blood transfusion and regular treatment with iron chelators. They were divided into 3 groups (deferiprone 60-80 mg/kg/d, deferasirox 15-35 mg/kg/d and deferoxamine 11-48 mg/kg/d). Blood and 24-hour urine samples were collected to determine glomerular filtration rate (GFR) and biochemical factors. Results No significant difference was observed between the studied groups in terms of GFR, urine albumin, serum creatinine, serum cystatin C, serum and urine phosphorus, and urine sodium (p > 0.05), but serum sodium and urine β2microglobulin (β2M) were significantly different between the studied groups (p < 0.05). Serum sodium was significantly higher in the deferiprone group compared to the control (P=0.004). Urine β2M was significantly higher in the deferoxamine and deferasirox groups in comparison with the control group (P=0.041, P=0.013). Finally, serum sodium was significantly higher in the deferiprone and deferasirox groups than that in the deferoxamine group (P=0.001, P=0.021). Conclusion Urine beta-2 microglobulin increased in patients receiving deferoxamine and deferasirox compared to the control group, which might indicate primary kidney damage.

Background and Objectives Lung cancer is the leading cause of cancer death globally. The epidermal growth factor receptor (EGFR) plays an important role in cell proliferation and signaling. In this study, we examined the association between EGFR (rs712829) gene polymorphism and lung cancer risk among the Iranian population. Subjects and Methods A total of 100 patients with primary lung cancer and 100 matched healthy controls were recruited into this study. EGFR rs712829 single nucleotide polymorphism (SNP) were genotyped by PCR-RFLP techniques for this association with lung cancer risk. Results A significant association was observed between the GG genotype (P= 0.039, OR= 5.500, CI=95%; 1.710- 11.921) and also G (P= 0.001, OR= 2.967, CI=95%; 1.557- 5.691) allele of rs712829 SNP with lung cancer risk, this was while the TT genotype and T allele of this polymorphism showed a protective role against risk of lung cancer. Conclusion In conclusion, EGFR rs712829 was associated with a risk of lung cancer among Iranians. More studies in other Iranian populations are required to confirm the present findings.

Background and Objectives In the last few decades, Escherichia coli strains producing extended-spectrum beta-lactamases (ESBLs) have increased and are now considered a major problem in hospitalized patients. The aim of this study was to investigate the prevalence of blaCTX-M and blaTEM genes in Escherichia coli with multiple drug resistance. Subjects and Methods This study was conducted from October 2021 to May 2022. The research site included the microbiology laboratories of Golestan, Imam Khomeini, and Shahid Beqai hospitals where isolates suspected of Escherichia coli were isolated from urine culture samples of patients with urinary tract infection. All Escherichia coli samples were identified by conventional biochemical and molecular methods. The antibiotic sensitivity of the isolates was determined by disk diffusion method. Then, in order to finally confirm the presence of blaCTX-M and blaTE genes, PCR method was used. Results Out of the 160 bacterial isolates examined, 138 (86.3%) showed multidrug resistance (MDR). The highest and lowest percentage of resistance was related to Amoxicillin-Clavonic acid (84.1%) and Meropenem (5.8%), respectively. Based on the combined disk method, 96 isolates (69.6%) were positive for Beta-lactamase enzymes (ESBLs). Among the 96 ESBL-positive isolates, 85 (88.5%) and 38 (39.6%) carried blaCTX-M and blaTEM genes, respectively. Conclusion Given the significant prevalence of Escherichia coli strains that are resistant to multiple drugs and carrying ESBLs beta-lactamase genes in hospital, there is a need for effective surveillance measures to prevent the further spread of drug resistance in these isolates.

Background and Objectives Obesity-induced metabolic disorders are related to the metabolic syndrome. The present study aimed to assess the effect of high-intensity interval training on body mass index (BMI) and serum levels of leptin, asprosin, insulin, and fasting glucose in inactive obese women. Subjects and Methods In this quasi-experimental research, 24 sedentary obese women were purposefully selected and randomly assigned to two groups of exercise and control(n=12 in each group). The intervention involved three sessions of high-intensity weekly interval training per week for 10 weeks. The control group did not receive any exercise intervention. Fasting blood samples were obtained 24 hours before the commencement of the intervention and 72 hours after the last training session. Statistical analysis involved paired sample t-tests and covariance analysis. Results Based on the results, after the intervention, there was a significant decrease in asprosin (η2=0.352; F=0.390; P=0.003), leptin (η2=0.478; F=19.229; P< 0.001) and insulin (η2=0.681; F=44.828; P<0.001) levels in the intervention group compared to the control group. Nonetheless, no significant difference was observed in BMI and fasting blood glucose (P>0.05). Conclusion As evidenced by the results of this research, high-intensity interval training had positive effects on cytokines related to energy homeostasis and hyperinsulinemia in obese women without causing any weight change.

