Avicenna Journal of Clinical Medicine
Year:2020 | Volume:27 | Issue:2 (SN 96)|Papers Count:8

Background and Objective: Hypertension is a common complication of spinal anesthesia in cesarean section (C-section). Which can be dangerous for both mothers and neonates. In this regard, the aim of this clinical trial study was to investigate the effect of using elastic bandage in the lower extremities on the prevention of postspinal hypotension in C-section. Materials and Methods: This prospective clinical trial study was performed at Fatemieh Hospital in Hamadan, Iran, within 2019-2020. A total of 64 patients undergoing C-section with spinal anesthesia were randomly divided into two groups with bandaging and without bandaging at the time of the surgery. Demographic characteristics, hemodynamic status in the first hour after spinal anesthesia, incidence of hypotension, nausea and vomiting, bradycardia, and tachycardia, and administered amounts of atropine and ephedrine were compared in both groups. The data were statistically analyzed by SPSS software (version 16). Results: The mean age of the patients in both groups was approximately 30 years (P=0. 958). The incidence rates of hypotension (25% vs. 78. 1%), bradycardia (9. 3% vs. 15. 6%), and intraoperative nausea and vomiting (12. 5% vs. 59. 4%) were significantly lower in the intervention group than those reported for the control group. The administered amount of ephedrine (4. 1± 3. 1 vs. 20. 6± 13. 2 mg) was lower in the intervention group than that of the control group (P=0. 01). Regarding the evaluation of hemodynamic status, systolic and diastolic pressure within the 2nd to 6th min and mean arterial pressure within the 2nd to 10th min after spinal anesthesia were significantly higher in the intervention group than those reported for the control group (P<0. 05). In other minutes, there was no statistically significant difference in terms of hemodynamic status. Conclusion: The obtained results of the present study showed that bandaging the lower extremities in C-section with spinal anesthesia, as an inexpensive available noninvasive procedure, can be effective in the prevention of postspinal hypotension and reduction of administered ephedrine.

Background and Objective: Immune-mediated polyneuropathy is divided into acute and chronic categories named as Guillain Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy based on the course of the disease. Although the basic mechanism of these conditions has not been yet clarified, genes that regulate immune responses are putative contributors in their development. The aim of this study was to compare the blood expression level of IL-34 gene between patients with GBS and healthy individuals. Materials and Methods: In this case-control study, blood samples were collected from 53 patients with GBS (i. e., 33 chronic patients and 20 acute patients) and 40 healthy individuals. Gene expression levels in the studied groups were measured using the real-time polymerase chain reaction technique. Finally, statistical analysis was performed using SPSS software (version 16) at a significance level of < 0. 05 was. Results: The patient group consisted of 36 (67. 93%) males and 17 (32. 07%) females. In addition, the healthy control group included 27 (67. 5%) males and 13 (32. 5%) females. The results showed a significant increase in IL-34 expression in the GBS patients, compared to that in the control group. Conclusion: The findings of the present study revealed an increase in IL-34 gene expression in patients with GBS. Accordingly, it seems that IL-34 gene has an important role in the pathogenesis of this disease.

Background and Objective: Unplanned pregnancies reduce the maternal role and decrease maternal-fetal attachment. The maternal-fetal attachment includes the thoughts, feelings, and behaviors that pregnant women express about their fetuses. The aim of this study was to determine the effect of midwifery counseling using a cognitive-behavioral approach on maternal-fetal attachment among women with unplanned pregnancies. Materials and Methods: This randomizes clinical trial was performed on 96 pregnant women with unplanned pregnancies referring to the health centers of Kazerun, Shiraz, Iran, in 2019 using convenience sampling with a randomized block design. The experimental group received four training sessions based on cognitive-behavioral counseling for 4 weeks. The control group received only the routine care program. At the baseline and immediately after the intervention, both groups completed the demographic and maternal-fetal attachment questionnaires. The data were analyzed using descriptive and inferential statistics (i. e., the independent t-test and Chi-square test) by SPSS software (version 21). Results: The obtained results of the present study showed no significant difference in the total scores of attachment (P=0. 886) before the intervention between the two groups. However, after the intervention, a significant difference was observed in the mean of attachment (P=0. 001) between the two groups indicating the effectiveness of cognitive-behavior therapy in the enhancement of maternal-fetal attachment. Conclusion: Considering the effect of cognitive-behavioral training on the promotion of maternal-fetal attachment, it is recommended to integrate this type of educational intervention into the womenʼ s care program with unplanned pregnancies.

