International Journal of Medical Investigation
International Journal of Medical Investigation
2322-2913
2345-640x
7
3
2018
9
1
Effect Of Vitamin D Supplementation With Anti-Viral Therapy On CD4 Levels In HIV-Infected Patients: Systematic Review And Meta-Analysis
1
10
EN
Fatemeh
Roozbeh
Mazandaran Uinversity of Medical Sciences, Sari, Iran
N
Maryam
Ghajar
Mazandaran Uinversity of Medical Sciences, Sari, Iran
Y
Introduction: Due to the effect of vitamin D on the immune response, There are controversial results about the effect of vitamin D supplementation on the immune system of AIDS patients. This systematic review and meta-analytical was conducted to determine the effect of vitamin D supplementation, along with antiretroviral treatment on CD4 count of HIV-infected patients. Methods: This systematic review and meta-analysis study was done with using specific keywords HIV and vitamin D and CD4 and related keywords on published articles by the end of 2017 in the some databases such as Pubmed (116 articles), Scopus (121 articles) and Web of Science (127 articles). All articles have been export to ENDNOTE and after deleting duplicate, there was 174 articles. Review selected articles by two individuals, first on the title and abstract. Clinical trial studies about vitamin D supplementation on HIV-infected patients which receiving ART were selected. Quality assessment of studies was conducted by Jadad criteria. CD4 count and viral load before and after intervention in treatment and placebo groups, age of patients and duration of intervention were extracted. Fiundings: Finally, 7 clinical trial studies with a sample size of 639 people were entered the meta-analysis. The mean age of patients in the treatment group and placebo was 27.2 and 26.5 years respectively, and mean duration of intervention was 8.3 months. The increase in CD4 after treatment was 0.73 (CI95%:-0.43 - 1.89) compared with the placebo group which was not statistically significant, but Vitamin D use in 3 studies was near one year and this change (SMD=3.56, CI95%: 1.17-5.96) was significantly in these studies. Egger's test results showed that there was no publication bias. Conclusion: The results showed that at least 10 months use of vitamin D supplementation with antiviral therapy can effectively help in increasing the CD4 level in comparison with placebo.
Vitamin D, Antiviral treatment, CD4, AIDS, HIV
http://intjmi.com/article-1-329-en.html
http://intjmi.com/article-1-329-en.pdf
International Journal of Medical Investigation
International Journal of Medical Investigation
2322-2913
2345-640x
7
3
2018
9
1
Evaluation between Cough Peak Flow and Cough Strength Score for Anticipating Reintubation after Scheduled Extubation
11
16
EN
Zaid
E.Alawneh,
jordan medical university,jordan
N
Kafa
M.Aldalala’h*,
jordan medical university,jordan
Y
Rayya
K.Almashaqbah,
jordan medical university,jordan
N
Hafiz
S.Alshorofat,
jordan medical university,jordan
N
Mohammad
Alhaek
jordan medical university,jordan
N
Introduction: Cough peak flow and cough strength score were used to anticipate extubation results in patients where extubation was scheduled. Methods: Our prospective, randomized and double-blind investigation included 204 patients who were candidates for extubation after a successful spontaneous breathing test in the intensive care unit of King Hussein medical center, Amman, Jordan, during the period Feb 2014-Apr2016. Cough strength score (CSS, graded 0-5) and cough peak flow (CPF) were evaluated before extubation. Reintubation was recorded 3 days after extubation. Findings: Reintubation incidence was 12.7 %( 26) during 3 days after scheduled extubation. Patients with successful extubation had more cough strength scores than did reintubated patients (mean +/-SD, 2.8 +/-1.4, 1.7 +/-1.3, respectively, P < 0.05) and cough peak flow (69.2 +/-31.4, 45.4 +/-19.9 L/min, respectively, P < 0.05). The cough strength score demonstrated a positive association with cough peak flow (P <0.05). Mean cough peak flows were 33.1 L/min, 34.4 L/min, 39.2 L/min, 52.6 L/min, 71.9 L/min, and 106.8 L/min in patients with cough strength scores of 0, 1, 2, 3, 4, and 5, respectively. While cough strength score increased from 0 to 1 to 2 to 3 to 4 to 5, the reintubation incidence reduced from 26.96%(55) to 22.5%(46) to 16.7%(34) to 13.7%(28) to 10.8%(22) to 1.96%(4). Conclusion: Cough strength score was suitable to record at the bedside in our intensive care unit. Cough strength score was positively associated with cough peak flow and had the same result for anticipating reintubation after scheduled extubation.
