S. O. Ojaghi Haghighi, N. Hamed, S. Ebrahimi, Jafar Ghobadi, H. Ameli
{"title":"Comparison of lung bedside ultrasound and BNP in the diagnosis of acute heart failure in the emergency department","authors":"S. O. Ojaghi Haghighi, N. Hamed, S. Ebrahimi, Jafar Ghobadi, H. Ameli","doi":"10.34172/JRCM.2020.050","DOIUrl":"https://doi.org/10.34172/JRCM.2020.050","url":null,"abstract":"Introduction: Congestive heart failure is heart muscle failure that causes pulmonary congestion and eventually pulmonary edema, which despite recent medical advances, is still a progressive syndrome with high mortality, the prevalence of which has increased in recent decades. Therefore, in this study we compared lung ultrasound findings in acute heart failure patients with the BNP. Methods: This study was performed in the emergency room of Imam Reza hospital in Tabriz. For patients entering the emergency room after taking a history, both standard gold (BNP) tests and beside ultrasound of the lung were performed. Ultrasound was performed at the same time as obtaining blood sample to ensure that the ultrasound specialist did not know the result of diagnosis. During the ultrasound, if there were multiple B-Lines that were at least 3 mm apart, patient was diagnosed with pulmonary edema due to heart failure. Results: Number of participants in this study was 108 people, 54.6% of whom were men and the rest were women. The correlation coefficient between width and number of kerley lines was 0.79, between NT-pro BNP and width of kerley lines was 0.65 and between NT-pro BNP and number of kerley lines was 0.77, which indicates a significant positive correlation (P value <0.001). Conclusion: The results of present study showed that in patients with acute heart failure, the number and width of kerley lines in pulmonary ultrasound evaluation increase rapidly. There is also a high correlation between number and length of kerley lines with NT-pro BNP serum values.","PeriodicalId":17071,"journal":{"name":"Journal of Research in Clinical Medicine","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86313431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mahsa Esmaeillou, Jalil Houshyar, F. Akbarzadeh, A. Aliasgarzadeh
{"title":"Evaluation of autonomic neuropathy in newly diagnosed and chronic type 2 diabetic patients: A retrospective cross-sectional study","authors":"Mahsa Esmaeillou, Jalil Houshyar, F. Akbarzadeh, A. Aliasgarzadeh","doi":"10.34172/JRCM.2020.049","DOIUrl":"https://doi.org/10.34172/JRCM.2020.049","url":null,"abstract":"Abstract Introduction: Diabetic autonomic neuropathy is one of the most important complications of diabetes mellitus (DM) that ultimately occurs in most patients. The purpose of this study was to screen and diagnose latent cases of autonomic neuropathy between patients who have a history of over 10 years DM and recently diagnosed diabetic patients. Methods: This cross-sectional study was performed on 104 patients (52 type 2 DM patients diagnosed in the last 6 months; and 52 type 2 DM patients with more than 10 years history) referred to outpatient Endocrine Clinic of Imam Reza Medical Center in Tabriz University of Medical Sciences between 2015-2016. Blood pressure, resting heart rate and corrected QT interval were evaluated according to standard methods. The history of gastrointestinal and urinary tract neuropathy was extracted from patients’ history and physical exam. Results: Of the 104 patients studied, 54 were male and 50 were female. Standing heart rate (p=0.02), resting (p<0.0002) and standing (p<0.0001) systolic blood pressure, and resting diastolic blood pressure (p=0.03) were significantly higher in chronic diabetic patients compared to newly diagnosed group. Additionally, blood glucose levels (p=0.03) and body mass index (BMI) (p<0.0001) were significantly higher in patients with neuropathy. Conclusion: Overall, the results of this study showed that in patients with type 2 DM, cardiac autonomic dysfunction is more common in patients with a longer history of DM.","PeriodicalId":17071,"journal":{"name":"Journal of Research in Clinical Medicine","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88424243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Somi, Masood Faghih Dinevari, L. Alizadeh, A. Riazi, S. Abbasian, Zeinab Nikniaz
{"title":"Comparison of the serum fibrinogen level and International Normalized Ratio in the assessment of the risk of gastrointestinal bleeding in decompensated cirrhosis","authors":"M. Somi, Masood Faghih Dinevari, L. Alizadeh, A. Riazi, S. Abbasian, Zeinab Nikniaz","doi":"10.34172/JRCM.2020.048","DOIUrl":"https://doi.org/10.34172/JRCM.2020.048","url":null,"abstract":"Introduction: Gastrointestinal (GI) bleeding is the most life-threatening complication of cirrhosis and it's predicting is crucial for the management of cirrhotic patients. The present study aimed to assess the relationship between INR and plasma fibrinogen level and the risk of GI bleeding using in cirrhotic patients. Methods: In the present cross-sectional study, seventy-eight cirrhotic patients were