Medical Journal of the Islamic Republic of Iran最新文献

{"title":"Association Between Lumbar Spine Disorder and Genovarum: A Population-Based Cross-Sectional Study.","authors":"Ali Yeganeh, Ava Parvandi, Mohammadreza Mehri, Hamed Tayyebi, Javad KhajeMozafari","doi":"10.47176/mjiri.38.44","DOIUrl":"https://doi.org/10.47176/mjiri.38.44","url":null,"abstract":"<p><strong>Background: </strong>It is becoming increasingly important to study pathology at the knee and spine because of their role in causing pain and deformity in one another. Compression of the lumbar nerve root can disrupt innervation to the thigh muscles, cause an imbalance of muscle and result in varus deformity. In this study, we try to figure out the relation between lumbar spine disorders and genu varum and realize if lumbar spine disorders can cause varus deformity in a patient.</p><p><strong>Methods: </strong>In this cross-sectional study, the number of 53 patients with knee varus greater than 20 degrees who visited the orthopedic clinics of Rasoul Akram and Moheb Mehr hospitals affiliated to Iran University of Medical Sciences between 2020 and 2022 were investigated in terms of association with lumbar disorders. The demographic characteristics and clinical findings of the patients were recorded and collected using a checklist by referring to the patient's medical profiles. Radiographic findings were evaluated by referring to the imaging department and using the Pacs system. The diagnosis of the patients was based on the history and findings of the knee graph, which was measured with a goniometer to measure the knee angle. The frequency of lumbar disorders caused by pressure on the lumbar nerves in patients with genu varum deformity including canal stenosis, osteoarthritis, spondylolisthesis, and disc herniation was investigated. To investigate lumbar problems, patients' history and radiographic images as well as lumbosacral and knee MRI of patients were used.</p><p><strong>Results: </strong>The mean age was 66.3 ± 7.66 years. 40 (75.5%) cases were female and 13 (24.5%) cases were male. Lumbar canal stenosis with 28(52.8%) and disc herniation with 32(60.4%) were the most common lumbar disorders in patients with knee varus more than 20 degrees. The mean age of patients with varus of more than 20 degrees with lumbar disorders was significantly higher than that of patients without lumbar disorders. (<i>P</i>: 0.001) There was no significant difference between gender distribution and lumbar disorders in patients with varus more than 20 degrees. Significant positive correlation between genu varum with lumbar canal stenosis (r: 0.53, <i>P</i>: 0.001), osteoarthritis (r: 0.38, <i>P</i>: 0.004), spondylolisthesis (r: 0.39, <i>P</i>: 0.002) and disc herniation (r: 0.46, <i>P</i>: 0.001) was reported2.</p><p><strong>Conclusion: </strong>An association between lumbar disorders and varus more than 20 degrees was found to be considerable.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"44"},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Medical Training Costs Internationally: A Systematic Review.","authors":"Asgar Aghaei Hashjin, Kamran Irandoust, Hanie Gholampoor, Claudia Fischer, Masoud Maleki Birjandi, Aireza Mazdaki, Hossein Abdolali, Hediye Seval Akgün","doi":"10.47176/mjiri.38.43","DOIUrl":"https://doi.org/10.47176/mjiri.38.43","url":null,"abstract":"<p><strong>Background: </strong>Acquiring a thorough understanding of the expenses linked to the education of health sciences students is crucial for effective university planning, budgeting, and overall preparedness. This systematic review aimed to identify and compare the per capita costs associated with educating medical and other health science students internationally-particularly emphasizing the context of Iran.</p><p><strong>Methods: </strong>A systematic review was conducted in 2023 according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search covered the period from January 1, 2000, to November 11, 2022, using MeSH and EMTREE terms. Databases such as PubMed, Scopus, Web of Science, Embase, and Iranian databases were searched. Manual searches were performed using Google and Google Scholar.