donya sheibani tehrani

Low Back pain is one of the most common diseases that face adults with various physical, psychological, economic, and social problems. Due to the fact that patients experience various degrees of disability during this period, the present study was conducted to determine the quality of life and functional outcome in patients with lumbar disc herniation. This study was a descriptive-interventional study that was performed in 2022. One hundred twenty patients undergoing lumbar disc surgery were included in the study by census method. Patients were investigated before and, 3, 6, and 12 months after the operation using a 12-question short-form questionnaire to measure the quality of life, the Oswestry Functional Disability Questionnaire to measure the severity of the disability, the European Quality of Life Questionnaire to measure the health-related quality of life, and the DASS Questionnaire to measure depression, anxiety, and stress. The data were analyzed using SPSS software (version 22) and the significance level was less than 0.05. The quality of life in the physical dimension improved after 12 months (P<0.05). Oswestry disability index improved from severe to moderate disability and preoperative disability improved compared to 12 months after surgery (P<0.05). The EQ-5D index improved after 12 months and significantly differed from before surgery (P<0.05). There was a significant difference between stress before and 12 months after surgery (P<0.05). The results indicated that there was a significant relationship between Oswestry functional disability index and body mass index (P=0.002) and age (P=0.01), and depression with gender (P=0.003). The results showed that the quality of life, functional ability, and stress in patients undergoing lumbar disc surgery improved after 12 months.

COVID-19 quickly spread around the world as an epidemic with potentially unknown hazards. Like its impacts on various occupations, neurosurgery has undergone changes due to the virus, including changes in surgical planning, inpatient and outpatient clinics, emergency management, and even academic activities.

The present study was performed to determine neurosurgery challenges during the COVID-19 pandemic in Iran.

The present study was conducted as a mixed qualitative and quantitative study in 2021. In the qualitative section using the targeted sampling method, 11 members of the target community were selected using the available sampling method and completed a questionnaire. The qualitative part was conducted in two stages of reviewing texts and interviewing experts and in the quantitative part we evaluated the validity of the structure and the reliability of the questionnaire.

This study examined in detail all aspects of the effects of COVID-19 on neurosurgery. 9 dimensions and 61 items were identified as the challenges of neurosurgery during the COVID-19 pandemic. In order of importance, the aspects were: treatment outcome, manpower, management psychological and physical diseases, education and research, tools and physical space, ethics, financial implications and information technology.

The outbreak of epidemics has different risks for specialties, among them neurosurgery. Accordingly, to observe patients’ right to treatment, all necessary measures were first taken to provide instructions, regulations, policies and ethical guidelines.

The COVID-19 pandemic has widely affected medical tourism on a global scale, thereby reducing the number and volume of medical services. Given the importance of this topic, the present study aimed to determine the challenges of medical tourism after the prevalence of COVID-19 in the field of neurosurgery. The present descriptive study was conducted by the neurosurgery department of Isfahan University of Medical Sciences, Isfahan, Iran in the first quarter of 2022. Using the convenience sampling method and based on Morgan’s table, 500 patients with neurosurgical diseases registered in Medical Tourism companies were identified and included in the study. The data were analyzed in SPSS. 142 (28.4%) out of 500 patients with COVID-19 were willing to come to Iran for neurosurgical treatment. The most important non-medical reasons included natural attractions (4.37±0.44), cost-effective accommodation (4.03±0.23), and support from a country of destination (place of residence) (3.75±0.22). The most important medical reasons included the short waiting list, the fast treatment response (4.26±0.76), the availability of qualified doctors (3.96±0.27), and the low-cost treatment (3.87±0.53). The present study focused on the functions and potentials of medical tourism in neurosurgery. It can be more successful by providing the right conditions to improve the current situation.

The adhesion between the dura and the muscle is one of the serious problems of patients who need delayed cranial bone replacement due to decompressive craniotomy after brain swelling, but there is no ideal solution to reduce this complication. This study aimed to determine the effect of implanting a silicone membrane between the muscle and the dura after craniotomy surgery in patients requiring delayed bone replacement at the craniotomy site.

