elham shafiei

Understanding the reasons for retreatment of dental restorations is crucial to preventing potential tooth failure. Due to limited information on retreatment causes in our region, this study aims to compare the factors leading to the failure of posterior amalgam and composite restorations.

This cross-sectional, observational study was conducted on patients referred to the restorative department of Ilam Faculty of Dentistry and private clinics who required retreatment of existing posterior restorations. Failure criteria for posterior restorations were evaluated based on established reference guidelines.

 The study found that secondary caries had an odds ratio (OR) of 3.08 (95% CI: 2.85 – 3.29; p < 0.001), indicating a strong association with restoration failure. Additionally, restoration fractures were significantly correlated with retreatment, with an adjusted OR of 2.50 (95% CI: 2.46 – 2.86; p < 0.001).

 Secondary caries emerged as the most common reason for retreatment, regardless of whether composite or amalgam materials were used. Restoration fractures also significantly contributed to the need for retreatment. Therefore, it is essential to consider factors such as restoration material, classification, and the number of restoration levels to reduce the likelihood of retreatment.

 Levels of the human epidermal growth factor receptor 2 (HER2) gene are low in normal breast tissue, but half of patients with breast cancer have higher levels of this receptor. The different expression levels of the HER2 gene in normal and malignant cells make this gene an excellent biomarker for therapeutic purposes. In this study, we evaluated the degree of HER2 overexpression in patients, its relationship with age and the occurrence of metastases.

In this retrospective, registry-based and two-center cohort study, information of 1500 patients with breast cancer recruited at the Shahid Mostafa Khomeini hospital in Ilam province was collected during the years 2020 to 2023.

The possible of metastasis in cancer patients who had the HER2 gene expression was 3 times higher (adjusted OR: 2.82; 95% CI: 1.79 – 3.29; P=0.001).  Also, Nodes involved (adjusted OR: 2.01; 95% CI: 0.87 – 3.79; P=0.03) was significantly associated with increased metastasis.

This study showed that the significant prognostic factor of the number of involved lymph nodes and HER2 gene expression is known as a factor that increases the risk of metastasis. Therefore, creating a background for breast cancer screenings can be an important factor for the treatment of the disease and the prevention of metastasis in breast cancer patients.

Systemic sclerosis is an incurable autoimmune fibrotic skin disease. Many factors were described as aetiology of SS, but the impact of nutritional factor is unknown. The aim of this study was to determine the nutritional status and gastrointestinal manifestations in patients with systemic sclerosis in Ilam, Iran. In a case-control study, 47 people confirmed with systemic sclerosis disorders were enrolled as case group and 47 subjects as control group; while they were matched for age and BMI and compared statistically. Food frequency questionnaire (FFQ) and demographicvariables were collected for all participants. Meat and dairy consumption was higher among case group (Adjusted OR=5.1, p<0.01, CI=1.08-24.64; Adjusted OR=4.2, p<0.01,CI=1.23-14.29, respectively); while there was a reduction for vegetables intake (Adjusted OR=0.09, p<0.05, CI=0.01-0.876). An increase in meat and dairy consumption and reduction in intake of vegetables seems to be the causes for systemic sclerosis in patients in the area. Further evaluations in a large sample size with a longer follow-up duration are needed to verify these findings. The results can help health authorities when planning for patients with systemic sclerosis.

 Post-traumatic stress disorder (PTSD) is a disorder that arises from experiencing traumatic events such as traffic accidents, war, natural disorders, and job incidents. This study focused on determining the epidemiology of PTSD in the Iranian population from 2019 to 2024.

 In this systematic review and meta-analysis, we explored databases such as PubMed, Embase, Web of Knowledge, Scopus, and Magiran to achieve a maximum variety of screened articles. The quality of the included articles was evaluated using the STROBE checklist. For data analysis, due to the variation in reporting the PTSD prevalence across the reviewed articles, heterogeneity was assessed using the I2 index, and a random effect model was applied to account for this variation.