</p><p><strong>Results: </strong>The study retrieved 1336 publications from bibliometric databases and, following thorough screening, included 8 relevant articles from 5 countries (Australia, Iran, United States, Thailand, and Vietnam). An additional 17 relevant articles from Iranian databases were also included. Based on USD purchasing power parity (PPP) 2019, the results show that the mean per capita cost of training a medical student for 1 academic year in Iran is $61,493.86 (range, $28,102-$133,603; standard deviation, $35,476.03). In comparison, the cost of training a medical student for 1 year is $263,305 in the United States and $44,674 in Australia. In Thailand and Vietnam, a 6-year medical program costs is $284,058 and $69,323, respectively. Moreover, according to most studies, training students in other health sciences in Iran for 1 academic year generally costs ˂$20,000 (PPP 2019).</p><p><strong>Conclusion: </strong>The study reveals that the costs associated with medical student education in Iran exceed that of most countries, second only to the United States. These findings highlight the importance of such data in improving the efficiency, sustainability, and informed resource allocation of global medical education programs for future planning and budgeting.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"43"},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Related to the Choice of Place of Death in Deceased Patients due to Cancer from 2011 to 2017 with Hospitalization Background in Firoozgar Hospital.","authors":"Raha Tabahfar, Fatemeh Oskouie, Hamid Haghani","doi":"10.47176/mjiri.38.42","DOIUrl":"https://doi.org/10.47176/mjiri.38.42","url":null,"abstract":"<p><strong>Background: </strong>Death in the place that the patient has selected and feels comfortable remaining in for the remainder of their life is one of the main objectives of palliative care for terminally ill cancer patients. Nevertheless, this problem is constantly disregarded. The goal of the present study was to look at variables that affected cancer patients' decisions about their place of death.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted from May to August 2018. Using a continuous sampling method, 631 patients who had passed away between 2011 and 2017 were selected among the patients with a history of cancer and hospitalization at the Firoozgar Hospital in Tehran. A self-made 3-section questionnaire with 21 questions was completed by phone calls made to the families who confirmed their patients' deaths due to cancer. Data were managed by SPSS software Version 13, and descriptive statistics were used in data analysis.</p><p><strong>Results: </strong>Based on the results, among 631 deceased patients, only 157 (24.9%) chose their place of death, and 474 (75.1%) had not spoken about it during their lifetime. Among the examined variables, age, sex, education, insurance status, duration of disease, activities of daily living, awareness of disease progression, and receiving home care had a significant association with this choice in people who died of cancer.</p><p><strong>Conclusion: </strong>Despite the importance of the choice of place of death by the patient in the final days of life, the possibility of having an option is not provided for most cancer patients. Patients who understand how their disease is progressing at this point are probably going to want to select where they pass away. Consequently, the healthcare system must be ready to grant cancer patients the option to choose their final resting place and ensure a comfortable and respectable passing. Future research can be built upon the results of this study.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"42"},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Effectiveness of Melatonin in the Treatment of Critically Ill Patients with COVID-19 Hospitalized in the Intensive Care Unit: A Double-Blind Randomized Clinical Trial.","authors":"Atefe Tirkan, Delaram Eskandari, Maryam Roham, Oldooz Aloosh, Tayeb Ramim, Hale Afshar","doi":"10.47176/mjiri.38.41","DOIUrl":"https://doi.org/10.47176/mjiri.38.41","url":null,"abstract":"<p><strong>Background: </strong>Melatonin, a tryptophan product, has anti-inflammatory and virucidal effects. A study evaluated whether melatonin is more effective than placebo in critically ill COVID-19 patients.</p><p><strong>Methods: </strong>The present study used a double-blind, randomized clinical trial in patients with COVID-19 hospitalized in the intensive care unit of Rasool Akram Hospital, Tehran. Iran. Melatonin 10 mg and placebo were given to the patients at night before bed. Patients were randomly divided into 2 groups. The first group was given melatonin with a therapeutic dose of 10 mg daily, and the second group was given a placebo with the same dose of 10 mg daily. Patients received melatonin or placebo for 7 days.The chi-square or Fisher exact test was used to compare qualitative variables. The study analyzed the mean of the variables under investigation by conducting a 2-factor repeated measures analysis of variance at 3 different time intervals in those administered medication or placebo.