فهرست مطالب mehrdad zamani esfahlani

The available literature offers valuable insights into various aspects of osteomyelitis and its management, but a dedicated investigation into its impact on mortality within the specific context of ICU admissions is warranted. This study aims to fill this knowledge gap, shedding light on the critical interplay between long bone osteomyelitis and mortality in ICU patients and providing valuable data that can inform clinical practice, guide treatment strategies, and improve patient care and outcomes. Identification of eligible patients using electronic medical records. Data collection, including demographic information, comorbidities, ICU admission details, microbiological findings, and mortality outcomes. Comparison of the osteomyelitis group and control group with respect to mortality rates during their ICU stay. Subgroup analysis within the osteomyelitis group to explore factors associated with increased mortality. Multivariate logistic regression was conducted to assess the independent association between osteomyelitis and ICU mortality while controlling for potential confounding factors. After adjusting for age, sex, and comorbidities, the odds ratio (OR) for ICU mortality in patients with osteomyelitis was 2.12 (95% confidence interval [CI], 1.11 to 3.89). Notably, this analysis did not reveal a statistically significant association between osteomyelitis and ICU mortality (p =0.125). Our study demonstrates a significant association between osteomyelitis of long bones and increased mortality in patients admitted to the ICU. Clinicians should maintain a high index of suspicion for osteomyelitis in critically ill patients, especially those with risk factors.

As we navigate the intricate terrain of lower limb amputation etiology, this article seeks to provide valuable insights for healthcare professionals, researchers, policymakers, and anyone interested in the complexities of this critical healthcare issue. By unraveling the multifaceted factors contributing to lower limb amputations, we aim to contribute to the development of more effective prevention strategies, improved treatment approaches, and enhanced support systems for individuals living with limb loss. This retrospective study was conducted at a single-center and involved patients referred to our orthopaedic department for lower extremity amputation (LEA) during the period spanning January 2007 to December 2019 in East Azarbaijan Hospitals. Data collected included the year of amputation, patient age, gender, level of amputation, and the underlying cause for the amputation. The study encompassed a total of 114 lower extremity amputations, with major amputations accounting for 60.5% of the cases. Notably, the incidence of major amputations exhibited an upward trajectory over the study period, with an annual increase of 0.6 amputations per year. Male patients were significantly more prone to LEA than their female counterparts. Within the patient population of our orthopaedic institution, the etiology of lower extremity amputations demonstrates a multifaceted nature that sets it apart from trends observed in other surgical specialties. Notably, the incidence of major amputations has shown a consistent upward trend over recent years.

The reduction of thyroid hormones during surgery can affect the amount of bleeding. This study aimed to evaluate the effects of prophylactic administration of oral levothyroxine on bleeding and hemoglobin levels during and after THA in patients with a history of IHD. In this double-blinded clinical trial, 40 THA candidates with a history of IHD were randomly divided into intervention and control groups. Twelve hours before the induction of anesthesia, patients in the intervention group received 20 µg levothyroxine, and patients in the placebo group received the same amount (one-fifth of a tablet) of a placebo. Also, during surgery, one tablet containing either 100 mg levothyroxine or a placebo was dissolved in 30 ml of water, and 20% of it was fed to the patients by gavage. One, two, three, and 12 hours after surgery, as well as on days 1st, 2nd, and 4th post-surgery, the same amount of the drug was given to the patients. Changes in hemoglobin level, bleeding volume (during and after surgery), and the number of blood units received were compared between the two groups.  Red blood cell count (RBC) (intervention: P=0.855 and control: P=0.214), hemoglobin level (intervention: P=0.673 and control: P=0.123), and hematocrit (intervention: P=0.666 and control: P=0.096) were more stable in the intervention than in the control group. Also, bleeding volume was considerably lower in the intervention group (P=0.339) than in the control group (P=0.032). Also, serum volume in the operation room (P=0.019) and post-surgery (P=0.041) and the number of packed cell units received in the operation room (P=0.014) and after surgery (P=0.041) were significantly lower in the intervention group than in the control group. The prophylactic administration of oral levothyroxine reduced bleeding volume and the need for blood transfusion and rendered blood indices (Hb, HCT, RBC, PT, and APPT) more stable in THA candidates with a history of IHD.

 Several studies have investigated the association between Multiple Sclerosis (MS) and pregnancy. However, the reported results are contradictory, which has caused confusion of obstetricians and gynecologists as well as neurologists concerning pregnancy planning of women with MS. Hence, the present study aimed to investigate.

