فهرست مطالب sima masudi

Prostate cancer is one of the most common cancers in men. This study investigates the effectiveness of oral pregabalin combined with local anesthesia in reducing pain for patients undergoing prostate biopsy.

In this randomized clinical trial, 78 patients candidates for prostate biopsy were divided into two groups: the control group (local anesthesia with lidocaine) and the intervention group (100 mg oral pregabalin two hours before the procedure + local anesthesia). The biopsy was performed under rectal ultrasound guidance. Patients’ pain intensity was evaluated one and six hours post-biopsy using the Visual Analogue Scale (VAS).

The most common reason for referral in both groups was Lower Urinary Tract Symptoms (LUTS) (48.7% in the control group and 41% in the intervention group). Pain intensity was significantly lower in the intervention group compared to the control group (p<0.001). This difference was observed both at one hour and six hours post-procedure. Cigarette smoking had no significant effect on pain levels.

Administration of 100 mg oral pregabalin two hours before prostate biopsy, combined with local anesthesia, results in a significant reduction in patient pain during the hours following the procedure. This finding could help improve patient experience and increase their acceptance of undergoing prostate biopsy.

Vitamin D deficiency has been linked to cardiovascular diseases, but its impact on outcomes in myocardial infarction (MI) patients remains unclear. This study investigated the relationship between serum vitamin D levels and short-term and medium-term outcomes in patients with myocardial infarction. Ischemic heart diseases (IHD) are the most common cause of death in the world. Identifying risk factors and predictors can play a critical role in identifying high-risk people in screenings, identifying high-risk patients during admission to the hospital, and adjusting these risk factors in patients to improve prognosis.  This prospective observational study was conducted on 212 patients diagnosed with myocardial infarction at Seyed al-Shohada Hospital in Urmia, Iran. Having been admitted, the patients had their serum vitamin D levels measured using the same blood sample for routine tests. Levels of vitamin D were categorized as normal (>30 ng/ml), insufficient (21-29 ng/ml), or deficient (<20 ng/ml). The patient's files provided the demographic, clinical, and biomedical information, echocardiography, and angiography data. The patients were followed for at least six months post-MI, with a maximum follow-up of 11 months.  Follow-up occurred through monthly phone calls and outpatient clinic visits as needed. Primary outcomes included in-hospital complications (such as death, significant bleeding, acute pulmonary edema, cardiogenic shock, and arrhythmias), cardiac readmissions, and mortality. Logistic regression and Cox regression analyses were used to examine the connection between outcome variables and vitamin D levels, adjusting for potential confounders including age, gender, blood pressure, diabetes, blood lipids, creatinine, disease severity (SYNTAX score*), and left ventricular ejection fraction. The mean serum level of vitamin D in patients on admission was 33. 62 ng/dL. The average number of hospitalization days was 4.8 days, and the rate of re-hospitalization was 26.6% in the six-month follow-up and 30.3% in the 9-month follow-up. The hospital mortality rate was equal to 1.4%, and the mortality rate at the end of the follow-up period was equal to 8.3%. The most common complication during hospitalization among the patients was ventricular tachycardia. However, in follow-up, re-hospitalization due to previous issues was the most common complication.  The mean serum vitamin D level was 33. 62 ng/ml,with 52.8% of patients having insufficient or deficient levels. The most common in-hospital complication was ventricular tachycardia (11.5%). Vitamin D deficiency was not significantly associated with in-hospital complications. However, during the follow-up period, vitamin D deficiency was significantly related to increased risk of readmission to hospital (HR: 6.984, 95% CI: 3.500-13.936, p<0.001). The 6-month readmission rate was 26.6%, increasing to 30.3% at 9 months. Vitamin D deficiency was also associated with increased cardiac mortality (HR: 12.936, 95% CI: 1.494-112.016, p=0.020) during follow-up. The 9-month mortality rate was 8.3%. Other factors contributing to cardiac mortality included disease severity (SYNTAX score) and female gender.  While vitamin D deficiency did not impact short-term complications, it was associated with increased risk of hospitalreadmission and mortality in MI patients during medium-term follow-up. These findings suggest that vitamin D status can significantly impact long-term outcomes for MI patients.