 Out of 800 articles found in the initial review, only 15 articles were entered in the final analysis based on inclusion and exclusion criteria, with a total of 9868 participants. The overall PTSD prevalence in the Iranian population was 31.87% (95% confidence interval [CI]=17.87- 45.87, I2=95.29%, P<0.001). Additionally, PTSD prevalence in men (36.64%) was higher than in women (35.52%).

 The prevalence of PTSD in young Iranian men is relatively high, and there was no statistically significant decrease in PTSD prevalence between 2019 and 2024.

Traumatic brain injury (TBI) may be a cause of criminal behavior, affecting various aspects of an individual's mental health.

The aim of the present study was to investigate the effect of difficulties in emotion regulation on psychiatric symptoms among patients with mild TBI.

This research was a retrospective cohort study that included 120 motorcyclists with mild TBI referred to the psychiatric clinic of Shahid Mostafa Khomeini Hospital, Ilam, during a 23-month period from January 2017 to March 2019. The data were analyzed using structural equation modeling with P < 0.05.

The results of AMOS analyses revealed a direct path from maladaptive cognitive emotion regulation strategies and an indirect path from adaptive cognitive emotion regulation to the relationship between difficulties in emotion regulation (DERS), bullying behavior, and aggression in 120 motorcyclists with TBI.

Reducing TBI rates, which is a major public health necessity, may have benefits in terms of reducing crime and improving clinical services.

The classification of Babesia spp. places them in order Piroplasmida within the phylum Apicomplexa, which is primarily transmitted to humans and animals through Ixodid vectors. This parasite invades the erythrocytes of their hosts, leading to various disease symptoms. The present study focuses on determining the prevalence of Babesia infection in the blood of dogs in Southeastern of Fars province, taking into account the favorable geographical and climatic conditions and the abundance of vector ticks in Fars province, Iran.

A total of 324 dog collars (132 females and 192 male) were selected from four different cities in Southeastern of Fars province, and categorized based on age, type of use, and sex. The samples were subjected to blood smear test. The obtained results were statistically analyzed using SPSS software and the Chi-square test (X2).

Forty two samples were infected with Babesia, indicating an infection rate of 12.96%. Among the infected samples, 13.02% were male dogs. Additionally, 12.87% of the infection was observed in female dogs. Finally, 12.71% of infection was observed in Shiraz city (15 sample), 14.94% in Kazerun city (13 sample), 8.92% in Fasa city (5 sample), and 14.28% in Jahrom city (9 sample).

The statistical analysis showed no significant relationship between gender and the level of infection, no significant association was found between the type of use (Pets, guard dogs, herding dogs, and stray dogs) and the level of infection. Furthermore, there was no significant correlation between age and Babesia parasite infection.

Periodontal inflammatory disease is one of the most common chronic inflammatory diseases that can affect individuals of any age. The results of some studies have shown that both type 1 (T1DM) and type 2 diabetes may be associated with an increased risk of periodontal inflammation. Inflammatory status and vitamin D deficiency create a suitable environment for the progression of chronic diseases such as diabetes and periodontitis in children. This study aimed to investigate the association between vitamin D levels and gingivitis in children with T1DM.

This case-control study was conducted in the city of Ilam to examine the association between 25-hydroxyvitamin D (25(OH)D) levels and gingivitis in 148 children with T1DM. The case-control group was randomly selected from all children aged 6 - 12 years. Participants were classified into two groups, healthy and T1DM, based on the presence of gingivitis. Fasting blood sugar, calcium, and serum 25(OH)D levels were assessed in this study.

