We decided to evaluate the effect of treatment of diabetic foot ulcers in improving heart function by strain echocardiography than conventional transthoracic echocardiography. This prospective ...cross-sectional study included patients with diabetic foot ulcer (DFU). Conventional and two-dimensional strain echocardiography performed before and after three months diabetic foot treatment. Then, we compared the echocardiographic parameters including left ventricular ejection fraction (LV-EF), left ventricular global longitudinal strain (LV-GLS). Multivariate and univariate logistic regression analysis were performed to find which variable was mainly associated with LV-GLS changes. 62 patients with DFU were conducted. After echocardiography, all patients underwent surgical or non-surgical treatments. Three months after the treatment, LV-EF was not significantly different with its' primary values (P = 0.250), but LV-GLS became significantly different (P<0.05). In the multivariate logistic regression analysis, with the increase in the grade of ulcer, LV-GLS improved by 6.3 times. Not only the treatment of DFU helps to control adverse outcomes like infection, limb loss and morbidity but also it enhances cardiac function. Of note, strain echocardiography found to be a better indicator of myocardial dysfunction than LV-EF. These findings make a strong reason for the routine assessment of cardiac function in patients with DFU.
Previous studies have shown an association between chronic endometritis and endometrial polyps, and only one study in infertile women reported an association between tubal obstruction and polyps. ...This study aimed to compare the prevalence of endometrial polyps in two groups of women with tubal factor infertility and male factor infertility to assess if is there any association between tubal factor infertility and endometrial polyps.
This case-control study was performed on infertile women. The case group included women with tubal factor infertility and the control group included all women with male factor infertility. In all patients, vaginal ultrasound was performed between days 8 and 12 of the menstrual cycle to diagnose endometrial polyp, its size, and number. Demographic and obstetrics variables were recorded. Patients underwent hysteroscopy and polypectomy and the diagnosis of the polyp was confirmed by pathology report.
In the present study, 245 people participated in two groups. There was a statistically significant difference between the two groups in terms of demographic and obstetric characteristics like type of infertility, duration of infertility, and gravidity. The prevalence of polyps in the tubal factor group was higher than in the male factor group (63 60% vs. 12 9.8%), and this difference was statistically significant (p = 0.0001). In addition, the prevalence of chronic endometritis in the tubal factor group was higher than in the male factor group (19 18.8% vs. 4 3.3%), and this difference was statistically significant (p = 0.001).
In the present study, a strong association was observed between endometrial polyps and tubal obstruction, and considering that the most common cause of tubal obstruction is pelvic and genital infections, after confirmation with more studies, it may be possible to consider antibiotic treatment in these patients, especially in patients with recurrent polyps.
Hemodialysis access has been considered as a support for end-stage renal patients. We measured the hemodynamic changes of the distal part of the upper extremity immediately after providing the AVGs ...in each method mentioned above and then compared the results. This method is a novel one and hasn’t been used in any other studies before. We studied 32 patients referred to the vascular surgery department of Rasht Razi Hospital between 2019-2020 (using the Convenient Sampling method). This study is a case-control study. Out of 32 patients referred to the vascular surgery department of the hospital, 68.8% were male, and their mean age was 53.41±12.75 years, ranging from 28 to 78 years. Changes in distal arterial hemodynamics of the upper limb before and after clamping in dialysis venoarterial loop versus straight grafts are different in studied patients (P<0.05). The mean hemodynamic changes before and after clamping in loop venoarterial grafts (19.5000) are less than straight grafts. In dialysis patients who do not have any superficial vein suitable for venous, arterial fistula, surgical placement of artificial grafts in the upper limb is appropriate. Based on the results of this study, the loop method seems to have lesser ischemic Complications and can be applied to dialysis patients.
Background
Menopausal symptoms are very diverse in terms of prevalence and severity, and this difference is due to various factors such as psychological factors, sociocultural status, lifestyle, ...geographical location, and other factors. This study aimed to assess the prevalence of menopausal symptoms and evaluate the predictive factors related to the prevalence and severity of menopausal symptoms.
