فهرست مطالب

Research in Medical Sciences - Volume:23 Issue: 6, Jun 2018

Journal of Research in Medical Sciences
Volume:23 Issue: 6, Jun 2018

  • تاریخ انتشار: 1397/04/10
  • تعداد عناوین: 10
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  • Shahla Akouchekian, Victoria Omranifard, Mohammad Reza Maracy, Ainour Pedram, Asiyeh Almasi Zefreh Page 1
    Background
    Major neurocognitive disorder (MCD) is an acquired progressive decline in cognitive abilities that causes a drop in specific acquired performance compared to former performances. We tried to investigate the efficacy of herbal combination of sedge, saffron, and Astragalus honey on cognitive and depression score of patients with MCD.
    Materials And Methods
    It was a randomized double?blind clinical trial conducted on sixty patients with MCD, who referred to the geriatric psychiatry clinic of Isfahan University of Medical Sciences in Iran. All the study participants had been using anti?MCD medications. Participants were randomized to receive a combination of sedge, saffron, and Astragalus honey in case group (n = 30) or placebo group for 8 weeks other than anti?MCD medications. Cognitive and depression scores were assessed using Addenbrook’s Cognitive Scale and Geriatric Depression Scale, respectively, before intervention and at the 1st and 2nd months after intervention. The ANCOVA repeated?measure test was used to analyze the data using SPSS 20 software.
    Results
    The Addenbrook’s Cognitive Test score was 32.2 ± 26.5 in intervention and 22.1 ± 15.1 in control group before intervention (P = 0.074) and 38.8 ± 27.7 in intervention group and 22.6 ± 14.1 in control group in control group 1 month after intervention (P = 0.007). In addition, Geriatric Depression Scale score was 14.6 ± 7.9 in intervention group and 14.5 ± 6.9 in control group before intervention (P = 0.945) and 12.9 ± 6.9 in intervention and 14.3 ± 7.1 in control group 1 month after intervention (P = 0.465) and 12.2 ± 6.5 in intervention group and 14.4 ± 7.1 in control group 2 month after intervention (P = 0.224).
    Conclusion
    Our findings suggest that adding the herbal combination of sedge, saffron, and Astragalus honey to the current protocols of treatment of MCD patients could be useful in the improvement of cognitive and depression score of these patients.
    Keywords: Astragalus plant, cognition, cognitive disorders, mental status tests
  • Razieh Avan, Ghasem Janbabaei, Narjes Hendouei, Abbas Alipour, Samaneh Borhani, Nasim Tabrizi, Ebrahim Salehifar Page 2
    Background
    The primary side effect of adjuvant chemotherapy with taxanes is the taxane?induced peripheral neuropathy (TIPN), which may have substantial negative impacts on patients’ quality of life (QOL). We investigated the effect of pregabalin and duloxetine on QOL of breast cancer patients who experienced TIPN.
    Materials And Methods
    This was a randomized, double?blind clinical trial conducted at a chemotherapy center of Mazandaran University of Medical Sciences, Sari, Iran. Breast cancer patients 18 or more years old were included if they received paclitaxel or docetaxel and experienced neuropathy grade one or higher; and neuropathic pain score of four or more. Patients were treated with pregabalin or duloxetine until 6 weeks. Assessment of sensory neuropathy and QOL was performed at baseline, and 6 weeks after the initiation of the treatment.
    Results
    At baseline, the mean score of global health status/QOL scale for pregabalin and duloxetine groups were 61 (standard deviation [SD]; 5.11) and 60.28 (SD; 5.44), respectively (P = 0.54). After 6 weeks, both nterventions were associated with improvement of global QOL compared to baseline. The global health status/QOL score was not different between two groups after 6 weeks. While the emotional functioning was improved more favorably with duloxetine (P
    Conclusion
    Pregabalin as well as duloxetine improve the global QOL of breast cancer patients with TIPN. Different effects of reatments on subscale of QLQ?C30 could help clinicians to select the appropriate agent individually.