enrolled. We assessed demographic, biochemical, hematologic parameters in all patients. Underlying diseases and the etiology of cirrhosis were documented. The Child-Pugh and the Model for End-stage Liver Disease (MELD) scores were used to assess the severity of liver cirrhosis. The history of bleeding episodes within 6 months before inclusion were recorded. A blood sample was drowned and fibrinogen and prothrombin time (PT) were measured and INR was calculated. Results: The patients' mean age was 51.23±15.08 years and 40 (51.3%) were male. About 17 patients (%21.7) had a history of GI bleeding within 6 months before the study. The significant difference was observed between the two groups who experienced bleeding and who did not regarding the fibrinogen level (P < 0.05). The fibrinogen level was a better predictive marker of bleeding in cirrhotic patients (AUC: 0.87). According to the results of predictive tests, the fibrinogen level had a sensitivity of (77%) and specificity of (%94) in the prediction of bleeding with the cut-off value of 182.5. Conclusion: The results of the present study showed that the fibrinogen level is a better predictor of bleeding in cirrhotic patients compared with INR.","PeriodicalId":17071,"journal":{"name":"Journal of Research in Clinical Medicine","volume":"6 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72614976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Paknezhad, K. Shahsavarinia, H. Samadi kafil, Parisa Nayeri
{"title":"Prevalence of methicillin-resistant Staphylococcus aureus colonization in the emergency department health care workers","authors":"S. Paknezhad, K. Shahsavarinia, H. Samadi kafil, Parisa Nayeri","doi":"10.34172/jrcm.2020.030","DOIUrl":"https://doi.org/10.34172/jrcm.2020.030","url":null,"abstract":"Introduction: AThe aim of this study was to evaluate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization in the health care workers of emergency department of Imam Reza hospital, Tabriz, Iran \u0000 \u0000Methods: In a total of 63 physicians and nurses in the emergency department of Imam Reza hospital, after obtaining written consent and completing a checklist, a sample of nasal mucosa was collected for microbiological examination and isolation of Staphylococcus aureus (SA) strain. Determination of resistance patterns (by diffusion method) was performed according to the standard methods of methicillin. \u0000 \u0000Results: Out of 63 participants, 8 subjects (12.7%) had colonization of S. aureus; 4 of them were physicians (17.3% of the participated physicians) and 4 were nurses (10% of the participated nurses). Out of 8 isolated SA, 2 cases (25%) and overall 3.1% were methicillin-resistant. In our study, there was a significant relationship between co-employment in other hospitals and patient care at home with SA colonization, but there was not a significant relationship with specialty, work experience, sinusitis, history of antibiotic use, history of skin disease, hand washing habits and use of personal protective equipment. \u0000 \u0000Conclusion: Prevalence of MRSA was not high among health workers of emergency department.","PeriodicalId":17071,"journal":{"name":"Journal of Research in Clinical Medicine","volume":"375 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76447568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Rafeey, Bozorgmehr Nasir, Z. Jalali, Nazanin Hazhir Karzar, M. Sadeghi-shabestari
{"title":"Efficacy of Helicobacter pylori eradication on recovery of chronic urticaria","authors":"M. Rafeey, Bozorgmehr Nasir, Z. Jalali, Nazanin Hazhir Karzar, M. Sadeghi-shabestari","doi":"10.34172/jrcm.2020.029","DOIUrl":"https://doi.org/10.34172/jrcm.2020.029","url":null,"abstract":"Introduction: The studies have been equivocal about the association of Helicobacter pylori infection with chronic urticaria (CU) given some controversial evidence in recovery of urticaria following H. pylori eradication. Methods: In this clinical trial, 120 patients between the ages of 4 and 20 with intractable CU were recruited. They were grouped into two categories based on urea breath test (UBT) result. UBT positive group received treatment and UBT was repeated after two months while being evaluated for clinical course over a six-month period. On the other hand, UBT negative group received standard treatment for urticaria. Results: All participants with CU have been studied as 40 cases of UBT positive and 80 cases of control group with negative UBT, consisted of 42 (35%) male and 78 (65%) female. Patients had suffered from urticaria on average 29.9 (±26.6) months prior to diagnosis. Statistically significant difference was noted between two groups, in terms of severity of urticaria, frequency of episodes, abdominal pain and duration of being symptomatic prior to diagnosis. After receiving treatment for H. pylori infection, among case group, 27(67.5%) of individuals achieved complete recovery of urticaria and 13 (32.5%) cases demonstrated partial resolution of urticaria, meanwhile 59 cases (73.8%) of control group became completely symptom-free, while 21 (26.3%) of the remaining individuals were in incomplete recovery. In comparison of response to treatment between the above-mentioned groups, there was not any statistically significant difference (P=0.47) Conclusion: Our findings reveal that H. pylori infection might contribute to developing CU which highlights the significance of H. pylori eradication as an approach for CU.","PeriodicalId":17071,"journal":{"name":"Journal of Research in Clinical Medicine","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74471878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Sever, N. Uzun, Serkan Ceritli, Halil Mutlu, A. Bayramoğlu