We systematically searched PubMed, Science Direct, Scopus, Web of Science, and Google Scholar databases and national databases (SID and MAGIRAN) to identify relevant studies published from 2000 to 2020, either in English or Persian, using the following keywords: autoimmune, hormonal disorders, pregnancy, menstrual cycle, multiple sclerosis, pre-pregnancy, post-pregnancy, and lactation. The keywords were combined using Boolean functions of AND and OR.

In total, 46 studies were identified. The results of these studies were reviewed in terms of defining disease, hormonal changes, menstrual cycle disorders, pregnancy of MS patients, evaluation of pregnancy of MS patients, hormonal changes during pregnancy, changes in immune system responses and cells, serum exosome, disease screening during pregnancy, disease management and treatment (if needed), recommendations for pregnant women, labor care, points for breastfeeding, and disease activity after delivery.

Pre-pregnancy consulting for MS patients should be performed carefully to reduce recurrence rates during pregnancy. The symptoms of MS decrease during pregnancy, and there is no concern about medication. It should be noted that in nine months after delivery, the patient will return to normal condition, and special attention should be paid to drug therapy.

Withing a short period of time up to six months after brain damage, the brain can be reconstructed and plasticity can be accelerated. Therefore, there is a possibility of recovering a collection of motions by rehabilitation within this time period. The present article investigated the process of neuromotor rehabilitation in patients with brain lesions, plus developed a skill in healthy people by analyzing the neuroplasticity and studied the changes of muscle synergy.

The present Sysyematic review researched the combination of terms such as rehabilitation(Mesh), neurorehabilitation(Mesh), brain stroke(Mesh), brain lesion(Mesh), skill (Mesh)with no time limit on scientific databases including Science Direct, Springer, Google Scholar, Pubmed, Scopus, SID, IranDoc, and Web of Science and the purpose of the research was specified on the basis of the articles found.

Among the researched articles, 32 related articles were reviewed, the most important of which were investigated and analyzed included rehabilitation in stroke, rehabilitation, and spasticity, rehabilitation recovery mechanisms in spasticity after a stroke, comparison between the effects of rehabilitation after a stroke and healthy people, required after stroke training for patients, the effectiveness of repetition in the rehabilitation exercises after stroke.

The process of neuromotor rehabilitation of patients with brain lesions and the development of skills in them compared to healthy individuals by analyzing the degree of plasticity is an effective way to strengthen muscles and can be effective; However further investigation is needed.

Recently, the use of knee braces in the elderly to increase the electrical range and activity of knee has become widespread, but the results have not been gathered in one study to determine its effects. Therefore, the present study was conducted with the aim of the effect of knee brace (as a non-chemical treatment) on the electrical activity range of the lower limb muscles during walking in a systematic way. In this systematic review, keywords such as knee brace, electromyography, elderly, and walking with the help of Boolean operators in English and Persian databases Iranmedex, SID, Magiran, MEDLINE, SCOPUS, Science Direct, PUBMED, Cochrane Library, Google Scholar, EMBASE, and Proquestand Ebsco/CINAHL were searched. In this review, 4 articles were included in the study. A total of 87 people were investigated and the period of publication of articles varied from 2010 to 2022. The results of all articles indicated that the use of a knee brace leads to an improvement in the functional state of the knee, an increase in the strength of the biceps biathlon muscles, and an increase in electrical activity and the quality of walking. The use of braces is effective in improving muscle activity in the elderly during different sub phases of walking. This is applied to both men and women. Despite this, more research is needed to prove this issue as well as possible.

Since the effectiveness of water therapy pre-rehabilitation exercises in people with chronic back pain and candidates for surgery as well as its effects on the results of laminectomy surgery have not been collected in a comprehensive study, it was decided to conduct the present study to obtain the issue of whether the hydrotherapy pre-rehabilitation exercises are effective on the electrical activity of central muscles in patients with chronic back pain who are candidates for laminectomy surgery, or not.

This study is a systematic review.

Initially, 66 articles were found. Reviewing the abstracts of the articles led to the removal of 30 articles, and from the remaining 36 articles, 28 articles were removed by reviewing the texts of the articles, and among the remaining articles, 4 articles were removed due to the low quality of the article, and finally 4 articles were included in this study and analyzed.

Water sports pre-rehabilitation program can be an important part of the comprehensive rehabilitation program for patients with back pain.