Cough peak flow, cough strength, reintubation, extubation
http://intjmi.com/article-1-331-en.html
http://intjmi.com/article-1-331-en.pdf
International Journal of Medical Investigation
International Journal of Medical Investigation
2322-2913
2345-640x
7
3
2018
9
1
A Study of Patient Clinician Interaction and Abnormal Illness Behaviours among Subjects with Chronic Non Organic Pain
17
24
EN
Geetha
Desai
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
Y
Santosh K
Chaturvedi
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
N
Introduction: Patient clinician interaction is an important component of Abnormal Illness Behaviours (AIB) and can have significant impact on the patients’ as well health care settings. AIB has been measured more with self-report scales compared to objective rating scales. This study assessed patient clinician interaction among in chronic pain using an objective scale, Illness Behaviour Assessment Schedule (IBAS). Method: Details of demography and illness were collected using a semis-structured schedule. IBAS was administered to 301 adult subjects with chronic non-organic pain to assess patient clinical interaction and illness behaviour patterns. Findings: Majority of the sample consisted of women (N=208 69%). The mean duration of pain symptoms in years was 5.78± 5.43. Majority of the subjects did not acknowledge or were not sure of receiving any explanation for their illness. Subjects recalled the causal explanation as having both psychological and somatic causes. Nearly 70% of the subjects attributed their affective disturbance to somatic problems. Gender differences were noted in communication of affect with more men having moderate to marked inhibition. (Chi square 7.78, p=0.005). Conclusions: This study highlights that patients often do not recall the explanations provided for their symptoms and may attribute their symptoms based on their own beliefs. This may correlate to abnormal illness behaviours. It is important to patient clinician interaction regarding the pain symptoms and attribution for appropriate management.
Abnormal Illness Behaviours, pain, patient clinician interaction
http://intjmi.com/article-1-332-en.html
http://intjmi.com/article-1-332-en.pdf
International Journal of Medical Investigation
International Journal of Medical Investigation
2322-2913
2345-640x
7
3
2018
9
1
Cervical Magnetic Resonance Imaging (MRI) Findings in Patients with Neck Pain A Cross Sectional Study in Southeast of Iran
25
31
EN
Mohammad
Safdari
Department of Neurosurgery, Zahedan University of Medical Sciences, Zahedan, Iran
N
Zahra
Safdari
Department of Radiology, Zahedan University of Medical Sciences, Zahedan, Iran
N
Sadegh
Sadeghi Ferezghi
Department of Neurosurgery, Zahedan University of Medical Sciences, Zahedan, Iran.
N
Mohammad
Shirdeli
Department of Radiology, Zahedan University of Medical Sciences, Zahedan, Iran
N
, Zohre
Safdari
Resident of Radiology, Zahedan University of Medical Sciences, Zahedan, Iran
N
, Masoud
Pishjoo
Resident of Neurosurgery, Mashhad University of Medical Sciences, Mashhad, Iran
Y
Introduction: Neck pain is a common problem in human societies around 67-70% of adults experience it throughout their lives. There is much controversy in the literature about chronic neck pain causes and the role of imaging in the evaluation of it. In this study, we aimed to investigate the MRI findings in patients with neck pain. Methods: This cross-sectional study was conducted in 2014 in Zahedan, Iran. The study population was consisted of the patients with neck pain, in which a total of 700 patients were studied. After the MRI imaging, the study subjects were asked some questions and the required information was collected. Findings: 32.3% of the subjects were males and the average age of the participants was 35.62±10.15 years. 76.8% of people had chronic pain and also 86.4% of people didn’t show any abnormal finding and in the rest of them spondylosis and trauma were the most common abnormal causes. Disc bulging and protrusion were the most common finding and C3-C4 and C4-C5 were the most common level of these damages. Conclusion: In this study, like previous studies, the most common causes of neck pain were non-specific causes and they followed by spondylosis and neck trauma.
Cervical - MRI - Findings - Neck Pain
http://intjmi.com/article-1-333-en.html
http://intjmi.com/article-1-333-en.pdf
International Journal of Medical Investigation
International Journal of Medical Investigation
2322-2913
2345-640x
7
3
2018
9
1
Evaluating The Relationship Between The Severity Of Psoriasis And The Prevalence Of Depression In Patients With Psoriasis Compared With Healthy Subjects Referred To Dermatology Clinics Of Gorgan In 2016-17
32
42
EN
Peyman
Rad
Resident of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Faculty of Medicine ,Golestan University of Medical Sciences, Gorgan , Iran .