Background and Objectives Depression in cardiovascular diseases produces a relative risk between 1.5-2.5 for cardiac mortality. Illness perception influences patients’ coping methods against the problems and outcomes of their disease. The aim of this study was to determine the association of illness perception with depression in patients with coronary heart disease undergoing percutaneous coronary intervention. Subjects and Methods This descriptive cross-sectional study was conducted on 342 patients with coronary heart disease undergoing percutaneous coronary intervention between 2016-2017. Participants were selected using convenience sampling, and data were collected using a valid 3-section questionnaire including demographic information, illness perception questionnaire and Beck depression inventory. Data were analyzed by descriptive and analytical statistics in SPSS-V.21.Results The mean score of patients’ depression was 10±11.35 out of 63. The mean score of patients’ illness perception was obtained 17.92±4.55 out of 32. A statistically significant correlation was observed between depression and illness perception (P=0.001). Employment status, functional status, and illness perception were regarded as depression predicators.Conclusion Illness perception as a cognitive variable seems to have a significant effect on psychological outcomes such as depression. Putting emphasis on the positive aspects of psychological well-being which enhance perception of the disease in these patients is of paramount importance.

Background & objective Poor sleep quality is common among patients with diabetes. It has destructive effects on physical and mental health as well as quality of life. This study was conducted with the aim of investigating the sleep quality of patients with myocardial infarction in two diabetic and non-diabetic groups. Subjects and MethodsThis descriptive and analytical study was conducted in 1402. 282 patients with myocardial infarction were included in the study as available. The data collection tool was a demographic information and standard sleep quality questionnaire. The data was analyzed in SPSS version 26 using descriptive and analytical statistics. The significance level of the tests in this study was evaluated with P<0.05.Results:The mean and standard deviation of age in diabetic group patients was 58.19±10.02. The type of myocardial infarction (p=0.3) and the level of education (p=0.2) were not significantly different between the two groups. The results of the Mann-Whitney test showed that the subjective sleep quality, sleep latency, daytime dysfunction, and the overall sleep score in the two diabetic and non-diabetic groups had statistically significant differences (p-value <0.05).Conclusion: The results of this study showed that the subjective sleep quality, sleep latency, daytime dysfunction and overall sleep score of patients with myocardial infarction were different in diabetic and non-diabetic groups. Therefore, it is recommended to create appropriate strategies to improve the treatment of these patients and effective training on improving their sleep quality

Background and Objectives Despite the increasing prevalence of metabolic syndrome among the youth, little is known about the knowledge of university students about this disease. This study aimed to evaluate the knowledge of students at Ahvaz Jundishapur University of Medical Sciences (AJUMS) about metabolic syndrome. Subjects and Methods A valid questionnaire was completed by 245 university students. The questions were divided into 4 sections: diabetes, obesity, high blood pressure, and high cholesterol. Correct answers received 1 score while incorrect ones received 0 score. The answers were presented as a percentage. All data were analyzed with SPSS27 software, and p < 0.05 was considered statistically significant. Results The students’ mean scores were obtained as follows: diabetes: 83.26±10.23, obesity: 89.72±10.45, blood pressure: 92.51±12.47, cholesterol: 86.66±20.33, and total score: 88.04±8.27. There was no significant difference between the two genders in terms of the mean total score and the sections of the questionnaire. A significant difference was observed between different educational levels in terms of mean total score (P<0.01), with the graduate students having the highest knowledge level. However, there was no significant difference between the educational levels regarding the knowledge score of obesity and cholesterol. There was a significant difference between the mean knowledge score in relation to the sections of the questionnaire and the total scores by faculty. The highest and the lowest total knowledge scores were related to the Faculty of Health and the School of Pharmacy, respectively. Conclusion Considering that a score of 81-100% is considered good knowledge, the results showed that AJUMS students had generally good knowledge about metabolic syndrome.

Background and Objectives Recently, performing regular sports activities has been considered an effective strategy for the rehabilitation of patients who have recovered from COVID-19. The present study aimed to assess the effect of eight weeks of selected aerobic and resistance exercises on the plasma levels of irisin, follistatin, and fibroblast growth factor 21 (FGF21) in women who recovered from COVID-19. Subjects and Methods A total of 33 women who recovered from COVID-19 were assigned to three groups, namely aerobic exercise, resistance, and control, after the general call and selection. Aerobic training with an intensity of 50%-70% of the reserve heart rate and resistance training with an intensity of 40%-75% of a maximum repetition was performed for eight weeks (three sessions per week). Irisin, follistatin, and FGF21 levels were measured using the ELISA method. The data were analyzed using the analysis of variance statistical test at the significant level of < 0.05. Results As illustrated by the results, selected aerobic and resistance exercises caused a significant increase in irisin, follistatin, and FGF21 levels. The results of the post hoc test demonstrated that this increase was significant in the aerobic and resistance groups compared to the control group. Moreover, within-group changes pointed to a significant increase in the mean before and after the intervention in the aerobic and resistance groups. Conclusion Carrying out selected aerobic and resistance exercises in women who recovered from COVID-19 boosts their physical strength and is effective in quick recovery by restoring some indicators of myokine profile.