Medical Journal of Tabriz University of Medical Sciences
Year:2024 | Volume:46 | Issue:3|Papers Count:10

Background. Considering the high prevalence of chronic diseases in older adults, providing care to them requires a special approach that focuses on palliative care. Therefore, the present study was conducted to investigate the role of companionship in palliative care in older adults and identify the research gap related to it. Methods. This scoping review study was guided by the method of Arksey and Malley. Researches on the role of companionship in palliative care in PubMed, Scopus, Web of Science, SID, Magiran, and Google Scholar with keywords of companion*, "palliative care" and their English and Persian equivalents were searched. based on the results of 10 studies,the consequences were categorized. Results. Based on the results of 10 studies included in this study, the role of companionship in palliative care can be divided into two categories of positive and negative outcomes. Positive consequences can be classified into physical, mental, spiritual, social, economic, and moral dimensions. Regarding the negative consequences, some roles were explicit, and others were implicit. The latter case indicates a gap in information that requires further study. Conclusion. It is necessary for researchers to pay attention to companionship in palliative care by focusing on its consequences, especially its negative consequences. It is recommended that qualitative and interventional studies should be conducted in Iran. Practical Implications. Researchers can be sensitized to conduct qualitative and interventional studies to accurately investigate the role of companionship in palliative care.

Background. Renal ischemia-reperfusion injury (IRI) is one of the inevitable complications of surgery. The evidence shows that fingolimod, with its anti-inflammatory effects, can play a protective role in renal IRI. The main aim of the present study was to investigate the role of fingolimod against renal IRI in the heart tissue. Methods. Twenty-four male Wistar rats (220±20g) were treated with a single dose of fingolimod (1mg/kg) by intraperitoneal injection before the induction of kidney IRI. At the end of the reperfusion period, the oxidative stress biomarker (malondialdehyde) and antioxidant biomarkers (catalase, superoxide dismutase, glutathione, glutathione peroxidase, and total antioxidant capacity) were evaluated in the heart tissue. Results. Fingolimod pretreatment could increase cardiac glutathione enzyme activity in the fingolimod+IR group compared to the IR group, which was not statistically significant (P>0. 05). The level of total antioxidant capacity in the heart tissue was also significantly increased in the fingolimod+IR group in comparison to the IR group (P<0. 05). Conclusion. Fingolimod was able to prevent oxidative stress damage in the heart caused by kidney IR induction by increasing the level of total antioxidant capacity of the heart tissue. It is suggested that future studies evaluate the effects of this drug in clinical trials. Practical Implications. The total antioxidant capacity of the heart, as a distant organ affected by kidney IRI, is increased following fingolimod pre-treatment.

Background. Hypocalcemia is a common complication of total thyroidectomy. It has many consequences for the health of patients and negatively affects the patient’s quality of life. The purpose of this study was to investigate the predictive role of vitamin D serum levels before total thyroidectomy in the occurrence of hypocalcemia. Methods. This cross-sectional study was conducted on 82 patients who were candidates for total thyroidectomy surgery and referred to 5 Azar Hospital in Gorgan in 2022. Demographic information, laboratory variables, and clinical symptoms of hypocalcemia before surgery, and 24 hours and two weeks after surgery were collected using a checklist. Data were analyzed with SPSS18 software, independent t-tests, U-Man-Whitney, Wilcoxon, paired t-tests, and a Chi-square test at a significance level of 0. 05. Results. The mean serum calcium level was significantly reduced 24 hours and two weeks after surgery. The average serum level of phosphorus also decreased significantly 24 hours after surgery. About 32. 9% showed symptoms of hypocalcemia 24 hours after surgery. Hypocalcemia was not related to the serum vitamin D level. The mean serum calcium level was significantly lower in patients with hypocalcemic symptoms. The average parathyroid hormone one day after surgery was significantly higher in patients with normal calcium levels. Conclusion. Vitamin D serum level before total thyroidectomy is not related to hypocalcemia after total thyroidectomy. Serum levels of parathyroid hormone and phosphorus are related to serum calcium changes after surgery. Practical Implications. Serum vitamin D levels before thyroidectomy cannot predict hypocalcemia after total thyroidectomy. Serum levels of parathyroid hormone and phosphorus are related to serum calcium changes after surgery. Therefore, long-term follow-up of calcium, vitamin D, parathyroid hormone, and phosphorus levels is recommended for these patients.