Y
Sadegh Ali
Taziki
Associated Professor of psychiatry, Psychiatry and Behavioral Sciences Research Center, Faculty of Medicine , Golestan University of Medical Sciences, Gorgan, Iran.
N
Introduction: Psoriasis is a systemic inflammatory disease and the most common recurrent chronic skin disease which affects almost 2% of the population and may occur at any age. This chronic disease causes changes in the appearance that impairs the patients’ mental image of themselves and causes rejection from society, isolation, personality disorders, depression, low self-esteem and weakened position of the person in the family. Due to the lack of permanent recovery of patients with medications, psychiatric interventions lead to improvements in the quality of life in these patients. An accurate assessment of the relationship between disease severity and psychopathology of it hasn’t been done in our society, so we decided to assess the relationship between disease severity and depression rate in patients with psoriasis referred to dermatology clinics is Gorgan in 2016-17 compared to healthy subjects. Method : In this case-control study, 68 patients with psoriasis referred to dermatology clinics in Gorgan in 1395 and 68 normal controls were examined for depression using standard Beck (Beck II ) test. Severity of the disease was calculated based on Psoriasis Area Severity Index Score (PASI Score). The data gathered was analyzed using statistical tests with confidence level of 0.95, and statistical power of 0.9 with SPSS software (version 18). Findings: This study evaluated 70 patients with psoriasis referred to dermatology clinics in Gorgan in 2016-17 and 70 healthy subjects as controls. In each group 22 subjects were male (31.4%) and 48 subjects were female (68.6%). Average disease severity was 35/17 ± 27 percent. With the increasing severity of psoriasis, the rate of depression is higher among patients. (P=0.0001) The rate of mild, moderate and severe depression in the case group was higher than the control group. This difference is statistically significant (p=0.0001) Conclusion: Depression symptoms are remarkably observed in psoriasis patients and the rate of these symptoms compared to healthy individuals is greater and these symptoms have a strong significant correlation with the severity of psoriasis.
Depression, psoriasis, Beck II
http://intjmi.com/article-1-334-en.html
http://intjmi.com/article-1-334-en.pdf
International Journal of Medical Investigation
International Journal of Medical Investigation
2322-2913
2345-640x
7
3
2018
9
1
Effect of Second Person Aid for Upward Displacement of Laryngoscope on Laryngeal View during Laryngoscopy
43
47
EN
Seyd Hedayatallah
Akhlagh
Anesthesiology and Critical Care Research Center , Shiraz , Iran
N
, Arash
Farbood
Anesthesiology and Critical Care Research Center , Shiraz , Iran
N
, Seyed Mohammadreza
Hadavi
Anesthesiology and Critical Care Research Center , Shiraz , Iran
N
Reza Raeesi
Estabragh
Anesthesiology and Critical Care Research Center , Shiraz , Iran
Y
Ramita
Shahabifar
Student Research Committee, Shiraz University of Medical Sciences, Shiraz,Iran
N
Farshid
Ghahramani Nejad
Student Research Committee, Shiraz University of Medical Sciences, Shiraz,Iran
N
Introduction: Difficulties or failure in airway management is among leading causes of death due to anesthesia. Secure airway management necessitates an acceptable level of prediction, regarding the probability of difficult intubation and in occasions of difficulty, quick lifesaving reaction is required. This study aimed to assess a novel manual technique that enhances the exposing of laryngeal view by upward displacement of laryngoscope. Methods: In this study, 300 patients in the age range of 18-88 and ASA class I and II were studied. Mallampati score of each patient was estimated before intervention. After anesthesia, an expert would attempt laryngoscopy and laryngeal view was recorded. Immediately after checking laryngeal view by the first expert, a second person aide and lifts the laryngoscope upward in order to provide a better laryngeal view, then the new laryngeal view is recorded. Findings: A significant improvement was shown in patients’ laryngeal view after performing the upward lifting of the laryngoscope (P value < 0.001). Conclusion: The result of this research indicates that the simultaneous upward displacement of laryngoscope during laryngoscopy provides a better laryngeal view for the clinician, making the process of intubation easier and more successful.
Laryngeal View, Laryngoscopy, Tracheal Intubation, Upward Displacement
http://intjmi.com/article-1-335-en.html
http://intjmi.com/article-1-335-en.pdf
International Journal of Medical Investigation
International Journal of Medical Investigation
2322-2913
2345-640x
7
3
2018
9
1
Investigating the Hidden Curriculum from the Perspective of Mazandaran Para-medical Students
48
58
EN
Ali Morad
Heidari Gorji
Assistance Prof, Members faculty (EDC), Mazandaran University of Medical Science, Sari, Iran
N
Kobra Ali
Golbandi
Healthcare Information Technology department, Paramedical Faculty, Mazandaran University of Medical Sciences, Sari, Iran
N
Sayyed Mahmoud
Hosseini Ashlaghi
MA of educational management, personnel of Para-medical, Mazandaran University of Medical Sciences, Sari, Iran.