{"title":"Hyponatremia in COVID-19 patient using angiotensin type 1 receptor (AT1R) blocker and diuretic: a case report","authors":"M. Sever, N. Uzun, Serkan Ceritli, Halil Mutlu, A. Bayramoğlu","doi":"10.34172/jrcm.2020.022","DOIUrl":"https://doi.org/10.34172/jrcm.2020.022","url":null,"abstract":"<jats:p>\u0000 </jats:p>","PeriodicalId":17071,"journal":{"name":"Journal of Research in Clinical Medicine","volume":"21 4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86759563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Masood Faghih Dinevari, M. Somi, M. Tarzamni, L. Alizadeh, S. Abbasian, A. Riazi, Zeinab Nikniaz
{"title":"The diagnostic value of non-invasive serum liver fibrosis indices in the prediction of portal hypertension in cirrhotic patients: a cross-sectional study","authors":"Masood Faghih Dinevari, M. Somi, M. Tarzamni, L. Alizadeh, S. Abbasian, A. Riazi, Zeinab Nikniaz","doi":"10.34172/jrcm.2020.023","DOIUrl":"https://doi.org/10.34172/jrcm.2020.023","url":null,"abstract":"\u0000 Introduction: Considering that portal hypertension is principally caused by hepatic fibrosis, some studies postulated the predictive value of serum liver fibrosis indices in the diagnosis of portal hypertension. In this study we assessed the prognostic value of serum indices in the diagnosis of portal hypertension in cirrhotic patients. Methods: One hundred two cirrhotic patients were selected according to inclusion/exclusion criteria. Cirrhosis and the Child-Pugh score was determined by the gastroenterologist. Portal hypertension was diagnosed by the radiologist using the color Doppler method. The fasting blood sample was drawn and different serum indices were determined. The following indices were calculated: FIB4, Fibroindex, APRI, FORNS, LOK. Results: The patients mean age was 54.39±6.60 years. About 52.94% of the patients were women. The mean liver enzymes level was higher in patients with portal hypertension. In 50.98% of patients, the etiology of cirrhosis was viral hepatitis. Significant differences was observed between the two groups regarding the studied indices (P<0.05). According to the results of the ROC curve, the FORNS index was a better predictive marker of portal hypertension in cirrhotic patients. The maximum AUC (area under the curve) was for the FORNS index. According to the results of diagnostic tests, the FORNS index had adequate sensitivity and specificity in the diagnosis of portal hypertension with the cut-off value of 8.51. Conclusion: The results of the present study showed that the FORNS index is a better predictor of portal hypertension in cirrhotic patients.","PeriodicalId":17071,"journal":{"name":"Journal of Research in Clinical Medicine","volume":"529 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77365088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Pouraghaei, M. Tarzamani, Payman Moharramzadeh, Sahar Nikniaz, S. Karimian, Moloud Balafar
{"title":"Ultrasound guided lumbar puncture reduces failed punctures, spent time and number of attempts in emergency department","authors":"M. Pouraghaei, M. Tarzamani, Payman Moharramzadeh, Sahar Nikniaz, S. Karimian, Moloud Balafar","doi":"10.34172/JRCM.2020.020","DOIUrl":"https://doi.org/10.34172/JRCM.2020.020","url":null,"abstract":"\u0000 Introduction: The present study was an attempt to evaluate the role of ultrasonography on decreasing the number of attempts, failed punctures, time needed to perform the procedure and patients’ pain. Methods: This study is a prospective case-control. Patients were divided in two groups randomly. A two-dimensional probe was used to localize intervertebral space in the ultrasound guidance (US group). In manual palpation (MP group) however, insertion level was determined using the standard technique by manual palpation. The number of attempts (needle insertion) required for a successful tap and successful/unsuccessful attempts were considered as the primary outcome measures. Results: Male patients with an average age of 44.08±15.83 years accounted for 60% (30 individuals) of the population. Success rate was 92% in the US group and 34% in the MP group (P<0.001). It took 79.64± 19.91 and 85.4±11.62 minutes to identify the proper location in US and MP groups respectively (P=0.21). In the first attempt, it took 6.33±0.95 and 6.87±0.7 minutes to collect cerebrospinal fluid (CSF) in US and MP groups respectively (P=0.02). Average time taken to localize the sites