Background. One of the significant lesions in patients with systemic lupus erythematosus (SLE) is oral lesions. Due to the high prevalence of these lesions and the lack of an accurate study on their frequency in Iran, the present study was performed to evaluate the frequency of oral lesions in patients with SLE in Isfahan to guide patients in receiving the necessary treatments. Methods. In this descriptive cross-sectional study, 106 patients with SLE referred to the Rheumatology Clinics of Isfahan University of Medical Sciences, Iran, were included. They clinically completed a checklist, and their medical records were evaluated. Sampling was done through convenience sampling, and the data were collected using a checklist. The collected data were analyzed using the SPSS software version 25, as well as descriptive statistical methods, including the preparation of frequency distribution tables and the calculation of the mean and standard deviation. Standard deviations, percentages, and correlation coefficients of Fisher's exact test, Kruskal-Wallis test, and one-way analysis of variance (ANOVA) were used. Results. The most common oral lesion was Erythema (29. 63%), and the least common was Candidiasis (3. 7%) and the most site of involvement was buccal mucosa. Conclusion. Due to the high prevalence of oral mucosal lesions in patients with SLE, it is very important to emphasize the cooperation of rheumatologists and oral disease specialists for early diagnosis and accordingly patient’s guidance to commence the treatment faster. Practical Implications. There were 74. 53% patients without oral lesions, whereas 25. 47% had oral lesions.

Background. Parkinson’s disease (PD) is a neurological disorder caused by the dysfunction of the basal nuclei, especially the substantia nigra, and a decrease in dopamine levels in the neural circuits of this part. In this paper, to investigate the effects of optogenetic stimulation on parkinsonian nervous systems, a complete model of basal ganglia (BG, including subthalamic nucleus [STN], globus pallidus interna [GPi], globus pallidus externa [GPe], and thalamus [TH] neurons) was first selected to simulate the neurons of the basal nuclei and was developed for PD using three-and four-state optogenetic stimulation. Methods. For this purpose, channelrhodopsin-2 (ChETA), ChRwt, and halorhodopsin (NpHR) opsins were evaluated in three-state and four-state stimulation modes, and different stimulation conditions according to different parameters in the BG model were taken into consideration. Results. To verify the developed model, the obtained results were compared with the results of experimental studies. The amount of compliance for different stimulation conditions and various genes underwent investigation. The value of the error index was calculated to evaluate the performance of the BG model for each gene in three-and four-state stimulation conditions with different values of basic parameters, and the stimulation conditions that created the error index equal to zero were introduced as optimal conditions. Based on the results, the frequencies of 20 Hz and 200 Hz in the four-state ChRwt model and the frequency of 80 Hz in the three-state ChETA model have been suggested as optimal genes, frequencies, and models. Conclusion. The response of GPe neurons was consistent with the experimental results, and the response of other neurons was also similar to the response of GPe neurons. In optimal conditions, STN and GPe neurons could provide excitatory input and appropriate inhibitory input to GPi, respectively, and GPi neurons could provide appropriate inhibitory input to TH, and as a result, its function improved and the pathological effects of PD disappeared. Practical Implications. In this research, it has been attempted to improve the function of the basal nuclei of the brain by using optogenetic stimulation and the elimination of the pathological symptoms of PD.

Background. More than 1 million colorectal cancers (CRC) are diagnosed annually. This cancer is the cause of 600, 000 deaths, and many of these deaths can be reduced by screening. Colonoscopy is the best screening method and tool to diagnose CRC, but it causes anxiety and worry in patients. In addition, no appropriate tool has so far been introduced for assessing anxiety in these patients. Accordingly, the present study aimed to design and psychometrically evaluate a tool for assessing anxiety in patients undergoing colonoscopy. Methods. This methodological study used a descriptive-cross-sectional approach to design a psychometric questionnaire. ­To this end, 106 ­­patients participated in this research, and the questionnaire was completed online. The validity of the list and the analysis of its main components were determined through exploratory factor analysis with varimax rotation and confirmatory factor analysis. The reliability of the tool was also checked with Cronbach’s alpha. Results. Overall, 20 terms of the questionnaire were examined by exploratory analysis, and 5 factors explained 57. 76% of the total variance. The internal consistency of the tool with Cronbach’s alpha was 0. 91. Conclusion. The findings of the research revealed that the tool for assessing anxiety in patients undergoing colonoscopy with 20 items and 5 factors has adequate validity and reliability and can be used to assess the anxiety of colonoscopy patients. Practical Implications. The results of this research can change policies in the field of treatment to reduce the anxiety of colonoscopy patients.

Background. The purpose of the present study was to investigate the effect of aerobic-resistance training on the population of cardiac multipotent cells, thickness, and diameter of the ventricular through the C-Kit pathway of male rats during the growth stages. Methods. Overall, 30 male Wistar rats in three age groups of 2 (n = 10), 8 (n = 10), and 96 (n = 10) weeks were accidentally divided into exercise and control groups. Resistance training programs (resistance ladder, 3 days a week) and aerobics (treadmill running, 3 days a week) were performed for 6 weeks. Hematoxylin-Eosin staining was done the heart tissue and histological images were prepared. Afterward, C-Kit gene expression was examined by the real-time polymerase chain reaction method. The statistical method of one-way analysis of variance (P ≥ 0. 05) and Tukey’s test were used at a significant level (P ≥ 0. 01). Results. The trained neonatal group had higher values in heart weight to body weight index, and the trained neonatal and trained young adult groups had higher values in left ventricular thickness (P ≥ 0. 01). The decrease in left ventricular internal diameter in the trained young adult group was significant compared to the control group (P ≥ 0. 01). There was a significant increase in C-Kit gene expression in trained young adult and trained old groups (P ≥ 0. 01). Conclusion. Aerobic-resistance training can be an effective stimulus for increasing the number of cardiac stem cells and creating structural adaptations of the heart, including increasing thickness and ventricular diameter in neonatal and young adult groups. Practical Implications. Participation in aerobic-resistance training programs leads to the improvement of the cardiac structure and an increase in cardiac stem cells.

