مجله مطالعات علوم پزشکی
سال سی و پنجم شماره 3 (خرداد 1403)

The trauma registry system was established as a tool to identify risk factors, assess service quality, and conduct research. To achieve this goal, complete recording of information and accurate coding are vital. The purpose of this study is to evaluate the quality of coded data in the trauma registry system of Urmia University of Medical Sciences.

This descriptive-cross-sectional and retrospective research was conducted in 2023. The research population consisted of 400 medical records, selected through random sampling. The data collection tool was a checklist developed by the researcher, whose validity and reliability were confirmed. The data were analyzed using SPSS software.

In total, 1001 and 1050 codes were registered by the system coder and the expert, respectively, for 400 cases. The obtained results showed a 95% completeness of the codes. The accuracy of coding diagnoses was at the level of the first three characters (81%), the fourth (61%), and the fifth (30%), and for coding external causes at the level of the first three characters (62%), the fourth (35%), and the fifth (28%). The reliability of the codes assigned by the coder in the first and second stages was found to be κ=91.8% for the first three characters, κ=84.3% for the fourth character, and κ=35% for the fifth character.

The results of this study showed that the coded data are favorable in terms of completeness and reliability of codes. In evaluating the accuracy of codes, at the level of the first three characters, it is favorable, but at the level of the fourth and fifth characters, it is unfavorable. Therefore, to improve the coding quality of the trauma registry system, continuous evaluation of coding is necessary, and necessary feedback should be provided to the coders.

Escherichia coli, a gram-negative bacillus, is one of the most common pathogens causing urinary tract infections. Several studies have demonstrated that the antibiotic fosfomycin has a significant inhibitory effect on Gram-negative pathogens, including Escherichia coli, by inhibiting peptidoglycan production. This study aimed to better understand the effect of fosfomycin against multidrug-resistant Escherichia coli causing urinary tract infections.

In this epidemiologic-descriptive study, 90 Escherichia coli isolates were collected between October 1401 and October 1402 from urine samples of teaching hospitals in Qazvin city. ESBL- and AmpC-producing strains were identified using the phenotypic method. Data were evaluated and analyzed using SPSS software version 2022 with a significance level of less than 0.05.

Among the 90 isolates of Escherichia coli, the highest antibiotic resistance was observed for ampicillin (96.6%), cefotaxime (90%), and ceftazidime (84.4%), while the highest susceptibility was related to the antibiotics fosfomycin (98.9%), meropenem (98.8%), gentamicin (88.8%), and nitrofurantoin (84.4%).

With the increase in antibiotic resistance and the spread of strains producing beta-lactamase enzymes, the treatment of infections caused by these strains has become a serious problem. In this study, the susceptibility of Escherichia coli isolates that produce broad-spectrum beta-lactamases and are resistant to multiple drugs to fosfomycin was investigated. It was found that 89 (98.9%) isolates were sensitive to fosfomycin, indicating that fosfomycin is an effective antibiotic against ESBL isolates in Iran.

The structure and function of mitochondria are impaired in the aged heart. However, it remains a challenge to find a potent compound to improve cardiac function abnormalities in the elderly. Olive oil (OLO), as an oil rich in unsaturated fatty acids, has various protective effects on the cardiovascular system, including anti-inflammatory and anti-diabetic effects, and reduces blood pressure. In the present study, the protective effects of OLO on heart dysfunction caused by aging were investigated.

Male Wistar rats were randomly divided into three groups: control, aged rats induced by D-galactose (D-GAL), and aged rats treated with OLO (D-GAL + OLO). Senescence was induced in rats by intraperitoneal injection of D-GAL at a dose of 150 mg/kg for eight weeks, and the D-Gal+OLO group was treated with oral OLO for eight weeks. The ratio of heart weight to body weight was considered as an index of cardiac hypertrophy. Heart tissues were removed to measure molecular parameters.

Aged rats showed cardiac hypertrophy (## p < 0.01) and a decrease in nuclear factor E2 related factor 2 (Nrf2) gene expression (### p < 0.001) compared to the control group. Treatment with OLO improved cardiac hypertrophy (** p < 0.01) and Nrf2 gene expression (*** p < 0.001).

In general, OLO may have a protective role in aging and cardiac hypertrophy, and its beneficial effects may be related to the improvement of antioxidant status. It is suggested to include OLO in the diet of elderly people and cardiac patients.

Mesenchymal stem cells (MSCs) are multipotent, non-hematopoietic precursor cells that can be found in many adult tissues. The multipotency and immunomodulatory potential of MSCs make these cells a remarkable tool for the treatment of some diseases. It seems that stimulation of toll-like receptors expressed on the surface of mesenchymal stem cells may potentiate the immunomodulatory potential of these cells. This study was conducted to investigate the effects of polarized bone marrow-derived mesenchymal stem cells from mice on the cytotoxic activity of natural killer (NK) cells.

MSCs were isolated from the bone marrow of the femur and tibia of NMRI mice. The third passage of cells was treated with LPS and Poly I-C, then the effects of polarized MSCs, as well as their culture supernatant, on the cytotoxic activity of NK cells against lymphoid cancer cells Yac-1 (as target cells), were evaluated using flow cytometry after 12, 24, and 72 hours.