Y
Introduction: The present study aims at investigating the hidden curriculum indicators in Mazandaran Medical Sciences University (Sari’s Para-medical school) from the perspective of the university students. Methods: This study has been conducted on a study population comprised of Sari’s Para-medical school (n=217) during the academic year of 2016-2017. The information collection tool was the hidden curriculum questionnaire containing 36 items. The data were analyzed with SPSS.V.16 using single-variable t-test, normality test, variance analysis test, Levene test and independent t-test. Findings: The findings indicated that the hidden curriculum enjoys a rank some 3.96 higher than intermediate. Also, there was not found any significant difference between the students’ perspectives (gender-based) regarding the hidden curriculum stance but there was found a significant difference between the students’ perspectives regarding hidden curriculum (based on study fields). Conclusion: according to the scientific and social problems with which the universities are faced, the students’ perspectives are reflective of their positive appraisal of the hidden curriculum in Para-medical schools.
Hidden curriculum, Rules and regulations, Professors’ knowledge
http://intjmi.com/article-1-336-en.html
http://intjmi.com/article-1-336-en.pdf
International Journal of Medical Investigation
International Journal of Medical Investigation
2322-2913
2345-640x
7
3
2018
9
1
Prenatal Diagnosis of Tetralogy of Fallot in a Fetus with Maternal Gestational Diabetes Mellitus, a Case Report
59
63
EN
Alireza
Golbabaei
Department of Pediatrics cardiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
N
Ehsan Aghaei
Moghaddam
Department of Pediatrics cardiology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
N
, Mohammad Taghi
Majnoun
Department of Pediatrics cardiology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
N
Ali
Mirabi
Medical Student, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.
Y
Gestational diabetes mellitus (GDM) is a teratogenic condition for the fetus. Congenital malformations among the newborns of diabetic mothers is 5-times greater than general population. Tetralogy of fallot is a common form of congenital heart defect. We would like to report a diagnosed case of fetal tetralogy of fallot based on findings including a ventricular septal defect (VSD), aortic valve overriding, bidirectional shunt via VSD in aortic long axis view, in addition to anomalies on the three-vessel view with small pulmonic annulus in a high risk mother with GDM with a gestational age of 19 weeks. It appears that although the risk of fetal cardiac malformations may be highest in women with GDM, all pregnancies of pre-gestational diabetes and GDM are at increased risk, given this, regular fetal echocardiographies should be consider in women with GDM.
Tetralogy of Fallot, prenatal diagnosis, fetal echocardiography, gestational diabetes mellitus
http://intjmi.com/article-1-337-en.html
http://intjmi.com/article-1-337-en.pdf
International Journal of Medical Investigation
International Journal of Medical Investigation
2322-2913
2345-640x
7
3
2018
9
1
Fracture-Dislocation of the Thoracic Spine without Any Neurological Deficit: A Case Report and Review of the Literature
64
72
EN
Naveed
Nabizadeh
Assistant professor, Department of Orthopedic Surgery ,Firouzgar Hospital , Iran University of medical sciences, Tehran, IR Iran;
N
Alireza Yousof
Gomrokchi
Bone and Joint Reconstruction Research Center , Shafa Orthopedic Hospital ,Iran University of Medical Sciences ,Tehran ,IR Iran
Y
Sam Bemani
Lirgeshasi
Bone and Joint Reconstruction Research Center , Shafa Orthopedic Hospital ,Iran University of Medical Sciences ,Tehran ,IR Iran
N
, Milad
Bahari
Bone and Joint Reconstruction Research Center , Shafa Orthopedic Hospital ,Iran University of Medical Sciences ,Tehran ,IR Iran
N
Introduction: Thoracic spinal fracture dislocation injury usually is caused by a high-energy trauma. Therefore, this kind of injury should always be suspected in the patients who have sustained a multiple trauma. The thoracic spinal fracture-dislocation is commonly accompanied by neurological symptoms. In the literature, only few cases are reported who did not present neurological symptoms. Case presentation: A 25-year-old man was brought to our emergency department following a vigorous motor-vehicle accident, complaining from excruciating pain in his right shoulder. The promptly obtained radiographs revealed right shoulder fracture dislocation that was reduced through intervenus sedation, in the emergency department. The overt shoulder injury distracted the ER physician’s attention from the vertebral translation, visualized in the initial chest radiographs. Secondary survey, obtained on the next day, revealed a serious T5-T6 fracture-dislocation and absence of neurological deficit. The computed tomography and magnetic resonance imaging provided the details of the spinal injury. Open reduction and stabilization was performed by application of the rods and pedicle screws. The neurologic condition remained intact postoperatively. A CTLSO brace was administrated to wear whenever he was walking or sitting. The brace was weaned off at the 24th week when he started physical exercises. Conclusions: In a small number of patients who suffered spinal fracture-dislocation, the radiographic feature or severity does not correlate with the clinical manifestation. The treatment strategy is tailored individually, i.e., open reduction and internal fixation is advised whenever surgical intervention is indicated.