Background. The coronavirus disease 19 (COVID-19) is one of the most important public health issues, and the evaluation and improvement of COVID-19 health literacy and self-care can be effective in preventing its spread. This study was conducted to investigate the health literacy of COVID-19 and its relationship with self-care among the health ambassadors of Urmia in 2021. Methods. In this descriptive-analytical study, 400 health ambassadors of Urmia were selected using the cluster random sampling method. The data-gathering tool was a questionnaire, including questions about self-care, COVID-19 health literacy, and demographic information. The data were analyzed by SPSS 19 using analysis of variance and regression tests. Results. COVID-19-related health literacy was reported to be at a good level (63. 5%) in most health ambassadors. In addition, it had a statistically significant relationship with the level of education and economic status. Similarly, there was a significant relationship between self-care and demographic characteristics such as age, gender, level of education, occupation, and economic status (P>0. 05). On the other hand, according to data analysis results, with an increase in health literacy related to COVID-19, regression modeling could predict 22% of self-care behaviors in the participants of the present study. Conclusion. Overall, there is a need for interventions by healthcare professionals for training to increase health literacy related to COVID-19 that results in self-care and adoption of health behaviors in health ambassadors, given the significance of COVID-19-related health literacy and its effects on self-care in these ambassadors. Practical Implications. The findings of this study can be presented to the Deputy of Health and healthcare providers so that actions can be taken to promote health literacy and self-care and prevent similar epidemics.

Background. Anxiety is independently associated with severe quality of life impairment and severe postmenopausal symptoms. The aim of this study was to evaluate the relationship of early postmenopausal symptoms, sexual function, and serum levels of dehydroepiandrosterone (DHEA) with anxiety scores. Methods. In this cross-sectional descriptive correlational study, 117 eligible postmenopausal women aged 50-60 years with mild to moderate anxiety were selected using convenience sampling method. The Beck Anxiety Inventory, Green's Menopause Symptoms Scale, and Female Sexual Function Index (FSFI) were completed. Data were analyzed using Pearson and Spearman tests and linear regression model. Results. By adjusting the confounding variables, the total score of FSFI and its sub-domains had no statistically significant relationship with Beck Anxiety Inventory score (P>0. 05). The total score of Greene Climacteric Scale (r=0. 535,P<0. 001) and sub-domains of anxiety (r=0. 448,P<0. 001), depression (r=0. 344,P<0. 001), and physical symptoms (r=0. 509,P<0. 001), as well as the serum level of DHEA (r=-0. 754,P<0. 001) had statistically significant relationship with Beck Anxiety Inventory score. The total score of Greene Climacteric Scale and its sub-domains, except for the sexual dimension, and DHEA level could predict anxiety score. Conclusion. The score of menopausal symptoms and its subdomains, except for the sexual domain and DHEA level, could predict the anxiety score. The findings of this study show the importance of the relationship between early menopause symptoms and serum level of dihydroepiandrosterone with anxiety score in postmenopausal women. Practical Implications. It is suggested to conduct a more comprehensive study considering a wider sample size and socio-cultural factors and barriers.

Background. One of the common treatments for prostate cancer is radical prostatectomy, which is performed in different ways. One of the advantages of the nerve bundle preservation method is better exposure, decrease in rectal damage the lower rectum. In addition, the possibility of a positive margin is less. Therefore, this study aimed to examine the results of using the high anterior release (HAR) technique in radical open prostatectomy surgery. Methods. In this cross-sectional study, after examining patients and their entry into the study and obtaining their medical records, questions were asked to assess erectile function and urinary incontinence. The prostate-specific antigen level was checked before and after the operation. In addition, the average surgical time, blood loss, and hospitalization time were evaluated. Finally, the data were analyzed using the SPSS statistical analysis program, version 19. Results. In this study, 102 patients underwent radical prostatectomy, with an average age of 62. 33 years. About 56. 9% of patients had stage t2b. During the 6-month follow-up after surgery, 70. 5% of patients had complete urinary continence. Data analysis demonstrated that there is a direct relationship between urinary incontinence, with a history of radiotherapy (P<0. 001), and the stage of the disease (P=0. 019). After surgery, 61. 8% of patients were satisfied with the erection function. Conclusion. The results of this study revealed that urinary incontinence and erectile dysfunction are relatively common complications of this surgery. However, compared to other similar studies, the incidence of these two complications is lower. Practical Implications. Urinary incontinence and erectile dysfunction are relatively prevalent complications of radical prostatectomy surgery using the HAR technique. Nonetheless, the incidence of these two complications is lower compared to other similar studies.