The results of the Mann–Whitney showed that 25(OH)D levels were significantly lower in the group with gingivitis (20/72±12/77) compared to the group without gingivitis (29/57±10/72) (p<0.05). In addition, there was no statistically significant difference in the level of 25(OH)D according to gender between the group with gingivitis and the group without gingivitis (p=0.673 and p=0.350). Also, the results of the chi-square test showed that there was no significant difference between the two groups with gingivitis and those without gingivitis in terms of gender and age distribution. (p>0.05)

The results of this study show that vitamin D deficiency is an effective factor in high gingivitis in children with T1DM. Timely monitoring of the level of this vitamin in patients with gingivitis is essential.

 Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity, which is usually caused by the most common premalignant lesion of oral leukoplakia (OL). For changes of dysplasia and malignancy, the level of antioxidants in the blood and tissue of patients changes significantly, which may be effective in early diagnosis of malignancies. Therefore, the purpose of this study is to evaluate antioxidants (enzymatic and non-enzymatic) in the blood of patients with OSCC and OL.

This study is a case-control study and was conducted on 75 blood samples of patients with OSCC and OL referred to the Cancer Institute of Imam Khomeini Hospital, Ilam. Enzymatic antioxidants [catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx)] and non-enzymatic antioxidants (ascorbic acid, beta-carotene, vitamin E) were evaluated in the blood of patients. The data obtained from this study were evaluated by ANOVA test and the significance level (P<0.5) was considered.

The results showed that the mean age in the HC group was similar in both sexes, while in the OL group, the age of women was 4 years younger, and in the OSCC group, the age of women was 2 years older than men. CAT, as an antioxidant indicator, significantly increased in the OL group compared to the HC group and OSCC group (P < 0.000). Also, CAT and SOD activity in OSCC serum samples significantly decreased compared to the HC group (P < 0.000). GPx also showed a significant decrease in both OL and OSCC groups compared to the HC group (P < 0.000). The results related to the non-enzymatic antioxidant factors, beta-carotene, vitamin E, and ascorbic acid, significantly decreased in both OL and OSCC groups compared to the HC group (beta-carotene (P < 0.000), vitamin E (P < 0.000), and ascorbic acid (P < 0.000)).

The results of this study show that the level of enzymatic antioxidants and beta-carotene in is not related to the degree of dysplasia of oral leukoplakia, therefore, it is not possible to predict the probability of occurrence of malignant oral lesions based on the measurement of the level of antioxidants in patients with OL.

Although soft tissue calcifications are relatively common and are commonly seen on panoramic radiographs, few studies have reported their causes. Therefore, the present study was conducted to investigate the relationship between systemic diseases and ectopic calcifications.

In this descriptive study, the study population included patients referred to the Radiology Department of two specialized dental clinics in Ilam and Kermanshah cities from 2020-2021. A total of 1000 participants were voluntarily examined. The collected data were analyzed using the correlation and logistic regression tests. 

The prevalence of calcifications was 39.4% in Ilam and 27.6% in Kermanshah. Also, the results showed that there was a significant relationship between systemic diseases and calcifications (P<0.05). The correlation coefficient between systemic diseases and calcifications was r=0.76 (P=0.02) in Ilam, and r=0.84 (P=0.00) in Kermanshah. Age and sex could not predict calcifications (P>0.05).

Based on the findings, calcifications on panoramic radiographs may serve as a predictor for presence of systemic diseases.

 Various micronutrients have been used to manage patients affected by coronavirus disease 2019 (COVID-19). However, data on the potential benefits of selenium for COVID-19 patients are scarce.

 This study was conducted to monitor the efficacy and safety of selenium supplementation in COVID-19 patients hospitalized at Shahid Mostafa Khomeini Hospital in Ilam, Iran, in 2021.

 In this randomized controlled trial, 100 COVID-19 cases were included and divided into two groups: The selenium group (n = 50) was prescribed the hospital treatment protocol as well as selenium supplementation in a daily dose of 200 µg, and the control group (n = 50) that received only the hospital treatment protocol. Laboratory tests, including platelet, white blood count (WBC), hemoglobin, ferritin, c-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), were performed before the trial and on the 14th day. Two groups were compared based on laboratory findings, duration of hospitalization, and dependency on mechanical ventilation.