Animal bites are one of the most important public health problems that cause rabies. This study aimed to investigate the preventive measures taken for animal bite cases that occurred in West Azerbaijan province during 2012 to 2019.

This cross-sectional study involved the review data from all animal bite cases referred to rabies care centers in West Azerbaijan province. Information regarding prophylactic measures to prevent rabies, including post-bite procedures (washing, disinfection, dressing, stitches and receiving antibiotics), anti-rabies vaccine status (referral delay, vaccine dose received, vaccination history, anti-rabies serum, tetanus vaccination history) was analyzed using descriptive statistics. The relationship between delay in referral and the measures taken was investigated using the Chi-square test.

Over the studied years, there were 47131 cases of animal bites. Among these, 63.9% were referred without delay, while 36.1% experienced a delay in referral. Notably, 99.6% of wounds were washed with soap and water, 94.5% were disinfected, and 31.3% received antibiotics. The proportion of individuals receiving antibiotics was significantly higher among those with delayed referrals. Regarding rabies vaccination, 77.3% had received all three initial doses, 15.4% had completed five doses, and 1.1% had not received any vaccine.

While prophylaxis measures for animal bite cases are commendable, there is a critical need for timely administration of rabies vaccine in rabies care centers. Implementing educational programs for general population to encourage prompt treatment-seeking in the event of animal bites is essential.

Study skills are among the factors affecting students' academic performance, and it is related to their success in future career. This study aimed to investigate the study skills and academic performance of medical students of Urmia University of Medical Sciences and factors affecting them.

In this cross-sectional study, 267 medical students participated who were selected by random cluster sampling. Data were collected using the study skills questionnaire. Based on their average grade point, students were classified into two groups of "good and average" and "poor" academic performances. The mean and standard deviation of study skill scores, also the proportion of the students with good, average, and poor study skills were estimated. The factors affecting students' study skills and academic performance were determined using logistic regression analysis.

In this study, 51% of students had good and average academic performance, and overall study skill score was moderate for 71.5% of students. The highest mean scores were obtained in the dimensions of "information organizing", "time management" and "concentration and memory". The lowest scores were obtained in the dimensions of "motivation and attitude" and "writing". Study skills were related to gender, father's education, grade and age. Academic performance was related to girl gender (OR=2.79, 95%CI: 1.56-4.97), being married (OR=4.69, 95%CI: 1.22-17.98), time management (OR=1.16, 95%CI: 1.05-1.24), and readiness to exam (OR=1.12, 95%CI: 1.01-1.24).

Academic performance and study skills of medical students are moderate. Improving study skills and identifying other factors affecting academic performance should be considered by university officials.

Overweight and obesity in women of reproductive age cause chronic diseases, fertility problems, adverse consequences of pregnancy, and mental diseases. Among the inappropriate behaviors that affect obesity are fast food consumption and growing sedentary lifestyle. This study aimed to determine the effect of educational and counseling intervention through smartphone applications on awareness of behaviors related to lifestyle and fast food consumption in the women of reproductive age with high body mass index.

In this experimental study, 106 women of reproductive age covered by comprehensive health service centers were selected by random sampling and assigned into intervention and control groups. The tools used in this research were a researcher-made questionnaire that included demographic information, a questionnaire of awareness about sedentary behaviors, and prepared foods. The educational intervention was carried out in the intervention group using the application. The control group received routine training from comprehensive health service centers. Three months after the intervention, the questionnaires were completed in both groups. Data analysis was done with SPSS ver. 20.0 software at a significance level of P<0.05

The study results showed that there was a significant difference between the mean scores of awareness of fast food consumption (P<0.001) and sedentary behaviors (P<0.001) before and three months after the intervention among the two groups. However, there was no significant difference in weight before and three months after the intervention (P>0.05).