in two attempts were 8.28±2.44 and 13.17±3.32 in US and MP groups respectively (P<0.001). Average number of attempts made in the US and MP groups were 1.08±0.27 and 1.64±0.66 (P<0.001) respectively. Conclusion: Ultrasonography has reduced the time needed for locating puncture to collect CSF, pain management in patients, determining the number of attempts, and defining the risk of traumatic puncture. Moreover, this technique is characterized by a higher success rate. Using ultrasonography in obese patients and people with lumbar problems is more important.","PeriodicalId":17071,"journal":{"name":"Journal of Research in Clinical Medicine","volume":"2015 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87027654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effects of color filters and anti-reflective coating on contrast sensitivity under glare condition","authors":"M. Mahjoob, S. Heydarian","doi":"10.34172/jrcm.2020.028","DOIUrl":"https://doi.org/10.34172/jrcm.2020.028","url":null,"abstract":"Background: Since light scattering has a great impact on visual performances, this study was conducted to compare the effects of color filters and anti-reflective coating on contrast sensitivity (CS) in normal people under glare condition. Methods: This semi-experimental study was conducted on 40 medical students (aged 19- 25 years). Ophthalmologic tests including visual acuity and refractive error measurement, biomicroscopy, fundoscopy, and CS assessment were conducted for all participants. CS was determined using Pelli-Robson chart at a distance of one meter. To measure the effect of glare on CS, we used an additional lighting source (60 W tungsten filament incandescent lamp) in the patient’s visual field. Thus, at an intensity of 2000 lux, the light source was placed at a distance of 18.5 cm from the patient’s eye in a way that it was 10 degrees above the subject’s visual axis. Monocular CS measurements were performed with and without glare. Monocular CS was evaluated again under glare conditions with the yellow and pink filters, with the transmission rate of 85%, and anti-reflective coating. Results: The mean log CS of subjects under glare (1.48±0.09) was lower than that in the absence of glare (1.71±0.09) (<0.001); moreover, repeated measures ANOVA showed the yellow filter (1.48±0.10), pink filter (1.47±0.10), and anti-reflective coating (1.47±0.09) had no significant impact on improving visual performance under glare condition (P=0.471). Conclusion: Colored filters and anti-reflective coatings are not effective in enhancing the vision of young normal individuals under glare conditions and at low spatial frequencies.","PeriodicalId":17071,"journal":{"name":"Journal of Research in Clinical Medicine","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83071911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad-Salar Hosseini, M. Fakhri, S. Hashemzadeh, M. Farhoudi, J. Mahmoudi, R. Piri, S. Mohammadi, M. Omrani-Hashemi
{"title":"Effect of erythropoietin on inflammatory response and ischemic brain damage after carotid artery clamp in rat","authors":"Mohammad-Salar Hosseini, M. Fakhri, S. Hashemzadeh, M. Farhoudi, J. Mahmoudi, R. Piri, S. Mohammadi, M. Omrani-Hashemi","doi":"10.34172/jrcm.2023.32053","DOIUrl":"https://doi.org/10.34172/jrcm.2023.32053","url":null,"abstract":"Introduction: Erythropoietin (EPO) is reported to have a minimizing effect on the ischemic condition, but the detailed association between EPO and the ischemic upshot is still not clearly understood. We aimed to evaluate the effect of EPO on inflammatory response and ischemic brain damage after carotid artery clamp in rats. Methods: In this experimental, animal trial study, which was conducted at the Animal Facility and laboratory at Tabriz University of Medical Sciences, 50 adult male Wistar rats with (250 to 300 g) were randomly allocated to intervention and control groups. The intervention and control groups were administered intraperitoneally with equal volumes of EPO (5000 U/kg) and normal saline, respectively. Both groups had common carotid arteries clamped for 20 minutes. Using the Nissl staining technique, the slides of brain ischemic areas were observed and the rate of ischemic injury in both groups was determined. The blood level of inflammatory cytokines was also measured. Results: The levels of inflammatory markers including creatine phosphokinase (CPK), interleukin (IL)-6, IL-1B and tumor necrosis factor alpha (TNF)-α in the intervention group were significantly lower than that of control group. Mean percentage of the ischemic area in the intervention group with an amount of 4.30±2.15%, was significantly lower than that of control group (11.20±2.35%, P=0.023). Conclusion: Findings of this study showed that the injection of EPO before carotid clamping is effective in preventing cerebral ischemic injury in rats.","PeriodicalId":17071,"journal":{"name":"Journal of Research in Clinical Medicine","volume":"121 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85254092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}