Background and Objective: One of the important steps in continuing the treatment of patients with mediastinal masses is the definitive diagnosis using tissue sampling of the lesion within the mediastinum. One of the methods used for this purpose is mediastinoscopy. In this regard, this study aimed to determine the results of mediastinoscopic surgery in patients with a mediastinal mass. Materials and Methods: This descriptive study evaluated the medical files of all patients who underwent mediastinoscopic surgery in Besat Hospital, Hamadan, Iran, from 2014 to 2019. Results: This study was conducted on 19 patients with a mean age of 50. 84 years. The majority of the participants were male (n=11). The mass was located in the anterior mediastinum in most of the patients (n=16), and in three cases, it was in the median mediastinum. Histopathological results showed inflammation (n=4), small cell carcinoma (n=3), lymphoma (n=2), squamous cell carcinoma (n=2), metastasis (n=2), adenocarcinoma (n=1), hydatid cyst (n=1), tuberculosis (n=1), sarcoidosis (n=1), anthracosis (n=1), and nonspecific (n=1) in descending order. Conclusion: In general, there are similarities between the results of this study and those of other studies in terms of age, gender, place of involvement in the mediastinum, and surgical complications. On the other hand, there are differences between this study and other studies regarding the pathology results. It seems that the frequency of malignant masses in our study is higher than that in other studies.

Background and Objective: Medial Knee movement during exercise causes disorder of normal body alignment and import stress on the tissues. Increased knee valgus during exercise is one of the risk factors for lower extremity injuries. With this background in mind, the current study aimed to make a comparison between healthy women and women with dynamic knee valgus in terms of isometric strength of the muscles and the range of motion of the hip. Materials and Methods: This case-control study was conducted on 20 healthy female athletes and 20 athletes with dynamic knee valgus who participated in regular exercise for at least 2 years. The maximum isometric strength of extensor, flexor, adductor, abductor, as well as external and internal hip rotators, was measured with a hand dynamometer (kg). Moreover, the active range of motion of extension, flexion, adduction, abduction, as well as hip external and internal rotation, was measured with a standard goniometer (degree). Independent t-test and Multivariate Analyses of Variance were used to determine differences in strength and range of motion between groups. Results: As illustrated by the obtained results, the group with dynamic knee valgus had less extensor (P=0. 006), hip external rotator muscle strength (P=0. 029), and hip external rotation range of motion (P=0. 005), compared to the healthy group. Nonetheless, no significant difference was observed between other variables in the two groups. Conclusion: Based on the results of the present study, training programs with a focus on the strength and range of motion of the hip joint can improve the kinematics of the knee joint in the frontal plane.