Educational and counseling programs with applications can be used to improve awareness about the symptoms related to sedentary and consumption of fast foods.

The importance of blood and its role in the medical system is undeniable; however, the excessive demand for blood and blood products in teaching hospitals is a major concern.

This study aimed to evaluate the demand and consumption of blood products and their causes in teaching and medical hospitals of Urmia, Iran, in 2017.

This descriptive cross-sectional study was conducted in teaching hospitals of Urmia using the census method in 2017. It included 15,489 needs of patients, which equaled 40,695 units of various blood products. The data was collected using a checklist including factors such as age, gender, hospital name, department, blood group, reasons for requesting blood, type of the requested product, and the purpose of requesting blood. All of these variables were in order of frequency and the number of units requested, received, and injected. After collecting the data, it was entered into the SPSS software (version 18) and analyzed using descriptive statistics (such as frequency and percentage).

The results showed that most requests were from males (21,653 units), patients aged between 65-71 years (5,422 units), and Imam Khomeini Hospital (27,026 units). Additionally, in the special care department, the majority of applicants were from the O-positive blood group, with 10,493 and 15,470 units. Chronic anemia was one of the main request reasons with 8,642 units, dense red blood cell was the most requested product with 15,809 units, and bleeding was one of the primary request purposes with 10,431 units. Most requests and deliveries of blood products were performed in the morning shift, and the majority of injections were performed in the evening shift.

The demand for blood products is very high, which requires a review of how to request blood and establishing a monitoring system for managing blood bank and ward communication.

Metabolic syndrome (MS), is an important risk factors for cardiovascular diseases. This study aimed to determine the prevalence of MS and its components in the population over 30 years in Naghadeh city and their relationships with demographic characteristics.

In this cross-sectional study, 10,296 people over 30 years who participated in the IraPEN program in Naghadeh during 2016-18 were studied. Demographic characteristics, waist circumference, blood pressure, fasting blood sugar, triglycerides, and HDL cholesterol were studied. MS was defined according to the ATPIII criterion. Relative frequency, 95% confidence interval, and mean and standard deviation were used to describe qualitative and quantitative variables. Direct standardization method was used to standardize the prevalence measures.

In this study, 57.6% of the sample were female and 62.3% lived in urban areas. The age-standardized prevalence of MS was 32.8% (95%CI: 31.9-33.8) (48.3% in women and 18.2% in men). Its prevalence was higher in urban areas, and increased with age and decreased levels of education. The prevalence of MS components had a similar pattern in demographic subgroups. Abdominal obesity in women (77.6%) and low HDL in women and men (75.3% and 49.7%, respectively) had the highest frequency.

The prevalence of MS and its components is high in Naghadeh city. Planning and implementing educational programs for the whole population, especially housewives, to change eating behaviors and increase physical activity, as well as appropriate screening and preventive programs to identify people who need intervention can be effective in reducing the complications of MS and its components.
 
 

Stress is a determinant factor in thyroid gland functions. A decrease in iodine concentration and thyroid hormones impairs cognitive functions in students. The responsiveness of thyroid hormones to stresses depends on many factors such as the intensity and duration of a particular stressor. This study aimed to examine the effect of mild and short-term social stress on heart rate (HR), blood pressure (BP), triiodothyronine (T3) and iodine concentrations of urine in students.

This controlled before-after study was conducted on 200 students aged 9-12 years (100 girls and 100 boys). The HR and BP of the students were measured and their urine samples were collected before and after the intervention in both stressed and control students. To induce stress, the students were asked to read aloud a text from their own book in front of some audience.

In a mixed sample of girls and boys, a significant effect of stress was detected on BP and HR. There was no significant association between the stress and urinary level of T3 and iodine neither in girls nor in boys (and mixed sample). In girls, HR significantly increased in the stressed group while there was no significant connection between stress and BP. In boys, there was a significant difference between stress and control groups in terms of systolic and diastolic BP, but not the HR.