 In the selenium group, platelets, WBC, and hemoglobin rose remarkably compared to their pre-treatment concentrations (P < 0.05), while a considerable drop was detected in levels of ESR, CRP, and ferritin (P < 0.05). The mean length of stay in the selenium and control groups was 9.27 ± 13.50 and 11.45 ± 14.33 days, respectively (P = 0.401). The mean mechanical ventilation dependency days in the selenium and control groups were 9.65 ± 11.71 and 7.45 ± 4.93, respectively, implying no statistically significant difference (P = 0.307).

 Selenium supplement may reduce levels of inflammatory markers in COVID-19 patients. Nevertheless, further trials are required to monitor its clinical effectiveness.

The infant mortality rate is one of the most important parameters for evaluating the health index in societies. The present study aimed to investigate the mortality rate of infants hospitalized in the neonatal intensive care unit (NICU) (Ayatollah Taleghani Hospital, Ilam) from 2018-2019.

This cross-sectional descriptive study was conducted on infants hospitalized in the NICU department of Ayatollah Taleghani Hospital in Ilam, from April 2018 to March 2019. The sampling was performed using the census method. The data collection tools included a demographic questionnaire and a researcher-made checklist. The collected data were analyzed in SPSS software (version 26) using chi-square and independent t-tests at a significance level (P<0.05).

In the current study, the total number of infants hospitalized in the NICU was 83, and 28 infants died, of whom 11 (30.6%) cases were girls and 17 (36.2%) neonates were boys. The mean age of deceased infants was 32.67 weeks. The most common type of disease at the time of death in these infants was asphyxia, with a frequency of 35.7% (n=10). Age and gender showed no significant relationship with mortality (P>0.05).

Due to the high mortality rate in premature neonates with less than 32 weeks of gestation, effective measures should be put on the agenda to prevent premature birth and respiratory distress syndrome.

Dyspepsia is a common disorder that puts much socio-economic pressure on patients due to its high prevalence. Various factors can cause this disorder.

This study investigated the relationship between dyspepsia, quality of life, and personality traits.

This case-control study selected 50 people with dyspepsia and 50 healthy people by simple random method. Patients’ demographic information was recorded using a researcher-made checklist. Then, the WHOQOL-BREF questionnaire measured the quality of life, and the NEO-FFI-60 questionnaire assessed personality traits. Finally, the data were analyzed using a chi-square test, independent t-test, and multivariate linear and logistic regression by SPSS software version 22 at the significance level of 0.05.

The mean score of anger was higher in people with dyspepsia than in healthy people (P = 0.000), but other indicators were higher in healthy people than in people with dyspepsia (P < 0.05). Finally, the personality traits of anger, acceptance of new experiences, and conscientiousness had a significant relationship with quality of life in people with dyspepsia (P < 0.05).

Dyspepsia reduces the quality of life and affects the personality traits of individuals. Thus, improving dyspepsia can improve patients’ personality traits and quality of life.

Context: 

The type of anesthesia in cesarean section can affect the mother and baby. This study aimed to determine the comparative effect of intrathecal hyperbaric bupivacaine vs. hyperbaric ropivacaine on maternal and neonatal outcomes after cesarean section.

Evidence Acquisition:

 PubMed, Web of Science, Embase, Google Scholar, IranDoc, MagIran, and Scopus databases were searched from 1 September 2022 to 1 November 2022. Eighteen clinical trials with 1542 patients were included in the analysis.