MSCs treated with LPS and Poly I-C, and their respective culture supernatants, decreased the percentage of dead cells (necrosis and apoptosis) (38% and 35% respectively) compared to untreated MSCs (44%). In the case of cell viability, this effect was the opposite; that is, the untreated cells showed higher viability.

Previous studies indicated that MSCs inhibit the expansion and cytotoxicity of NK cells on tumor cells; however, our results revealed that MSCs treated with LPS potentiated the inhibitory effects of MSCs on NK cell activity.

AKT, PI3K and IL-1 are related to diabetes and cardiac inflammatory. The aim of this study was to investigating cardiac inflammatory markers via AKT, cardiac PI3K gene expression and serum IL-1β with combined exercise and consumption of taurine supplementation in diabetic male Wistar rats.

in this experimental study, 30 male adult Wistar rats weighing 250-300 grams and 6 weeks old were randomly divided into 3 groups including: diabetic exercise+supplement group (T+S) (10 rats), diabetic control group (CD) (10 rats), and healthy control group (CH) (10 rats). To make rats diabetic, 55 mg/kg body weight of streptozocin was injected. Blood sugar above 250 mg/dL was considered as diabetes. Combined exercises and taurine supplementation were performed for eight weeks and 5 times a week. Taurine supplement was taken as a 1% solution in water daily. To compare the inter-group and intra-group changes of the variables, two-way ANOVA and Tukey's follow-up were used. The significance level was 0.05.

PI3K gene expression was significantly increased in the diabetic exercise+supplement group compared to the diabetic control group (P=0.001). The serum level of IL-1β factor in the diabetic exercise-supplement group had a significant decrease in comparison with the diabetic control group (P=0.001). However, there was no significant change in AKT gene expression in the diabetic exercise+supplement group compared to the diabetic control group.

It seems that combined exercises with consumption of taurine supplementation may lead to the improvement of heart inflammatory factors in diabetic people while increasing PI3K, decreasing IL-1β and creating favorable changes in glucose metabolism. Therefore, it is suggested to use combined exercises and consumption of taurine as a non-invasive and low-cost method in improving cardiac inflammatory markers in diabetic persons.

Preeclampsia (PE) is a pregnancy-specific syndrome recognized as a major risk factor for preterm delivery. Preeclampsia (PE) is characterized by high blood pressure, significant proteinuria, and an excessive maternal systemic inflammatory response. The aim of this study was to investigate the role and function of regulatory T cells (Tregs) in pregnancy and preeclampsia.

This study is a narrative review that utilized the PubMed-Medline and Embase databases to search for the role of regulatory T cells (Tregs) in pregnancy and preeclampsia. Data were obtained from searching and extracting relevant articles.

The results of various studies indicated that paternal antigens and female sex hormones are responsible for the increased number of Tregs during pregnancy. The expansion of Tregs and the regulation of the immune system are essential for maternal tolerance towards the fetus. Indeed, the number and function of Tregs play a crucial role in pregnancy; a reduction in the number and function of these cells is observed in unsuccessful pregnancies such as those complicated by preeclampsia.

Regulatory T cells play vital roles in maintaining immune tolerance towards the fetus during pregnancy. A decrease in the number or function of these cells can lead to pregnancy complications, including preeclampsia. Health professionals should be aware of the importance of immune balance during pregnancy and consider immune system-related factors when assessing the risk of preeclampsia. Additionally, a better understanding of the role of Tregs could contribute to the development of new diagnostic and therapeutic methods for preeclampsia.

Abdominal Aortic Aneurysm (AAA) is a common vascular condition that its prevalence increases with age and predominantly affects men. Early diagnosis and treatment of AAA are crucial to prevent severe complications, particularly rupture. This article presents a rare case of a 68-year-old man with AAA complicated by intraluminal thrombosis. The patient's non-specific symptoms led to a delayed diagnosis. Eventually, CT angiography revealed an infrarenal aortic aneurysm measuring 84 mm in diameter and 128 mm in length, with thrombosis extending into the iliac branches. This case report underscores the importance of accurate differential diagnosis, the utility of advanced imaging modalities, and the therapeutic challenges in complex AAA cases. Furthermore, this study emphasizes the need to consider risk factors and pathophysiological mechanisms in managing this condition.

The COVID-19 pandemic has highlighted the need for effective treatment options for outpatients. Resigen and Remdesivir are two commonly used drugs, but their relative effectiveness in treating outpatients with COVID-19 is unclear. The purpose of this study is to compare the effectiveness of Resigen and Remdesivir in the treatment of outpatients with COVID-19.

The present study is a retrospective cohort study with an available sampling method by referring to the records of Mitla patients with covid 19 referred to the respiratory clinic of Shahid Beheshti Hospital (the group receiving interferon beta 1a) and reviewing the electronic files of the patients. Referrals to the specialized lung and emergency clinic of Shahid Beheshti Hospital in Qom with inpatient records (remdesivir receiving group) were conducted between April and August 2021 and the information was created, extracted and analyzed through the researcher's checklist.

The mean age of the patients was 48.12±14.36 years. Only 30 patients (6%) were hospitalized and 466 patients (94%) were treated as outpatients. This study found no significant association between hospitalization and mortality.

Our study suggests that early treatment with resection or remdesivir may reduce the risk of hospitalization and mortality in outpatients with COVID-19. These findings have implications for the management of COVID-19 in ambulatory settings.