Background and Objective: Dry eye syndrome is a multifactorial ocular surface disease characterized by visual disturbance, irritation, discomfort, and injury. Due to the impact of dry eye on vision function, daily activities, and quality of life, patients with dry eye may experience some levels of depression and anxiety. Therefore, the present study was carried out to investigate the prevalence of depression and anxiety in patients with dry eye syndrome. Materials and Methods: This cross-sectional descriptive study was conducted on 113 female patients with the symptoms of dry eye referring to the Ophthalmology Clinic of Farshchian hospital in Hamadan, Iran, within 2018 to 2019. The subjects were evaluated by an ophthalmologist for the symptoms and signs of dry eye using the Schirmerʼ s test and tear breakup time. Then, the patients with dry eye syndrome were assessed in terms of depression and anxiety by the Beckʼ s Depression Inventory. The data were analyzed using SPSS software (version 16) at a 95% confidence interval. Results: In this study, the mean age of the patients was 42. 90± 13. 50 years. The frequency rates of mild, moderate, and severe dry eye syndrome were reported as 8. 8%, 64. 6%, and 26. 5%, respectively. The prevalence rates of depression and anxiety (i. e., mild, moderate, and severe) were 28. 3% and 54. 5%, respectively. There was a positive and significant correlation between the dry eye score with depression (r=0. 210; P=0. 026) and anxiety (r=0. 324; P<0. 001). Conclusion: In patients with dry eye syndrome, a significant correlation was observed between the severity of dry eye and severity of depression and anxiety, requiring further investigation. The results of this study recommend to carry out psychological studies on this group of patients simultaneously with the treatment of dry eye.

Background and Objective: Infertility and its treatment are among the most important challenges in the field of gynecology. This study aimed to compare two methods of administration of GnRH agonists and GnRH antagonists on the occurrence of pregnancy. Materials and Methods: This randomized controlled clinical trial included 84 infertile couples with male factor infertility problems referred to Fatemieh Hospital, Hamadan, Iran. They were randomly assigned into two groups of 42 cases. The first group was treated with GnRH agonist (Bucereline), and GnRH antagonists (Cetrotide) was administered to the second group. The two groups were compared with each other regarding the incidence of pregnancy, number of oocytes obtained, the mean days of induction, the number of fertilized oocytes, the incidence of Ovarian Hyperstimulation Syndrome (OHSS), and treatment costs. Results: The findings showed that the rates of clinical pregnancy were 19 (45. 23%) and 7 cases (16. 67%) in the agonist and antagonist groups, respectively. Moreover, there was a significant difference between the groups in this regard (P<0. 009). Furthermore, the number of fertilized oocytes in the agonist group was significantly higher than that in the antagonist group (P<0. 004). In addition, the mean induction days in the antagonist group was significantly lower, compared to another group (P<0. 001). There was no significant difference between the two groups regarding the incidence of OHSS syndrome and the overall cost of treatment. Conclusion: According to the results, the efficacy of agonist drugs was much better than that of the antagonist medications in terms of the occurrence of pregnancy. However, no significant difference was observed between the groups regarding the complications.

Background and Objective: Today, the Internet and Internet addiction are among the most important issues involving the young generation. Regarding the spread of coronavirus disease-2019 (Covid-19) as a destructive factor, this problem has caused mood disorders, anxiety, and aggression, which need proper identification. Therefore, the present study aimed to predict the computer voyeurism and stigma of the first wave of the Covid-19 pandemic based on the dimensions of Internet addiction among young people. Materials and Methods: This study was conducted based on a practical, descriptive, and correlational design. The study population included all undergraduate students in Tabriz Branch, Islamic Azad University, Tabriz, Iran. Out of all students, 252 cases were selected to participate in this study through an online voluntarily call due to traffic restrictions. The data were collected using the Yang Internet Addiction Assessment Questionnaire, a researcher-made computer voyeurism questionnaire, and a researcher-made corona stigma questionnaire. The data were then analyzed using Pearson statistical methods and multivariate regression. Results: According to the results, all dimensions of Internet addiction correlated significantly with the rate of computer voyeurism and Covid-19 stigma. Out of the dimensions of Internet addiction, lack of control, and negligence of professional and educational tasks can predict the extent of changes in computer voyeurism and Covid-19 stigma among young people. Conclusion: There is a significant relationship between the increased level of Internet addiction and the power of direct prediction of computer voyeurism and youth stigma. With an increase in each of the dimensions of the mentioned variables, the amount of Covid-19 stigma increases, thereby promoting the mood-anxiety disorders among young people.