</p><p><strong>Results: </strong>The study analyzed 44 melatonin patients and 42 placebo groups. The mean intensive care unit (ICU) hospitalization days were 11.23 ± 4.73 days in the melatonin group and 11.90 ± 6.52 days in the placebo group (<i>P</i> = 0.582). The mean days of hospitalization in the melatonin group were 19.70 ± 8.77 days and 21.48 ± 10.85 days in the placebo group (<i>P</i> = 0.407). The mean oxygen saturation before and after discharge from ICU in the melatonin group was 81 ± 6.73%, 91.02 ± 1.17%, and in the placebo group, 83.36 ± 8.27%, 91.21 ± 1.26, respectively (<i>P</i> = 0.467 and <i>P</i> = 0.150).</p><p><strong>Conclusion: </strong>Melatonin can significantly reduce inflammation and oxidative stress markers in patients, making it a promising therapeutic option for COVID-19 patients. Further research is needed to determine the optimal treatment dosage and duration. Nonetheless, these results offer a promising avenue for future research and clinical practice.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"41"},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 12-year Life History of a Girl with Profound Intellectual Disability and Leukoencephalopathy: A Rare Clinical Presentation of X Chromosome Pentasomy.","authors":"Akmaral Izbassarova, Aisulu Zholdybayeva, Galiya Kadrzhanova, Khadisha Kashikova, Asel Izbassarova, Natalya Petrova, Alima Tolybekova","doi":"10.47176/mjiri.38.40","DOIUrl":"10.47176/mjiri.38.40","url":null,"abstract":"<p><p>This paper presents a unique 12-year case analysis of a girl with Penta-X syndrome, a chromosomal abnormality characterized by five X chromosomes instead of the normal two in healthy women. Pentasomy of X is a genetic, but not a hereditary disease affecting only women. Our patient demonstrated delayed mental, speech, and motor development along with physical anomalies such as craniofacial deformities, and eye pathology and was diagnosed with pentasomy of the X chromosome at the age of 3 after a cytogenetic examination. She developed epileptic seizures at the age of nine. Magnetic resonance imaging(MRI) revealed leukoencephalopathy with ventriculomegaly. The peculiarity of this observation is that the polysomy 49, XXXXX detected in the patient is characterized by a typical phenotypic presentation combined with demyelinating leukoencephalopathy, which has not been a typical feature of the disorder.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"40"},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Three-Year Investigation on Corpses Referred to Legal Medicine Organization from An Iranian General Hospital: A Cross-Sectional Study.","authors":"Saba Dahaghin, Ava Aghakhani, Azadeh Memarian, Pardis Monjezi, Kamran Aghakhani","doi":"10.47176/mjiri.38.39","DOIUrl":"10.47176/mjiri.38.39","url":null,"abstract":"<p><strong>Background: </strong>A Medical Certificate of Cause of Death (MCCD) is a legal and enforceable document issued by the attending physician. However, according to the instructions, in many cases such as sudden, unexplained, and extraordinary deaths, along with some uncommon causes, such as cases suspicious of murder, the deceased patient must be referred to the Iranian Legal Medicine Organization (ILMO). Moreover, the unnecessary referral of corpses to ILMO can increase the workload of the staff, finally confronting the family of the deceased with high emotional and financial costs.</p><p><strong>Methods: </strong>In this cross-sectional study, the medical records of all deceased patients referred from Hazrat Rasool Hospital to the ILMO (565 cases) in a three-year period from April 2016 to March 2019 were investigated and analyzed using SPSS22 software with chi-squared and T-test.</p><p><strong>Results: </strong>Among all the patients who passed away during this time (4,239 patients), 565 were referred to ILMO, accounting for 13.3% of deaths. The most common causes of referral were car and motorcycle accidents, with a total prevalence of 27.1%, dead-on-arrival (DOA) prevalence of 21.3%, and death with an unknown cause prevalence of 15.3%. Significant correlation was also detected between causes of referral with gender, time of death, and age. For example, Car accidents and lawsuits against medical staff were more common in men and women, respectively.