Although the stress had a significant sex-specific impact on HR and BP, urinary levels of T3 and iodine were not affected in elementary students.

Washed blood is a product obtained from whole blood by centrifugation and removal of plasma and washing of red blood cells in an isotonic solution. This study aimed to determine the causes of consumption of washed blood in Urmia teaching and medical hospitals in 2017.

This study was a retrospective and includes 75 requests for washed blood of patients that were requested from the blood bank during 2017 in a total of 135 units in Imam Khomeini, Taleghani, Seyed Al-Shohada, and Motahhari hospitals under the auspices of Urmia University of Medical Sciences.

In this study, the results showed that female gender with 41 (54.7%) cases and also the age group between (31-45) years with 18 (24%) cases with a total of 29 units were among the most requested, also dialysis ward with 27 (36%) cases with 48 units and kidney and heart failure with 18 (24%) cases and 32 units were among the most requested, Chronic anemia was also the main reason for requesting a blood transfusion. Most of the requests were in the morning shift and most of the deliveries and injections were in the evening shift, and most of the patients had only 1 unit of blood washed and had one request, delivery, and injection.

The amount of washed blood use in Urmia teaching and medical hospitals is relatively appropriate, but it needs training and informing to officials of medical centers for proper and appropriate use of this product.

Adherence to antihypertension medications is an important factor in the control of hypertension. In this regard, the present study aimed to estimate the extent of medication adherence in hypertensive patients and its determinants in the special clinic of Seyed-al Shohada Cardiovascular Tertiary Hospital in Urmia, Iran.

In this cross-sectional study, a total of 650 hypertensive patients were investigated during October to December 2016. In this study, two questionnaires were used to collect the data. The first questionnaire included the demographic and clinical characteristics, smoking status, family history of hypertension, and blood pressure measurements. The eight-item Morisky medication adherence scale was used to measure the extent of medication adherence of the participants. Moreover, the Chi-square test and logistic regression model were employed to identify the determinants of medication adherence.

Mean value of the participant age was reported as 59.5±10.4 years, and 63.5% of the subjects were female. Overall, 48%, 30.8%, and 21.2% of the subjects were reported with complete, moderate, and poor adherence, respectively. Among the investigated determinants, age (OR=1.02, 95% CI: 1.01-1.05), occupational status (OR=1.83, 95% CI: 1.19-2.83), absence of adverse effects of the drugs (OR=1.83, 95% CI: 1.02-2.71), use of two drugs (OR=1.75, 95% CI: 1.12-2.74), use of three drugs and more (OR=2.25, 95% CI: 1.30-3.88), and history of angioplasty (OR=1.80, 95% CI: 1.19-2.71) were associated with good adherence (i.e., complete and moderate) in this study. Only 39.4% of all participants had controlled level of hypertension.

According to the obtained results, the patients with hypertension had good medication adherence. The determinants effective in medication adherence outlined in this study can help identify patients with low extent of adherence.

Cardiovascular disease is the main cause of death in many countries in the world, including Iran. High blood pressure is one of the most common risk factors for cardiovascular disease. The aim of this study was to estimate the deaths from cardiovascular diseases and all cause attributed to high blood pressure in West Azarbaijan province. In this study, the required data about the prevalence of hypertension was obtained from a national study on the prevalence and risk factors of hypertension in Iranian adults. The corresponding effect size for death from ischemic heart diseases, stroke and all-cause mortality were obtained from the results of a study on the data of Golestan cohort study. Data on the number of deaths by sex and the cause of death were obtained from the Death Registration System of the West Azerbaijan province. Cardiovascular disease accounted for 27% of deaths in the 25-64 years age group. The population attributable fractions of hypertension for death from ischemic heart disease, stroke and all cause death for men were 14.4%, 26.1% and 6.4%, respectively. In women they were 18.6%, 32.4% and 8.1%, respectively. The number of deaths attributed to the hypertension for aforementioned causes in men was 46, 30 and 154, respectively. In women they were 29, 28 and 120, respectively. Blood pressure has a significant contribution in death from cardiovascular diseases, especially stroke. It emphasize on the importance of programs for controlling and preventing hypertension to reduce its associated deaths in the province as one of the priorities of health programs.

