JOURNAL OF SHAHREKORD UNIVERSITY OF MEDICAL SCIENCES
Year:2025 | Volume:27 | Issue:2|Papers Count:8

Background and aims: Contrast-induced nephropathy (CIN) is a common and serious complication related to the intravenous injection of iodinated contrast media. Thus, the aim of this study was to evaluate CIN frequency and the relationship of some variables with CIN in patients who were referred to Hajar hospital, Shahrekord, Iran. Methods: The study was performed on 200 patients who were candidates for contrast-enhanced computed tomography with intravenous contrast in Shahrekord, Iran, in 2018. Metformin and non-steroid anti-inflammatory drugs were discontinued from 48 hours before to 48 hours after the contrast prescription. Almost 100 mL of nonionic, iso-osmolar contrast media (Visipaque or Dixopaque) were used for patients. After 48 hours of contrast injection, blood urea nitrogen and serum creatinine (Cr) were checked, and the related data were collected. Cr rising>0.3 mg/dL of baseline and Cr rising>0.5 mg/dL were considered acute kidney injury (AKI) and CIN, respectively. Results: The mean age of patients was 63.65±20 years. In addition, the mean serum Cr of patients before and after the contrast injection was 1.13±0.83 mg/dL and 1.10±0.72 mg/dL, respectively (P=0.44). The frequency of AKI nephropathy (serum Cr rising>0.3 mg/dL) was 11.5% (n=23). However, with a 0.5 mg/dL increase in serum Cr, it was 4.5% (n=9). Only the age of patients was found to be a risk factor for CIN. Conclusion: CIN was not common in cases with normal or near-normal renal function. However, contrast prescription should be performed more carefully in old age patients.

Background and aims: The etiology of congenital hypothyroidism (CH) is important in determining its severity, prognosis, genetic counseling, and clinical management. The present study was performed to investigate the etiology of CH in children in Chaharmahal and Bakhtiari. Methods: Screened children over the age of 3 years for hypothyroidism in the province were enrolled in this cross-sectional study. Then, in the case of permanent CH in the patient, demographic and laboratory findings, including thyroid-stimulating hormone (TSH) in primary screening, primary serum TSH, TSH after discontinuation of treatment, and age at the start of medication, were investigated, and patients were radiologically examined. The data were analyzed by SPSS 18 using descriptive statistics, a one-sample t-test, and a Chi-square test. Results: Dyshormonogenesis accounted for the most etiological percentage of the disease (72%), followed by dysgenesis (28%). Gender was significantly associated with etiology (P=0.022). Thus, dyshormonogenesis was more common in boys. The weight (P=0.564) and length at birth (P=0.978), maternal age (P=0.306), age at the beginning of medication (P=0.185), primary filter TSH (P=0.267), primary serum TSH (P=0.344), and TSH after discontinuation of medication (P=0.371) were not significantly associated with etiological factors. Conclusion: Among the etiological factors of CH, dyshormonogenesis was the most common cause among children in Chaharmahal and Bakhtiari province.

Background and aims: Depression is a widespread mental disorder. Maternal separation (MS) stress during early life increases the risk of depression. Modafinil (MOD) exhibits potential antidepressant-like properties, but its underlying molecular mechanisms remain unclear. The phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway is implicated in neuropsychiatric disorders. This study aimed to investigate the role of the PI3K/Akt/mTOR pathway in the antidepressant-like effects of MOD in MS mice, offering potential insights into new therapeutic targets for depression treatment. Methods: In this study, 50 male NMRI mice were divided into five groups (n=10). The control group received normal saline, while the MS groups received normal saline and MOD at 25 mg/kg, 50 mg/kg, and 75 mg/kg for seven days. The counting open field test (OFT), forced swimming test (FST), and splash test were conducted to assess depression in rodents. The expression of PI3K, AKT, and mTOR genes was evaluated in the hippocampal tissue with real-time polymerase chain reaction (RT-PCR). Results: The results revealed that MS could induce depressive-like behaviors in mice. MOD administration significantly diminished immobility time in the FST at all doses (P<0.001) and amplified cleaning time in the splash test at doses of 25 mg/kg (P<0.01), 50 mg/kg (P<0.001), and 75 mg/kg (P<0.001). Additionally, MOD noticeably downregulated the expression of PI3K, AKT, and mTOR genes in the hippocampus at all doses (P<0.001). Conclusion: MOD possessed antidepressant-like properties in maternally separated mice. MOD could effectively ameliorate depressive-like behaviors and suppress the hippocampal expression of PI3K/AKT/mTOR genes. However, future studies are warranted to find the exact and more mechanisms of action of MOD in depression.