Materials and Methods
This was a cross‐sectional analytical study that was performed on 214 women aged 35–65 years old who were referred to Alzahra Educational, Research and Treatment Center in Rasht, Iran. The data collection tool was a valid and reliable questionnaire, using the list of menopausal symptoms and a checklist of subjects’ general characteristics.
Results
16.8% of postmenopausal women in our study had at least one menopausal symptom. Using multiple linear regression, race (p = 0.02), history of chronic diseases (p = 0.04), place of residence (p = 0.02), and marital satisfaction (p = 0.02) were associated with menopausal symptoms. Nineteen percent of the covariates related to the logistics function were explained by the predictor variables in the model.
Conclusion
Evaluation of menopausal symptoms showed that the severity of menopausal symptoms was related to factors such as body mass index (BMI), ethnicity, place of residence, marital satisfaction, and history of chronic diseases, and need to address BMI, psychological issues, and chronic illness.
Background
This study aimed to examine maternal serum concentration of β‐human chorionic gonadotropin (β‐hCG) on Day 16 after embryo transfer and risk of miscarriage, pre‐eclampsia, and intrauterine ...growth restriction (IUGR).
Methods
In this study, we evaluated 125 pregnancies following in vitro fertilization (IVF). β‐hCG concentrations were measured on the morning of Day 16 after embryo transfer. Baseline characteristics of the study participants were also recorded.
Results
Concentrations of β‐hCG on Day 16 after embryo transfer were inversely associated with the higher risk of miscarriage (p < 0.001), but did not with pre‐eclampsia and IUGR (p > 0.05). Spearman's correlation coefficient showed a reverse and significant association between β‐hCG and higher risk of miscarriage (σ = 0.531 and p < 0.001). There was a significant association between frozen embryo transfer and the risk of IUGR and pre‐eclampsia (p = 0.005 and p = 0.023, respectively).
Conclusions
Maternal serum concentrations of β‐hCG on Day 16 after IVF/embryo transfer were associated with the higher risk of miscarriage, but not pre‐eclampsia and IUGR.
Background and Aims
Cesarean scar pregnancy (CSP) is a rare medical condition accounting for 1:2000 of all pregnancies with prior history of cesarean deliveries (CS). As the rate of CS is increasing ...worldwide, it is important to know the nature of CSP and its complications.
Methods
In this retrospective case–control study, we evaluated 264 pregnant women; 86 cases with ultra‐sonographic findings of CSP and 178 controls: normal pregnancies with gestational age less than 12 weeks. The variables consisted of demographic characteristics, the features and causes of the prior CS, the time distance to the current pregnancy, sonographic features, and the final management. All data analyzed using SPSS version 21.
Results
There was a significant difference between the two study groups regarding to parity, abortions and D&Cs (p < 0.001). In the case group, 19.8% of patients had positive results for STDs versus 16.3% in the control group (p > 0.990). The mean average of intervals between the last CS and current pregnancies were 48.22 ± 37.03 in the case group versus 61.25 ± 36.25 months in the control group (p < 0.001). Regression Logistic analysis showed advanced maternal age (p < 0.001), positive history of abortions and D&C (p < 0.001), elective type of prior c/s (p < 0.001) and the short time interval between prior CS and current pregnancy (p < 0.001) could significantly predict the patients at higher risk of presenting CSP in the case group.
Conclusions
Based on our findings, advanced maternal age, positive history of abortion, the elective type of the former CS, and short time intervals between previous CS and current pregnancy are the main risk factors of CSP.
Abstract
Purpose:
Percutaneous nephrolithotomy (PCNL) in the elderly is challenging due to age-related decline in organ function and the general depletion of the physiological reserve. We aimed to ...compare the efficacy and safety of complete supine PCNL (csPCNL) between young and elderly patients with kidney stones.