The aim of this study was to investigate knowledge, attitude and practice (KAP) of cardiovascular disease (CVD) patients about their oral health status.
In this cross-sectional study, we analyzed the data of 150 CVD patients that collected by a self-administered questionnaire consists of demographic characteristics and KAP. Oral health indicators calculated based on the results of oral examination by an expert dentist.
CVD patients had an overall moderate level of knowledge and attitude, but their practice was lower than moderate. There were important associations between knowledge scores with gender, education, residential area and financial status, between attitude scores with education and residential area, and between practice scores with education and financial status. There were no associations between KAP and age, marital status or job. Significant positive correlations were found between KAP components. Significant negative correlations were found between oral hygiene index with knowledge and practice.
The practice of heart disease patients about their oral health was poor, and declares that increasing awareness and attitude may not promote practice. Efficient programs are needed to promote oral health practice of adult populations in special groups.

Random errors in the measurement of risk factors lead to bias in the exposure-disease association.. This study aimed to examine the extent of underestimation in the association of total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and triglyceride (TG) with cardiovascular disease (CVDs) in the Tehran Lipid and Glucose Study..Patients and Of 6327 eligible people in the original cohort followed for about 10 years to detect CVD events, 3063 (1224 men and 1839 women) had replicate measurements for blood lipids. Two regression dilution ratios were calculated by nonparametric and parametric methods, using replicate data from reexaminations three and six years after baseline. Adjusted and unadjusted hazard ratios (HR) were corrected for regression dilution bias.. By parametric method, based on reexamination three years after baseline, the strength of real association of usual levels of TC, TG and HDL-C with cardiovascular disease, considering β coefficients of related models, were underestimated about 42%, 51% and 81% in men and 40%, 43% and 62% in women, respectively. Underestimations were relatively independent of age, sex and body mass index. Correction for regression dilution bias led to more than 60% increase in estimated HR for TC adjusted for confounders.. Using baseline measurements of lipids led to considerable underestimation in the association of these factors with CVD outcome in TLGS. The underestimation increased with time interval between baseline and follow-up measurements for TC and TG. TC had more attenuation on estimated HR due to stronger relation with CVD risk..

Use of single measurement of risk factors can distort their estimated effects, due to random error in measurements. The aim of this study was to examine the extent of underestimation in the estimated effect of common variables in physical exam i.e. systolic and diastolic blood pressure (SBP, DBP) and body mass index (BMI) on cardiovascular diseases in Tehran Lipid and Glucose Study (TLGS). A subsample (1167 men and 1786 women) of the original cohort, who had replicate measures of the variables in triennial interval, was used to calculate the regression dilution ratios (RDRs) in men and women. RDRs were determined by parametric and nonparametric methods. Hazard ratios (HR) of risk factors, per one standard deviation change, were corrected for regression dilution bias. The estimated RDRs by parametric method in men and women were 45% and 35% for SBP and 54% and 64% for DBP respectively. There were 26% and 25% underestimation in HR of SBP and 23% and 33% in HR of DBP in men and women. The corresponding underestimation for BMI was about 8%. RDRs of men and women and in age groups by both methods were fairly similar. They were relatively constant during the 10-year follow-up for SBP and BMI. Using baseline measurements of blood pressure underestimate its real association with CVD events and the estimated HRs. The underestimations are independent of age and sex, and it can be fairly constant in short to moderate time intervals.

