مجله پزشکی بالینی ابن سینا
سال سی و یکم شماره 2 (پیاپی 112، تابستان 1403)

Sudden sensorineural hearing loss (SSNHL) is a complication that is usually unilateral and can be accompanied by tinnitus and vertigo. Although various infectious, vascular, and immune etiologies have been proposed for SSNHL, the cause is unknown in most cases. Therefore, this study aimed to determine the effect of coenzyme Q10 in the treatment of SSNHL.

This study was a double-blind, randomized, controlled clinical trial, which was conducted using the available sampling method. A total of 60 patients with SSNHL (18-70 years old) lasting less than one month were divided into two groups: intervention and control. The routine treatment of both groups included weekly injections of dexamethasone in the middle ear for 3 weeks. The intervention group also received 100 mg of coenzyme Q10 per day for 4 weeks, while the control group received a placebo. Patients were evaluated by basic audiological tests at the baseline and third and sixth months after the treatment. Statistical analysis of findings was done in SPSS26 software.

The difference in the mean pure tone hearing thresholds of the intervention and control groups was significant in the third month (29.33±15.96 dB and 35.34±12.24 dB; P=0.02) and sixth month (dB 28.00±16.27 and dB 34.33±11.87; P=0.01).

In patients with SSNHL, combined treatment with oral coenzyme Q10 at the rate of 100 mg per day, along with intratympanic injection of dexamethasone for four weeks, can improve pure tone hearing thresholds and facilitate the treatment

De Quervain's tenosynovitis is one of the common causes of wrist pain. The present study aimed to compare the effectiveness of high-power laser therapy and local corticosteroid injection in the treatment of De Quervain's tenosynovitis.

In this clinical trial, 30 patients diagnosed with De tenosynovitis were randomly assigned to two groups of 15, A and B. Group A underwent high-power laser therapy, five sessions for three consecutive weeks, and group B received corticosteroid injections of 1 ml triamcinolone and 1 ml lidocaine 2% in the wrist under ultrasound guidance. Tendon thickness, pain intensity, quality of life, and treatment satisfaction were measured and compared in both groups pre-treatment, month one, and month three post-treatment.

In groups A and B, respectively, the mean scores of the thickness of extensor abductor pollicis longus and abductor pollicis brevis muscles before the treatment were 7.57±0.63 and 7.25±0.58 (P=0.120). these value were calculated at 6.55±0.61 and 6.54±0.40 one month later (P=0.955). They were 5.71±0.75 and 5.99±0.45 (P=0.239) mm three months post-treatment. In addition, pain scores before the treatment were 8.60±1.18 and 8.47±1.46 (P=0.785). One month later, they were 2.73±1.66 and 4.27±1.16 (C=0.785), and three months post-treatment, they were 1.73±1.33 and 2.47±1.06 (P=0.007). There was no significant difference between the two groups in terms of quality of life and satisfaction with treatment (P<0.05 for all).

Both local corticosteroid injection and high-power laser treatment methods were safe in the treatment of De Quervain's tenosynovitis, leading to a reduction in pain and tendon thickness, as well as an increase in the patient's quality of life

Stroke is the second leading cause of disability and mortality across the globe. The present study aimed to assess the effect of doxycycline on clinical outcomes of patients with ischemic stroke.

In this double-blind clinical trial, 60 patients with ischemic stroke were selected in the first 24 hours of post-stroke and randomly assigned to two groups: intervention and control. In the intervention group, patients received 100 mg of doxycycline every 12 hours for seven days in addition to standard treatments. Both groups were followed up before the intervention, on days 7, 30, and 90 after the treatment in terms of the severity of stroke clinical outcomes using National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (mRS) tests.

The mean age of patients in the intervention and control groups were 68.33±12.15 and 67.40±9.99 years (P>0.05). No significant difference was observed between the intervention and control groups in terms of NIHSS and mRS scores at baseline and on the seventh day. Nonetheless, in the intervention group, the NIHSS score on days 30 (P=0.007) and 90 (P<0.001), as well as the mRS score on days 30 (P=0.009) and 90 (P<0.01) was significantly less than the control group.

In ischemic stroke, the administration of doxycycline 100 mg every 12 hours for seven days is safe, reduces neurological disorders, and improves the clinical outcome of patients within one to three months after the treatment.

Renal failure is associated with significant mood and emotional problems in patients, which necessitates effective psychological interventions. This study aimed to evaluate the effectiveness of Acceptance and Commitment Therapy (ACT) on difficulties in emotion regulation in depressed dialysis patients.

This semi-experimental study employed a pretest-posttest design with an unequal control group. The statistical population comprised dialysis patients undergoing treatment at Shahid Hashminejad Hospital (Tehran) during 2020-2021. A total of 42 depressed dialysis patients, each scoring above 29 on the Beck Depression Inventory (BDI), were selected through purposive sampling (homogeneous type) and randomly assigned to an experimental group or a control group. First, both groups completed the Difficulties in Emotion Regulation Scale (DERS) as a pretest. The experimental group then participated in ACT sessions, while the control group remained on the waiting list. Finally, the groups completed the posttest, and the data were collected.