Materials and Methods:
In this cross-sectional comparative study, a total of 656 patients aged 18–64 years (young group) and 83 patients aged ≥65 years (elderly group) who underwent csPCNL between April 2009 and September 2021 were studied. The two groups were compared in terms of clinical characteristics, stone-related parameters, perioperative parameters, and postoperative outcomes.
Results:
The mean age of elderly and young patients was 69.87 and 47.1 years, respectively. The female-to-male ratio was 1:1.21. The mean hemoglobin drop was significantly greater in the younger group (1.38 ± 1.08 vs. 1.01 ± 0.84 g/dL,
P
= 0.007). The stone-free rate was comparable in the two groups (96.8% vs. 91.5%), whereas hospitalization was significantly longer in the younger group (
P
= 0.014). There was no significant between-group difference regarding the postoperative complication rates (
P
= 0.36). On multivariate analysis, body mass index, stone burden, and presence of staghorn stone were identified as independent predictors of the success of the operation (
P
= 0.04, odds ratio OR = 1.091;
P
= 0.000, OR = 0.962;
P
= 0.045, OR = 0.404). None of these factors had an independent effect on the occurrence of postoperative complications (
P
> 0.05).
Conclusion:
CsPCNL in the elderly age group is an effective and safe procedure with high stone-free rates and similar complication rates compared to younger patients.
The spirometry test is a valuable test to evaluate the performance of the respiratory system. The interpretation of the results is highly dependent on the quality of its performance, while the ...inappropriate quality results in unwanted consequences for individuals and the healthcare system. This study investigated the quality of spirometry tests performed in occupational health.
In this cross-sectional study, the quality of 776 spirometry tests in different occupational centers by the specialists in Rasht, Iran, in 2020, based on the guidelines of the American Thoracic Society (ATS), was investigated. The quality and success rate of the test and the demographical characteristics of the operators and the participants were collected. All data was analyzed using SPSS software version 20.
Out of 776 spirometry tests, about 69.7% were unacceptable. Among the unacceptable tests, a pause error between inhalation and exhalation was identified in 7.4% of tests. Additionally, 4.6% of the unacceptable tests exhibited a cough error within the first second, while an exhalation error of less than six was observed in 85%. Repeatability errors were found in 60.9% of the tests. Furthermore, among some errors, the communication error between the characteristics of the technicians and the test performance errors were evident.
According to the results, most of the performed tests were unacceptable with no repeatability, which indicated that the validity and quality of spirometry tests and their interpretation were inappropriate in the field of occupational health in Rasht, Iran.
Surgical approaches to primary hyperparathyroidism (PHPT) have been associated with a change from invasive to non-invasive methods in the last 20 years. In this cross-sectional descriptive study, 55 ...patients with primary adenoma-induced HPT underwent surgery. The parathyroid gland in patients with primary hyperparathyroidism caused by parathyroid adenoma was removed by open surgery with an incision of about 2 cm in the neck in a targeted manner in a site localized by ultrasound or Sestamibi scan. The patients' personal information, including age, sex, length of hospital stay, serum calcium and parathyroid hormone (PTH) levels, success rate, and problems and unwanted adverse consequences of surgery (e.g. infection and bleeding) were recorded for each patient and collected information was analyzed in SPSS software. Most patients were women (80%) and individuals in the age range of 41-60 years (47.3%). The hospital stay length ranged from 2 to 5 days with an average of 3.25±0.9 days. Success was considered as a decrease in PTH and calcium levels during the first 24 h after the intervention, and success rates of 100, 98.2, and 69.1%, respectively, were evaluated for a reduction of at least 50% in PTH levels and less than 40 ng/ml of PTH levels. No major complications were reported in the studied patients. Wilcoxon test revealed significant decreases in patients' postoperative serum calcium and PTH levels (P=0.000). Mini-incision Parathyroidectomy with limited incision was associated with significant reductions in serum calcium and PTD without complications.
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