There was no statistically significant difference in hypotension, bradycardia, and Apgar score between the 2 groups (P > 0.05). The risk of nausea (relative risk (RR), 1.526; 95% CI, 1.175 - 1.981; P = 0.001) and vomiting (RR, 1.542; 95% CI, 1.048 - 2.268; P = 0.02) caused by bupivacaine was 0.53% and 0.54% higher than that of ropivacaine. The incidence of shivering (RR, 2.24; 95% CI, 1.480 - 3.39; P = 0.00) was 2.24 times higher in the bupivacaine group than in the ropivacaine group. The average onset time of sensory block (standardized mean difference (SMD), -0.550; 95% CI, -1.054 to -0.045; P = 0.032) and motor block (SMD, -0.812; 95% CI, -1.254 to -0.371; P = 0.000) was significantly lower in the bupivacaine group than in the ropivacaine group.

Despite the fact that ropivacaine and bupivacaine are effective in cesarean section, ropivacaine is more favorable because of lesshemodynamicchanges, less duration of sensoryandmotorblock, andfewer side effects, whichare effective in patient recovery.

 Older adults need more specialized care due to their complex conditions, and each part of the healthcare system plays a specific role. In addition, nurses have the most human relationship regarding patient duration and depth. Therefore, the quality of providing care to the elderly is influenced by many factors, including nurses’ attitudes and ethical sensitivity.

 This study aimed to determine the relationship between nurses’ attitudes and ethical sensitivity ability towards the elderly in hospitals and their effective factors.

 This descriptive-analytical study was conducted on selected (training and non-training) hospitals affiliated with the Ilam University of Medical Sciences, Iran, in 2022. The population included 380 nurses, who were selected by random sampling. The data were collected using two questionnaires, including the standard questionnaire on nurses’ ethical sensitivity in decision-making and Kogan’s Attitudes Toward Old People Scale (Kogan OP Scale). Finally, the data were analyzed by descriptive-inferential statistical tests and SPSS software version 24.

 The results showed no significant difference between the mean score of nurses’ ethical sensitivity and attitudes (P = 0.807). In addition, no significant relationship was found between the level of ethical sense and individual characteristics of nurses, including age, gender, education level, marital status, work experience, workplace sector, and nursing work type (P > 0.05). However, a significant relationship was found between age and attitude (P = 0.031).

 Nurses have to deal with many ethical situations when caring for elderly patients, so a positive attitude is essential when dealing with the elderly. As a result, nurses respect the rights of elderly patients to make decisions and preserve their independence. Further, educational programs such as workshops and continuous training courses can help develop nurses’ ethical sensitivity.

As a complete food source, milk contains nutrients, minerals, and vitamins needed by the body. However, raw milk has many microorganisms that can cause a wide range of diseases for consumers, so sterilization is one of the important steps in the dairy industry that must be paid enough attention to obtain a healthy product that preserves its primary nutritional value. The current study is a review study with the aim of investigating different thermal methods such as conventional heating (CH) and ohmic heating (OH), and new non-thermal methods such as cold plasma (CP) on inactivation Raw milk microorganisms and the effectiveness rate of this methods are compared. This study includes a review of 13 experimental studies, of which 5 studies investigate the inactivation rate of OH and CH sterilization on Staphylococcus thermaphilus, Listeria monocytogenes, Escherichia coli, Salmonella typhimurium and Lactobacillus acidophilus, and 8 other experimental studies investigate the inactivation rate of CP method as a non-thermal alternative method which is less destructive to foods on Staphylococcus aureus, Enterococcus faecalis, and on microorganisms in general. According to the contents mentioned in this article, it can be concluded that OH has the ability to produce safe products by preserving nutrients, and at the same time, it does not harm the quality of the products. The amount of microbial load of milk using the OH method was much lower than the CH method, and also less time and energy is needed to reach the sterilized state of the milk, as the energy and time required by OH are 72% and 19% less than CH respectively. Also, CP affects the production of biofilm from microorganisms, especially Staphylococcus aureus and Enterococcus faecalis, and reduces the microbial load in foods through this way, and by increasing the time of CP irradiation on bacterial isolates, a significant decrease in the Bacteria growth rate is observed.