There is a need to prepare clinical guidelines for conducting elective or emergency spinal cord surgeries in people who may be carriers of the COVID-19. Therefore, the study aimed to design a guideline for conducting elective spinal cord surgeries during the COVID-19 pandemic. The clinical guidelines and systematic reviews providing recommendations for elective and emergency spinal cord surgeries were collected by an initial search. A group of nine experts were designed a domestic preliminary guideline using six available guidelines presented in four studies. Scoring was conducted based on the AGREE (Appraisal of Guidelines Research and Evaluation) tool. The guideline was prepared in eight subscales, including outpatient visit and counseling, protective measures for health personnel, surgical considerations during the coronavirus pandemic, intraoperative considerations, managing aerosol producing activities, elective and emergency spinal cord surgery, and patient intubation and cardiopulmonary resuscitation. Each of these subscales included several specific recommendations. It recommended to reduce the capacity of inpatient wards to half during the coronavirus pandemic, give priority only to emergency surgeries, presence of skilled residents (senior year residents), use personal protective equipment, use the least number of people in the operating room, and reduce the length of surgery without compromising its quality.

Women with breast cancer spinal metastases are highly prone to coronavirus disease 2019 (COVID-19), resulting in the incidence of stress in these women. The present study aimed to investigate the perceived stress and its effect on the quality of life (QoL) and coping strategies of female chemotherapy patients with breast cancer spinal metastases during the COVID-19 pandemic.

This descriptive-correlational study was conducted during February 20, 2020 and May 21, 2020 at Tabriz University of Medical Sciences during the COVID-19 pandemic. A total of 61 female chemotherapy patients with breast cancer spinal metastases completed the Perceived Stress Scale (PSS) and Billings, SF-36 questionnaire, and Moos’ Coping Checklist. The data were analyzed in SPSS using the Pearson correlation coefficient test at the significance level of P<0.05.

The overall perceived stress level of the participants was high (51.10±2.45). The overall score of coping strategies was 46.10±1.15 while the scores of problem- and emotion-focused subscales were 22.25±1.41 and 30.42±01.30, respectively. The perceived stress level had a significant correlation with overall coping (P=0.009, r=0.8), emotion-focused coping (P=0.04, r=0.5), and problem-focused coping (P=0.02, r=0.6) strategies. Finally, the results showed poor relationships between problem-focused and physical health (P=0.009, r=0.4), problem-focused mental health (P=0.01, r=0.4), emotion-focused and physical health (P=0.02, r=0.3), and emotion-focused and mental health (P=0.03, r=0.3).

Based on the findings, there are direct correlations between the perceived stress (strong) and QoL (poor) levels of female chemotherapy patients with breast cancer spinal metastases and their coping strategies during the COVID-19 pandemic.

Pregnancy is one of the pleasant periods of a woman’s life that turns into a bitter experience by common complications such as low back pain (LBP). Due to prevailing climatic conditions in Iran and the harmful social norms concerning Iranian women, the present study aimed to investigate the prevalence of pregnancy-related LBP and its influencing factors during different months of pregnancy.

This descriptive cross-sectional study was conducted in 2019 on 550 pregnant women for LBP who were eligible based on the inclusion criteria. The research instruments were a demographic questionnaire, a LBP examination, and the visual analog scale (VAS). The obtained data were analyzed using the chi-square test, the independent t test, and multiple logistic regression in SPSS 20, and a P<0.05 was considered statistically significant.

The prevalence of LBP was 67.27%, and the most important factors influencing pregnancy-related LBP were maternal age (OR=950, P<0.008), gestational age (OR=1.023, P=0.015), body mass index (OR=802, P=0.045), duration of sitting (OR=1.812, P=0.036), and the duration of standing (OR=1.625, P=0.042).

Overall, there was a high prevalence of pregnancy-related LBP in primiparous women in the present study and its predisposing risk factors included advanced maternal age, obesity, and low level of ability to sit and stand for a long time.

Lymphedema due to breast cancer treatment has a wide range of complications, including carpal tunnel syndrome (CTS). This syndrome causes disability for breast cancer survivors, so knowing its prevalence is essential for future action. This study was performed with aim to evaluate the frequency ratio of carpal tunnel syndrome in women with breast cancer treated with lymphedema.

This descriptive cross-sectional study was performed on 160 breast cancer survivors with lymphedema in Tabriz city health centers in 2018-2019. Demographic data and Boston CTS Questionnaire (CTS) were used for the purposes of the study. Data were analyzed by SPSS software (version 20) and Regression and Spearman Correlation tests. P<0.05 was considered statistically significant.

Thirty-three (20.62%) patients had carpal tunnel syndrome. The results of Chi-square test indicated that there was a significant association between carpal tunnel syndrome and age (p= 0.009), lymphedema (p= 0.001), history of radiotherapy (p= 0.001), history of surgery (0.019), history of lymph node removal (p= 0.03) and history of diabetes mellitus (p= 0.04).

The incidence of carpal tunnel syndrome in the present study was 20.62% in women with breast cancer treated with lymphedema. Identifying the risk factors for this syndrome may be the basis for preventive and controlling measures in these patients.