    Keywords: Duloxetine, neuropathy, pregabalin, quality of life, taxanes
  • Mohammad Zolfaghari, Seyyed Jalil Mirhosseini, Maryam Baghbeheshti, Alireza Afshani, Shadrooz Moazzam, Allahyar Golabchi Page 3
    Background
    This study aims to assess the impact that physiotherapy (PT) has on the quality of life (QoL) of patients who have undergone coronary artery bypass grafting (CABG) surgery. The objective of this study was to assess the effect of PT on physical and mental aspects of patients’ QoL.
    Materials And Methods
    The study population consisted of 50 patients who aged between 60 and 70 years and who had previously undergone CABG surgery. The patients were randomly allocated to two groups: a PT group (n = 25) and a control group (n = 25). The physical characteristics of the participants were recorded at the outset of the study. The patients who were allocated to the PT group completed 16 sessions of classic PT. QoL assessments of all participants were performed before and after the program in the form of a short form?36 health survey. An independent sample t?test and an ANCOVA were performed for the purpose of statistical analyses.
    Results
    The QoL scores of the patients (mean age = 62.08 years) who underwent PT significantly improved after the intervention (P
    Conclusion
    PT can help relieve pain, reduce depression, help patients more effectively perform the tasks of everyday living, and help ease the symptoms of other disabilities associated with cardiac surgery. In the current study, the implementation of a PT program improved the patient’s mental health and increased their QoL.
    Keywords: Coronary artery bypass, physiotherapy, quality of life
  • Javad Javan Noughabi, Aziz Rezapour, Aziz Kassani, Nahid Hatamn, Niloofar Ahmadloo Page 4
    Background
    A decision analysis model was developed to assess the cost?effectiveness of adriamycin and cyclophosphamide (AC) in comparison with paclitaxel and gemcitabine (PG) in women with advanced breast cancer in Iran.
    Materials And Methods
    This is a cost?effectiveness analysis performed as a cross?sectional study in Namazi Hospital in Shiraz, Iran. Patients were divided into two groups by random numbers, 32 women in the AC group and 32 women in the PG group. The costs were measured using the societal perspective and effectiveness of 2 regimens were assessed using tumor response. By a decision tree, the incremental cost?effectiveness ratio was calculated. In addition, the robustness of results was examined by sensitivity analysis.
    Results
    The estimated total cost of AC and PG per patient was 1565.23 ± 765.31 and 2099.08 ± 926.99, respectively. Response to treatment in AC and PG arm were 84% versus 75% respectively. The incremental cost?effectiveness ratio results showed AC is a dominate alternative.
    Conclusion
    Overall, AC was a simple dominate strategy. In other words, AC was estimated to have a lower cost and greater effectiveness than PG.
    Keywords: Breast neoplasms, cost?benefit analysis, cyclophosphamide, doxorubicin, paclitaxel
  • Hamid Mazdak, Mojgan Ghavam, Shahaboddin Dolatkhah, Parnaz Daneshpajouhnejad, Mehdi Fesharakizadeh, Shahriar Fesharakizadeh, Abdolamir Atapour, Parvin Mahzouni, Mozaffar Hashemi, Roxana Salajegheh, Diana Taheri Page 5
    Background
    The aim of this study was to determine the pathologic causes of renal allograft failure in transplant nephrectomy specimens.
    Materials And Methods
    In this cross?sectional study performed in the referral transplant center of Isfahan, Iran, medical files of all patients who underwent nephrectomy in 2008–2013 were studied. Age at transplantation, sex, donor’s characteristics, causes of primary renal failure, duration of allograft function, and pathologic reasons of nephrectomy were extracted. Slides of nephrectomy biopsies were evaluated. Data were analyzed using SPSS.