In this clinical prospective cohort trial study with no evidence, all patients undergoing late cranial bone grafting after craniotomy were selected, and a total of 24 people were included in this study. During the craniotomy, a silicone mesh measuring 5 × 5 cm was placed between the dura and the muscle. Adhesion between the dura and the muscle and side effects associated with this procedure were examined during cranial bone grafting.

Out of 24 patients requiring delayed cranial bone grafting, three individuals died and six individuals did not refer for cranioplasty; therefore, the operation was performed on 15 patients. During the operation, no cases of muscle-dura adhesion were observed, and in all 15 patients, the dura was completely detached from the muscle. Also, none of the patients presented side effects such as muscle bleeding at the surgery site, infection, and allergy to the mesh.

Implantation of silicone layer between the dura and the muscle during craniotomy in patients suffering from cerebral edema can prevent muscle-dura adhesion without causing serious complications for the patients.

Craniosynostosis mostly occurs as a single abnormality; however, it may rarely occur concomitantly with other congenital abnormalities known as syndromic craniosynostosis. Cardiac anomalies are among the most common ones occurring coincidentally with craniosynostosis. Nevertheless, the information about the exact prevalence of cardiac anomalies in craniosynostosis has not been well-understood yet. We aimed to assess the prevalence of different cardiac anomalies that coincidence with craniosynostosis.

This cross-sectional study was done on 145 patients with craniosynostosis from January 2015 to December 2019. 103 patients with a single-suture involvement were placed in the non-syndromic group, and the remaining 42 with pansynostosis or the clinical manifestations of Apert, Pfeiffer, Crouzon, and Carpenter syndromes in the syndromic group. The prevalence of cardiac anomalies was evaluated and compared between the groups.

The prevalence of congenital cardiac anomalies was 22.3% and 50% in non-syndromic and syndromic cases, respectively (P = 0.001). Syndromic boys predominantly presented cardiac anomalies (P = 0.85), whereas non-syndromic girls were mostly affected by cardiac anomalies (P = 0.75). Age was not associated with congenital cardiac anomalies, neither in non-syndromic (P = 0.31) nor in syndromic (P = 0.26) patients. The number of affected sutures was not associated with cardiac anomalies (P > 0.05). Tricuspid regurgitation (TR) (16.7%), patent ductus arteriosus (PDA) (14.3%), and ventricular septal defect (VSD) (11.9%) were the most prominent anomalies found among the syndromic patients, while TR (8.7%), atrial septal defect (ASD) (3.9%), and PDA (3.9%) were common among the non-syndromic ones.

Congenital heart disease is a prevalent abnormality among children with craniosynostosis. Therefore, cardiac assessment in craniosynostosis is strongly recommended.

With the spread of COVID‑19, treatment of diseases such as multiple sclerosis (MS) should be resumed with caution due to the disease‑modifying therapies (DMTs) used in this subset of patients and the immunoregulatory effects of these drugs. We aim to assess the outcome of COVID‑19 infection in MS patients receiving DMTs.

This is a cross‑sectional study involving 45 COVID‑19‑infected patients previously diagnosed with MS. The data regarding their MS status and the type of DMT taken by the patients were extracted from the Isfahan MS Institute registry and were summarized. Diagnosis of MS was based on the 2017 McDonald Criteria, and the diagnosis of COVID‑19 was based on computed tomography scan and polymerase chain reaction of nasopharyngeal swabs.

Out of the 45 MS patients infected with COVID‑19, 5 had unfavorable outcomes. Two patients deceased and the other three had persistent respiratory complications on the 4‑week follow‑up visit. Hypertension, diabetes, seizures, and rheumatoid arthritis were among the comorbidities that the patients reported. Both patients who died received rituximab as part of their MS treatment. All other patients recovered completely.