Congenital heart diseases (CHDs) can cause death and severe disorders in the developmental process of children and, in most cases, are associated with other congenital defects. The current study investigates the prevalence of such defects among infants born in 2019 and 2020. This analytical cross-sectional study was conducted in Ilam province on 91 referred neonates, with the possibility of heart diseases, who were diagnosed with CHDs. Demographic, clinical, and definitive diagnoses of cardiologists were recorded and analyzed in these infants, followed by a 6-month follow-up. Data were analyzed using SPSS software with descriptive statistics, Chi-square test, and correlation coefficients. A total of 91 infants out of 16,064 newborns were diagnosed with CHDs, and the prevalence of heart diseases was 5.9 in every 1000 live births. The most frequent defects were ventricular septal defects (VSDs) and PDA, with prevalence rates of 59.3% and 14.2%, respectively. Among 54 VSDs, mus VSD (n = 39) was the most common form of this disorder. The incidence of CHDs in Ilam province was lower than the global average, which may be attributed to the easier access of several cities to the health centers of the bordering provinces. The highlighted results of this study were the frequency of VSDs and the high rates of muscular VSD compared to membranous VSD.

Anemia often worsens the severity of respiratory illnesses, and few studies have so far elucidated the impact of anemia on COVID-19 infection. This study aimed to evaluate the effect of anemia at admission on the overall survival of COVID-19 patients using AFT models.

This registry-based, single-center retrospective cohort study was conducted in a university hospital in Ilam, the southwest of Iran, between March 2020 and September 2021. AFT models were applied to set the data of 2,441 COVID-19 patients. Performance of AFT models was assessed using AIC and Cox-Snell residual. On-admission anemia was defined as Hb concentration <120 g/l in men, <110 g/l in women, and <100 g/l in pregnant women.

The median in-hospital survival times for anemic and non-anemic patients were 27 and 31 days, respectively. Based on the AIC and Cox-Snell residual graph, the Weibull model had the lowest AIC and it was the best fitted model to the data set among AFT models. In the adjusted model, the results of the Weibull model suggested that the anemia (adjusted TR: 1.04; 95% CI: 1.00-1.08; p = 0.03) was the accelerated factor for progression to death in COVID-19 patients. Each unit of increase in hemoglobin in COVID-19 patients enhanced the survival rate by 4%.

Anemia is an independent risk factor associated with the risk of mortality from COVID-19 infection. Therefore, healthcare professionals should be more sensitive to the Hb level of COVID-19 patients upon admission.

Aluminum phosphide is known in our country as Phostoxin tablet. Human contact with Phostoxin tablet can have severe and fatal consequences. The present study aimed to evaluate and compare the group of patients dying due to Phostoxin tablet poisoning with the group that survived despite taking Phostoxin tablet.

This descriptive-analytical and cross-sectional study was performed on all patients poisoned with Phostoxin tablet in 2018 and 2019. The sampling method was a full census. According to the purpose of the study, T-test, Mann-Whitney, and Chi-square tests were employed in SPSS software version 24 and Graph pad prism version 8.

This study included 35 poisoned individuals with a mean age of  (16-82) years. The highest frequency was in the age group of 20-40 years (82.9%) and 21 women (60%) and 14 men (40%). There was a statistically significant relationship between mortality rate with drug use, length of hospital stay, blood pressure, number of breaths, level of consciousness, abdominal pain (P<0.05). Meanwhile, the mean level of ALT and AST liver enzymes and blood pressure in the two groups of dead and rescued were significantly different (P<0.05).

Phostoxin Tablet poisoning is a common cause of poisoning in Iran that has a high mortality rate. This is a serious health problem in communities where Phostoxin tablet is used. Consequently, you must go to the hospital immediately after contact with Phostoxin.

Electrolyte imbalances are common in COVID-19 infection and are associated with poor outcomes in hospitalized patients.

This study examined whether serum phosphate imbalances at admission are associated with mortality in hospitalized COVID-19 patients.