    Results
    Medical files of 39 individuals (male: 56.4%; mean age: 35.1 ± 16.0 years) were evaluated. The main disease of patients was hypertension (17.9%), and most cases (64.1%) were nephrectomized 2 years posttransplantation. There were 14 cases in which biopsy results showed a relationship between primary disease of patients and pathologic assessment of allograft (P = 0.04). A significant relationship between transplantation?nephrectomy interval and both the nephrectomy result and histopathologic result existed (P
    Conclusion
    The most pathologic diagnoses of nephrectomy in a period of less than and more than 6 months posttransplantation were RVT and TCMR, respectively. Early obtained allograft protocol biopsy is suggested, which leads to better diagnosis of allograft failure.
    Keywords: Allograft nephrectomy, chronic Tcell mediated rejection, kidney transplantation, renal vein thrombosis
  • Mohammad Minakari, Vahid Sebghatollahi, Maryam Sattari, Elaheh Fahami Page 6
    Background
    The aim of the present study was to assess 2? and 4?h postendoscopic retrograde cholangiopancreatography (ERCP) serum amylase and lipase levels for prediction of post?ERCP, pancreatitis (PEP), and their predictive cutoff values.
    Materials And Methods
    In this cross?sectional study, we evaluated serum amylase and lipase levels before the procedure, 2 h and 4 h after the procedure, and in patients with persisting abdominal pain, 24 h afterward. A total of 300 adult patients who underwent ERCP procedures from March 2014 to June 2015 in referral hospital in Isfahan were studied. The receiver operating characteristic analysis was applied to determine the predictive score of amylase and lipase levels for PEP 2 and 4 h after ERCP.
    Results
    The 2?h serum amylase cutoff values of 241 IU/L (normal range: 28–100 IU/L) had a very high negative predictive value (NPV) (98.7%) but a poor positive predictive value (49.2%) for prediction of PEP (area under curve [AUC]: 0.947; 95% confidence interval [CI]: 0.914–0.979). Based on our results, the patients might be considered for supportive therapy of PEP with the 4?h serum amylase above the cut point of 839.5 IU/L with a specificity of 95.1% (AUC: 0.978; 95% CI: 0.964–0.992). In addition, the 2? and 4?h serum lipase levels at cut points of 216 IU/L (AUC: 0.954; 95% CI: 0.931–0.977) and 656.5 IU/L (AUC: 0.966; 95% CI: 0.945–0.986) (normal value
    Conclusion
    Measurements of serum amylase and lipase 2? and 4?h post?ERCP might be useful in prediction of PEP.
    Keywords: Amylases, cholangiopancreatography, endoscopic retrograde, lipase, pancreatitis
  • Farshid Hassanzadeh, Elham Jafari Page 7
    Cyclic imides as building blocks in the synthesis of natural products, drugs and polymers display a diverse of pharmacological activities such as antibacterial, antifungal, anticonvulsant, anticancer, and anti-inflammatory effects. This review summarizes recent findings on antimicrobial activities of cyclic imide derivatives and emphasis on the importance of cyclic imides for drug design and development of new antimicrobial compounds.
    Keywords: Antibacterial agents, antifungal agents, imides
  • Elif Inan Eroglu, Aylin Ayaz Page 8
    Aluminum (Al) is widely found in the nature. Although the relation between Al and neurodegenerative diseases is still controversial, Al is related with many brain diseases including Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis. Al exposure occurs mainly through environment, occupational, and dietary factors for humans. Al exposure with diet can be through foods, food additives, water, and contamination of Al equipment/utensils. The aim of this review is to summarize various hypotheses, which link Al and neurodegeneration, and to determine the roles of Al exposure through different sources including diet, environment, and occupation. Future studies should be done in vulnerable subgroups of population including children, patients receiving antacid or Al?containing pharmeteucials on a daily basis, patients with reduced renal function, and patients on parenteral nutrition regimens that are likely to be affected by possible adverse health effects of Al. In addition, gender, age, and Al interactions need to be determined. One of the most important challanges in future epidemiological studies is to determine which variables should be controlled. In addition, experimental studies should be more focused and translational. In this context, exposure dose, dose–response effects, and time lapse between exposures and cognitive assessments are very important.
    Keywords: Aluminum, Alzheimer's disease, multiple sclerosis, neurodegenerative diseases, Parkinson's disease