Each different drug category may possess a distinct risk for infection, therefore until robust evidence are available, the safest drug should be utilized or the therapy should be postponed, if possible, to minimize patient risk. Disease‑modifying therapy use in MS patients should be cautiously applied as their effect on COVID‑19 infection prognosis is not yet studied.

Patients undergoing surgery may need transfusion of blood products for a variety of reasons. Therefore, this study aimed to determine the incidence of blood transfusion complications in patients undergoing surgery.

The present study was performed as a cross-sectional study in 2020 at Shohadaye Tajrish Hospital in Tehran, Iran. A total of 1132 patients who had complications during surgery upon transfusion of blood and blood products from 2015 to 2020 were included in the census. To collect information, a checklist, including patients’ information, the type of product, and types of complications was used. SPSS software version 21 was used for data analysis.

In this study, 99.7% of the complications were acute, and in 91.1% of the cases, the severity of complications was mild. Of the confirmed complications, 46.4% were allergic reactions, and 43.8% were reported as non-hemolytic febrile reactions. A total of 91.1% of patients completely recovered after the onset of the complication, 6.2% had a partial disability, 0.4% had severe disability, and 0.3% died.

The results showed that most patients had acute complications in terms of the type of complication and mild in terms of the severity, thus a completely regular program is recommended to control side effects related to blood and blood products transfusion.

The most important goal of a proper health‑care system is to provide good health. Today, patients do not consider hospitals as simply a place of rehabilitation; rather, they compare the hospital with a hotel in terms of environment, facilities, services, and quality of accommodation. This study aims to use DEMATEL approach to extract factors affecting the hoteling quality.

This was a descriptive, cross‑sectional study conducted in 2018. The study was carried out in two steps. In the first step, the factors affecting the hoteling quality were extracted, and in the second step, the DEMATEL technique was used to analyze and rank the cause and effect. The study population consists of all experts in the fields of medicine and health care (hospital managers, deputies, and faculty members familiar with accreditation and hoteling), among which twenty experts were selected using purposeful sampling and a questionnaire designed by the researcher consisting of 11 dimensions was distributed among them. The reliability of the questionnaire was calculated using Cronbach’s alpha coefficient which was equal to 0.85 while its validity was confirmed using Delphi technique. DEMATEL approach was used for data analysis.

The results show that among factors, human factors and economical–financial factors and, among subfactors, maintaining human dignity and quick action in providing emergency services are among the most important factors affecting the hoteling quality. Maintaining human dignity and speed of action in providing emergency services to patients was identified as the most important factor in improving hoteling quality.

The results of this study can be used to evaluate the quality of accommodations and health facilities, medical equipment, and building quality of hospitals, which can lead to effective actions and improvement of patient satisfaction and the eventual success of health transformation plan.

Iran has considerable potentials for growth of health tourism. However, they have not been properly realized towards national development.This paper has attempted to prioritize the development strategies of health tourism in Iran which has been conducted on the hospitals of Tehran.

This study is a descriptive-analytical research. It was carried out in 2013 and the sample size was determined through snowball non-probability sampling. A questionnaire was administered to 29 participants and the development strategies were formulated by SWOT.

The findings of the research showed that the weakness points of the health tourism industry override the strength points. This is while the opportunities of development are more than threats.

One may conclude that Iran’s health tourism is in a weakness opportunity (WO) situation and needs strategies which have been specially designed for such situations. Therefore, the improvement strategies (WO) have been located in priority for the development of health tourism in Iran.

Travel medicine is devoted to the health of travelers who visit foreign countries. It is an interdisciplinary specialty concerned not only with prevention of infectious diseases during travel but also with the personal safety of travelers and the avoidance of environmental risks.

This review examines 15 appropriate papers by PRISMA from 28 papers searched in PubMed via the NCBI Entrez system.

A traveler’s health and safety depends on a practitioner’s level of expertise in providing pretravel counseling and vaccinations, if required.

The standards of medical care given to travelers before, during and after travel should be as high as those practiced in every other field of medicine.