The results of the MANCOVA test revealed a significant difference in the linear combination of the components of difficulties in emotion regulation between the two groups (Pillai's T= 0.904, F6,25= 39.070, P=0.001). The ANCOVA test results also showed a significant decrease (P<0.01) in all components of emotion regulation difficulties in the experimental group compared to the control group.

The findings demonstrate that the ACT program is an effective treatment for reducing difficulties in emotion regulation in depressed dialysis patients. It is recommended as a treatment priority for this population

Alzheimer's disease is a progressive and irreversible disorder that not only affects patients but also has severe repercussions on the daily lives, social relationships, and mental health of caregivers. This qualitative study aimed to delve deeper into the daily challenges faced by caregivers, the coping mechanisms they employ, and the positive outcomes they may experience, focusing on caregivers in Richmond Hill, Ontario.

A qualitative research approach was adopted, utilizing semi-structured interviews to collect data until theoretical saturation was achieved. A total of 26 participants were selected using purposive sampling method from Alzheimer Clinics of the Richmond Hill area, ensuring a representation of varied experiences. Data were analyzed using thematic analysis method and NVivo software was utilized to assist in the organization and analysis of the data.

Four main themes were identified: daily challenges, coping mechanisms, health impacts, and positive outcomes. Caregivers reported significant daily challenges, including time management difficulties, financial burdens, behavioral problems of the patients, and lack of social support. Coping strategies varied widely, encompassing both active and passive approaches, with some caregivers displaying significant psychological resilience and resourcefulness. Positive outcomes, such as personal growth and improved family relationships, were noted, despite the substantial burdens.

Caregivers of Alzheimer’s patients endure considerable psychological and physical burdens. Nonetheless, the presence of effective coping strategies and social support significantly affected their ability to manage these challenges. Future interventions should focus on enhancing caregiver support systems and providing targeted education and resources to alleviate caregiver strain.

Extensive research is underway to find effective treatments for clinical manifestations of COVID-19. Given the proven effectiveness of certain micronutrients, such as vitamins, in antimicrobial activity and immune system modulation for treating or preventing infectious diseases, the potential role of vitamins in the treatment or prevention of COVID-19 should be considered. The present study aimed to assess the correlation between serum folate levels in patients hospitalized with COVID-19 and the severity of the disease, emphasizing the importance of relevant awareness regarding different folate levels.

In this cross-sectional study, folate levels were measured in 117 COVID-19-infected patients hospitalized from January 2020 to November 2020 at Sina Hospital, Hamadan. Patients were categorized based on disease severity into three groups: mild to moderate, severe, and critical. Group differences were statistically analyzed using appropriate tests.

Our study revealed a statistically significant difference in folate levels among the three examined groups. Logistic regression analyses demonstrated that for every one microgram per milliliter increase in folate, the probability of severe COVID-19 symptoms decreased by 23%. The large area under the ROC curve (0.864) indicates that mortality in COVID-19 patients can be well predicted based on folate levels.

As evidenced by the obtained results, it can be stated that a reduction in serum folate levels among hospitalized patients with COVID-19 is common and is recognized as a predictive factor for COVID-19-related mortality. Consequently, monitoring folate levels and considering supplementation, if necessary, should be considered for hospitalized COVID-19 patients.

Vitiligo is a chronic skin disease. Considering that this disease affects a person's appearance, psychological symptoms, such as depression, isolation, and low self-confidence, are very common in these patients. The present study aimed to determine the effectiveness of Acceptance and Commitment Therapy (ACT) on psychological symptoms of patients with vitiligo disease.

The present study employed a quasi-experimental design featuring a pre-test, post-test, and unequal control group. The statistical population of the research comprised soldiers and other military personnel with vitiligo who were serving in military centers of the armed forces in Tehran in 2020. The experimental group (n=11) received ACT, and the control group (n=13) did not receive any intervention. The subjects completed the questionnaires before and after the intervention. The analysis of covariance was used to analyze the data.

The results indicated that ACT improved depression, quality of life, and acceptance, and reduced experiential avoidance in vitiligo patients. No significant difference was observed in anxiety or mindfulness between the two groups. The effect size indicated that the differences between the groups were moderate.

ACT is an evidence-based treatment for vitiligo patients, and psychologists can use this treatment to improve the quality of life and reduce the psychological symptoms of these patients.

Chronic Achilles tendinopathy is among the most prevalent musculoskeletal disorders, especially among athletes. Despite numerous non-surgical procedures performed for this disorder, the treatment of these patients is still challenging. Given that electroacupuncture is a novel technique for the treatment of tendinopathy, a few studies have addressed it. This case report aimed to present the electroacupuncture technique for the treatment of chronic Achilles tendinopathy.

A 53-year-old male patient with a 6-month history of left Achilles tendon pain and limited daily activities was referred to Mobasher Physiotherapy Clinic in January 2024. For this purpose, 3-mm needles were inserted into the distal part of Achilles tendon at points BL 60, BL 61, KI 3, and KI 4. The patient received ten 20-min sessions of electroacupuncture treatment (three times per week at the frequency of 5 Hz and current intensity of 5 mA). Pain intensity and ankle range of motion were evaluated at first and last sessions.

As evidenced by the results of this study, applying electroacupuncture for Achilles tendinopathy, especially chronic tendinitis that has not been treated with other conservative procedures, could improve the patient’s symptoms and ankle function, enhancing the patient’s functional activities and life quality.