Background and aims: Autism spectrum disorder (ASD) is a multifaceted condition that significantly impacts social interactions, communication, and behavior. Given the profound effects of ASD on families, it is essential to understand the factors influencing the well-being of caregivers, particularly mothers. This study aimed to investigate the relationship between maternal self-differentiation and behavioral disorders in children with ASD, emphasizing the mediating role of maternal mental health. Methods: This study utilized a descriptive-correlational design employing structural equation modeling (SEM). The population comprised all children diagnosed with ASD and their mothers registered with the Autism Association in Ahvaz in 2023. A convenience sample of 262 participants was selected from the Autism Association of Ahvaz. The data were collected using the Child Behavior Checklist (CBCL), the Differentiation of Self Inventory, and the Symptom Checklist-90-Revised (SCL-90-R). Following data collection, Pearson correlation analysis and SEM were performed using SPSS-27 and AMOS-24. Results: The findings indicated a significant negative correlation between maternal self-differentiation and child behavioral disorders (β=-0.13, P=0.029). Additionally, a significant positive correlation was identified between maternal self-differentiation and maternal mental health (β=0.37, P=0.001). However, there was a significant negative correlation between maternal mental health and child behavioral disorders (β=-0.58, P=0.001). An indirect relationship was also found between maternal self-differentiation and child behavioral disorders, mediated by maternal mental health (β=-0.32, P=0.010). All goodness-of-fit indices for the model fell within acceptable ranges. Conclusion: Overall, it was revealed that the emotional well-being of mothers and their capacity to maintain a distinct sense of identity are significantly associated with their children’s behavior, particularly in the context of ASD. Enhancing maternal mental health and fostering self-differentiation may yield positive outcomes for children with ASD.

Background and aims: National and international medical agencies have developed innovative methods to expedite the market entry of promising new technologies and enable early patient access. By adopting insights from experts, key informants, and stakeholders in the field of medical equipment, the present study aimed to identify the most critical features of a national model for developing health-related technologies. Methods: This study was conducted over a six-month period in 2023. Firstly, all documents related to the national model for developing health-related technologies, including regulations, standards, licenses, structures, procedures, and processes, were precisely reviewed by the research team. Subsequently, the strengths and weaknesses of the mentioned model were extracted from these documents. Next, a two-round Delphi technique was applied to identify additional features. More than four focus group discussions (FGDs) were conducted by the research team to determine solutions for the improvement of the national model. After that, the Delphi method was applied again to collect further suggestions. Results: Most participants emphasized the importance of developing and implementing supportive strategies. Key findings included strengths of the ongoing process, challenges in marketing medical equipment nationally, policy-making and management aspects, and suggestions to improve processes. Conclusion: While policymakers’ and health managers’ efforts are welcomed, such achievements will be ineffective if micro and macro programs are overlooked.

Background and aims: Serotonin and dopamine are monoamine neurotransmitters that are reduced in Parkinson’s disease) (PD). This study examined the effects of the 12-week combined strength, aerobic, and balance training program on dopamine and serotonin plasma levels in patients with Parkinson’s disease (PD). Methods: This study was designed as a randomized clinical trial. A total of 30 participants were selected using convenience sampling and randomly assigned to one of two groups using block randomization, including a combined exercise group (strength, aerobic, and balance exercises) of 15 participants and a PD group with 15 participants. The study was conducted in 2024 in Isfahan, Iran. The training program lasted 12 weeks, with five weekly sessions held at a sports club. The data were analyzed using ANCOVA for between-group comparisons and a paired test for within-group changes (P<0.05). Results: The results revealed significant differences in dopamine and serotonin among the two PD groups (P<0.001). However, there was a substantial increase in the combined exercise program group compared with the PD group (P<0.001). In the combined exercise group, dopamine levels increased from 0.0141±0.003 at the pretest to 0.0853±0.033 at the posttest (P=0.001). Finally, serotonin levels rose from 4.59±0.56 to 6.59±0.90 (P=0.001). Conclusion: The combined exercise increased the dopamine and serotonin levels in PD. Accordingly, performing combined exercise can be used as a therapeutic intervention in PD prevention and treatment strategies.

The COVID-19 pandemic has resulted in a significant number of hospitalizations worldwide, complicating the diagnosis of rare respiratory diseases, such as pulmonary alveolar proteinosis (PAP), which can present with clinical symptoms and radiological findings similar to those of COVID-19. Consequently, accurate diagnosis is crucial. This report describes a case involving a young man with a history of progressive shortness of breath who was initially treated for COVID-19 pneumonia based on high-resolution computed tomography (HRCT) findings. However, following three negative polymerase chain reaction tests from the patient’s throat swab and a lack of clinical improvement despite COVID-19 treatment, he underwent bronchoscopy and bronchoalveolar lavage. The results of these procedures demonstrated PAP. Given that COVID-19 presents with a wide range of manifestations and that HRCT of the lungs is currently the most sensitive diagnostic test for the disease, it is essential to consider the patient’s medical history when diagnosing various pulmonary conditions. More precisely, a thorough assessment of the patient’s history can significantly influence the diagnostic outcome.

This study aimed to investigate the effects of working memory dual tasks on postural sway in chronic stroke patients. Twenty chronic stroke survivors were recruited from rehabilitation clinics in Mashhad. Centre of pressure (COP) was measured on a force plate in the baseline standing condition, the standing condition while the phonological loop component of working memory was activated, and in the standing condition while the visuospatial sketchpad component of working memory was activated. Repeated measures analysis of variance was used to analyze the data. The results indicated the effects of interference on postural sway exhibited in mean velocity in the mediolateral direction (P=0.01). Notably, the visuospatial task caused greater disruption to postural control compared to the phonological loop task (P=0.019 vs. 0.006, P=0.03). The mediolateral speed of changes in COP reduced significantly with the phonological loop working memory task in comparison to the without memory task. The visuospatial working memory dual task interfered more with the postural control of stroke people.