Dislocation, Fracture, Thoracic vertebrae, Neurological deficit
http://intjmi.com/article-1-338-en.html
http://intjmi.com/article-1-338-en.pdf
International Journal of Medical Investigation
International Journal of Medical Investigation
2322-2913
2345-640x
7
3
2018
9
1
Management of Cardiac Arrest in a Patient with End Stage Renal Disease: a Case Report
73
76
EN
Fatemeh
Jahanian
Emergeny Medicine department, Mazandaran University of medical sciences, Sari, Iran.
N
Seyed Mohammad
Hosseininejad
Department of Emergency Medicine, Diabetes research center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
N
Farzad
Bozorgi
Emergency Department, Orthopedic research center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
N
Sepideh
Amirifard
Emergeny Medicine department, Mazandaran University of medical sciences, Sari, Iran
Y
Cardiopulmonary resuscitation (CPR) performed due to cardiac arrest for return of blood circulation and oxygenation to the patient. We describe a case of successful CPR in a patient with several stages of pVT. She was a known case of end stage renal disease (ESRD) that was on hemodialysis. Advanced cardiac life support performed for her and after emergency hemodialysis. After that, she awoke with stable hemodynamics. Echocardiography revealed a moderate to severe MR and LVEF% of 40. The patient continued hemodialysis for 3 times a week and referred to cardiologist for further examination and angiography.
Cardiac arrest, ESRD, Hemodialysis, Cardiopulmonary Resuscitation.
http://intjmi.com/article-1-339-en.html
http://intjmi.com/article-1-339-en.pdf
International Journal of Medical Investigation
International Journal of Medical Investigation
2322-2913
2345-640x
7
3
2018
9
1
Ectopic Cushing\'s syndrome Of Unknown Origin: A Rare Case Report
77
82
EN
Saied
Amirkhanlou
Department of Internal Medicine, Golestan University of Medical Sciences, Golestan, Iran.
N
Mohammad Mehdi
Ebrahimi
Department of Internal Medicine, Golestan University of Medical Sciences, Golestan, Iran.
N
Arash
Rezaei Shahmirzadi
Medical student, Student Research Committee, Golestan University of Medical Sciences, Golestan, Iran
Y
Background: Cushing’s syndrome is a rare disease caused by excessive secretion of cortisol by adrenal cortex (hypercortisolism). Bilateral adrenal hyperplasia due to increased secretion of adrenocorticotropic hormone (ACTH) by pituitary gland is usually known as the main cause of Cushing’s syndrome. The 5-year survival rate for patient with Cushing’s syndrome is approximately 50% unless associated with treatment. Etiologic diagnosis therefore plays an important role in prompt treatment. The purpose of this study is to inspect a Cushing’s syndrome with unknown cause. Case presentation: A 36-year-old married man with complaint of periorbital and upper trunk swelling (with no buffalo hump) and lower extremity weakness presented to doctor’s clinic. He also had a one-year history of blurred vision, hypertension, facial and periorbital edema and difficulty getting up from a sitting. After physical examinations and laboratory testing, diagnosis of Cushing’s disease with unknown cause was made and surgical removal of both adrenal glands was suggested. He underwent bilateral adrenalectomy in two separate operations and his symptoms gradually reduced during the next months. Conclusion: According to this study and other same case report studies conducted, surgical removal of adrenal gland is the most effective treatment if the patient does not respond to medication. Even if the cause of Cushing’s disease is not known, like the case mentioned.
Cushing's syndrome, Adrenocorticotropic hormone, hypercortisolism
http://intjmi.com/article-1-340-en.html
http://intjmi.com/article-1-340-en.pdf