In this registry-based single-center retrospective cohort study, 1349 inpatients with COVID-19 were included from March 2020 to March 2021 in an academic hospital in Ilam (southwest Iran). The Cox proportional hazard (PH) regression model was applied to the data set of COVID-19.

The in-hospital median survival time for patients with low, normal, and high serum phosphate levels was 14, 25, and 8 days, respectively. In a multivariate model, adjusted for the other variables, patients with hypophosphatemia (adjusted hazard ratio [HR], 2.53; 95% CI, 1.15 - 5.58; P = 0.02) and hyperphosphatemia (adjusted HR, 1.77; 95% CI, 1.00 - 3.14; P = 0.05) had an increased mortality hazard compared with those who had normal levels of serum phosphate.

Our results demonstrate a strong effect of hypophosphatemia and hyperphosphatemia with increased in-hospital mortality in COVID-19 patients. Intensive medical care and more attention must be paid to COVID-19 patients with serum phosphate imbalances at admission.

Thalassemia major (TM) is an inherited hemolytic disease with a high prevalence. Nowadays, no complications have been studied in these patients. Therefore, this study aimed to investigate the complications of tuberculosis packs and iron chelators in patients with TM in Mostafa Khomeini Hospital in 2018-2019.

This cross-sectional study was performed in Mostafa Khomeini Hospital in 2018-2019. All eligible patients' records and necessary information, including age, sex, and periodic tests (cardiac, liver, bone, and hormonal and infectious examinations), were reviewed and collected using a checklist. Data were analyzed using SPSS22 software with a significance level of 0.05.

Enrolled patients were 93 cases with TM. The incidence of osteopenia and osteoporosis (69.9%) was the most common, and the lowest cases were hypogonadism (35.5%), hypothyroidism (9.7%), heart failure (5.4%), hepatitis C (2.2%), and liver failure. Hepatitis B and HIV were not seen in these patients.

Results demonstrated that the highest rate of complications was related to the bony part of the body structure, which is due to the pathophysiology of the disease. The low rates of heart failure and liver failure were because the patients with this level of complications may not survive for long.

Research evidence has approved the effectiveness of surfactant prescription for respiratory distress syndrome (RDS). However, previous studies have not reported the priority of curosurf and Beraksurf. The present study aimed to compare the effectiveness of Iranian surfactant (beraksurf) and Italian surfactant (curosurf) in the treatment of pulmonary distress. This clinical trial was performed on 80 premature infants with respiratory distress in NICU of Taleghani Hospital in Ilam, all of whom were treated with surfactant. There was no significant difference regarding the duration of needs for ventilation and/or oxygen, duration of hospitalization, pulmonary hemorrhage, bronchopulmonary dysplasia, intraventricular hemorrhage, patent ductus arteriosus (PDA) and pneumothorax between the groups (p>0.05). Beraksurf seems to be as effective as curosurf in premature neonates with RDS, but is less expensive than it.

Vesicoureteral reflux is a common urinary tract abnormality, which could damage the renal parenchyma. The present study aimed to investigate the prevalence of microalbuminuria and its association with the severity of urinary reflux and renal scarring with reflux nephropathy in children aged less than 12 years referred to Imam Khomeini Hospital in Ilam, Iran.

This longitudinal study was conducted during one year on the hospitalized patients who had tested positive for urine and urine culture. After the treatment of urinary tract infection and obtaining a negative urine culture, isotope cystography or radiographic cystography was performed to diagnose urinary reflux. Data analysis was performed in SPSS version 20 using descriptive statistics, chi-square, and correlation-coefficients.

The prevalence of microalbuminuria in Ilam province was 35.7%. No significant difference was observed between the rates of microalbuminuria and reflux (P > 0.05). However, the inverse correlation in this regard was not considered significant (P > 0.05). A direct correlation was observed between the rate of microalbuminuria and the incidence and severity of scars, which was considered significant (P < 0.05).