Renal transplant recipients are known to be susceptible to viral infections, with more severe clinical presentations compared to healthy persons. Hepatitis E is generally a self-limited disease, which is caused by hepatitis E virus. Recently, hepatitis E has become more important in organ transplant recipients, because of new findings regarding the potential for chronic infections in this patient group. This study aimed to evaluate the seroprevalence of anti-HEV IgG among kidney transplant recipients in Urmia, in the north-western region of Iran.Patients and 91 patients were selected randomly from amongst patients who had undergone kidney transplantation in Urmia, Iran. Each patient was tested for the presence of anti-HEV IgG antibody using an enzyme-linked immunosorbent assay (ELISA, Dia.Pro; Diagnostic Bioprobes, Italy). 28 subjects (30.8%) were seropositive for anti-HEV IgG. Seropositive patients were generally older than seronegative patients (P = 0.009). There was no correlation between HEV infection and the level of education (P = 0.206), the history of blood transfusion (P = 0.164), or history of pre-transplantation hemodialysis (P = 0.228). There was no significant difference in the serum alanine aminotransferase (ALT) levels of the anti-HEV seropositive and seronegative patients. Multinomial logistic regression analysis indicated no significant relationship between HEV infection and increase in ALT levels, even after controlling for treatment with azathioprine (P = 0.79, OR = 1.1; 95% CI: 0.45–2.76). The anti-HEV IgG antibody has a high prevalence in Iranian kidney transplant recipients, and it is significantly higher in comparison with previous studies in the general population or in hemodialysis patients.

Renal transplant recipients are known to be susceptible to viral infections, with more severe clinical presentations compared to healthy persons. Hepatitis E is generally a self-limited disease, which is caused by hepatitis E virus. Recently, hepatitis E has become more important in organ transplant recipients, because of new findings regarding the potential for chronic infections in this patient group. This study aimed to evaluate the seroprevalence of anti-HEV IgG among kidney transplant recipients in Urmia, in the north-western region of Iran.Patients and 91 patients were selected randomly from amongst patients who had undergone kidney transplantation in Urmia, Iran. Each patient was tested for the presence of anti-HEV IgG antibody using an enzyme-linked immunosorbent assay (ELISA, Dia.Pro; Diagnostic Bioprobes, Italy). 28 subjects (30.8%) were seropositive for anti-HEV IgG. Seropositive patients were generally older than seronegative patients (P = 0.009). There was no correlation between HEV infection and the level of education (P = 0.206), the history of blood transfusion (P = 0.164), or history of pre-transplantation hemodialysis (P = 0.228). There was no significant difference in the serum alanine aminotransferase (ALT) levels of the anti-HEV seropositive and seronegative patients. Multinomial logistic regression analysis indicated no significant relationship between HEV infection and increase in ALT levels, even after controlling for treatment with azathioprine (P = 0.79, OR = 1.12; 95% CI: 0.45-2.76). The anti-HEV IgG antibody has a high prevalence in Iranian kidney transplant recipients, and it is significantly higher in comparison with previous studies in the general population or in hemodialysis patients.

Introduction. Viral infections are a real threat in kidney transplant recipients because of their immunocompromised condition. This study aimed to evaluate herpes simplex virus-2 (HSV-2) seropositivity among kidney transplant recipients.Materials and Methods. Serum samples of 91 kidney transplant recipients from Urmia, Iran, were examined serologically for antibodies against HSV-2 using an enzyme-linked immunosorbent assay.Results. The mean time from transplantation at HSV-2 testing was 5.04 ± 4.45 years. The anti-HSV-2 immunoglobulin G antibody was positive in 5.4% of the kidney transplant recipients. Seropositive patients did not present any clinical manifestations of genital herpes infection. There was no association between HSV-2 seropositivity and age, gender, history of hemodialysis and transplantation, blood transfusion, or immunosuppressive regimen.Conclusions. Seroprevalence of HSV-2 is not high among our kidney transplant recipients. However, it remains a source of concern, considering the compromised immune system in this specific population.