According to the results, the mean rate of microalbuminuria in reflux decreased with the increased degree of reflux. Due to the changes in microalbuminuria compared to the severity of urinary reflux, this method cannot be used to determine the severity of reflux, which it could be considered an influential factor and a method used for the early diagnosis and follow-up of patients and preventing final kidney damage and renal failure.

Rheumatoid arthritis is a chronic inflammatory autoimmune disease characterized by synovial involvement, inflammation, andjoint destruction that, if not properly controlled, can damage cartilage, bone, ligaments, and tendons and, in some cases, lead todisability. The aim of this study was to identify inflammatory biomarkers in rheumatoid arthritis patients.This case-control study was performed on 50 rheumatoid arthritis patients who referred to the Rheumatology Clinic of ShahidMostafa Khomeini Hospital in Ilam and their healthy counterparts. All patients were examined by a rheumatologist for diseaseactivity based on DAS28 (Disease Activity Score Calculator for Rheumatoid Arthritis) criteria.The results of this study showed that the mean lymphocyte count in the case group was lower than the control group, and therewas a statistically significant relationship between lymphocyte level in the two groups. The mean neutrophil count was higher inthe case group than in the control group, and this relationship was significant. The mean neutrophil/lymphocyte ratio was higherin patients with rheumatoid arthritis than in controls and in women more than men. Stepwise logistic regression also showed thatage, sex, DAS28, VitD (Vitamin D), RF (rheumatoid factor), and NLR (neutrophil-to-lymphocyte ratio) significantly predict theincidence of rheumatoid arthritis (p value < 0.05). Therefore, NLR can be used as a prognostic factor.

Aluminum phosphide is known in our country as Phostoxin tablet. Human contact with Phostoxin tablet can have severe and fatal consequences. The present study aimed to evaluate and compare the group of patients dying due to Phostoxin tablet poisoning with the group that survived despite taking Phostoxin tablet.

This descriptive-analytical and cross-sectional study was performed on all patients poisoned with Phostoxin tablet in 2018 and 2019. The sampling method was a full census. According to the purpose of the study, T-test, Mann-Whitney, and Chi-square tests were employed in SPSS software version 24 and Graph pad prism version 8.

This study included 35 poisoned individuals with a mean age of  (16-82) years. The highest frequency was in the age group of 20-40 years (82.9%) and 21 women (60%) and 14 men (40%). There was a statistically significant relationship between mortality rate with drug use, length of hospital stay, blood pressure, number of breaths, level of consciousness, abdominal pain (P<0.05). Meanwhile, the mean level of ALT and AST liver enzymes and blood pressure in the two groups of dead and rescued were significantly different (P<0.05).

Phostoxin Tablet poisoning is a common cause of poisoning in Iran that has a high mortality rate. This is a serious health problem in communities where Phostoxin tablet is used. Consequently, you must go to the hospital immediately after contact with Phostoxin.

Rheumatic diseases are among the most health problems that exert economic and social burden on the general population. Patients’ information based on the inclusion criteria were collected from hospital records in separate questionnaires, that were assessed in terms of age at the time of referral, sex, ethnicity, initial clinical manifestations, involved joints, presence of comorbid disease and extra-articular involvement. The study population was 3049 patients. The mean age of patients was 52.24 ± 12.99 years. 81 % of the patients were female. The prevalence of osteoporosis (OP) was 22.00%, Rheumatoid arthritis (RA) was 21.51%, and Osteoarthritis (OA) was 16.59%. Joint pain (OR 4.21, 95% CI 3.02–4.81, p < 0.001), BMI>25 (OR 3.83, 95% CI 2.01–6.79, p < 0.001), and Lack of physical activity (OR 2.34, 95% CI 1.14–3.75, p = 0.018) were risk factors of osteoporosis. It is recommended to control the known risk factors associated with these diseases, such as lifestyle modifications, and regular and effective exercise, as well as to review the associated risk factors, especially in women.