</p><p><strong>Conclusion: </strong>Car and motorcycle accidents, DOA, and unknown causes were the most prevalent causes of referral in this study. In general, few studies have been conducted regarding the causes of referral of the deceased to the Legal Medicine Organization. In this study, we collected relevant variables to investigate this issue thoroughly.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"39"},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Single-Subject Study to Consider the Premature Infant Oral Motor Intervention Combined with Kinesio-Tape in Premature Infants with Feeding Problems.","authors":"Ehsan Naderifar, Maryam Tarameshlu, Reza Salehi, Leila Ghelichi, Arash Bordbar, Negin Moradi, Brenda Lessen Knoll","doi":"10.47176/mjiri.38.38","DOIUrl":"10.47176/mjiri.38.38","url":null,"abstract":"<p><strong>Background: </strong>The survival rate in premature infants (PIs) has increased, but many have medical and developmental complications. Difficulty with sucking, swallowing, and poor nourishment are common complications. This study aimed to investigate the effects of Kinesio-tape (KT) combined with premature infant oromotor intervention (PIOMI) on feeding efficiency (mean volume intake [%MV]), oromotor skills (Preterm Oral Feeding Readiness Assessment Scale [POFRAS]), and weight gain in PIs.</p><p><strong>Methods: </strong>In this single-subject study, 5 PIs with feeding problems were received the PIOMI-KT for 7 consecutive days. The main outcome measure was the POFRAS scale. The %MV and weight gain were the secondary outcome measures. Measurements were taken before treatment (T0), after the 4th session (T1), and after the 7th session (T3).</p><p><strong>Results: </strong>The POFRAS scores, %MV, and weight gain improved in all infants after treatment. The maximum and minimum change in level between the baseline and treatment phase was +26 and+16 for POFRAS, +54 and, +34 for %MV, +180, and +100 for weight gain. The treatment trend was upward for all infants and shown by the directions of the slopes indicated by positive values. The feeding problems were resolved in all infants after the 7th treatment session.</p><p><strong>Conclusion: </strong>The combination therapy of PIOMI-KT improved feeding function in PIs.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"38"},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Factor Structure and Generalizability of the Iranian Socioeconomic Status (SES) Questionnaire Administered in a Nationally Divergent Population.","authors":"Homayoun Sadeghi-Bazargani, Hamid Soori, Seyed Abbas Motevalian, Omid Aboubakri, Ali Jafari-Khounigh, Alireza Razzaghi, Hamid Reza Khankeh, Seyyed Taghi Heydari, Forouzan Rezapur Shahkolai, Mojtaba Sehat, Davoud Khorasani Zavareh, Mohammad Asghari-Jafarabadi, Ali Imani, Mohammad Bagher Alizadeh Aghdam, Hossein Poustchi, Mahdi Rezaei, Mina Golestani","doi":"10.47176/mjiri.38.37","DOIUrl":"10.47176/mjiri.38.37","url":null,"abstract":"<p><strong>Background: </strong>Measuring socioeconomic status (SES) as an independent variable is challenging, especially in epidemiological and social studies. This issue is more critical in large-scale studies on the national level. The present study aimed to extensively evaluate the validity and reliability of the Iranian SES questionnaire.</p><p><strong>Methods: </strong>This psychometric, cross-sectional study was conducted on 3000 households, selected via random cluster sampling from various areas in East Azerbaijan province and Tehran, Iran. Moreover, 250 students from Tabriz University of Medical Sciences were selected as interviewers to collect data from 40 districts in Iran. The construct validity and internal consistency of the SES questionnaire were assessed using exploratory and confirmatory factor analyses and the Cronbach's alpha. Data analysis was performed in SPSS and AMOS.</p><p><strong>Results: </strong>The complete Iranian version of the SES questionnaire consists of 5 factors. The Cronbach's alpha was calculated to be 0.79, 0.94, 0.66, 0.69, and 0.48 for the occupation, self-evaluation of economic capacity, house and furniture, wealth, and health expenditure, respectively. In addition, the confirmatory factor analysis results indicated the data's compatibility with the 5-factor model (comparative fit index = 0.96; goodness of fit index = 0.95; incremental fit index = 0.96; root mean square error of approximation = 0.05).</p><p><strong>Conclusion: </strong>According to the results, the confirmed validity and reliability of the tool indicated that the Iranian version of the SES questionnaire could be utilized with the same structure on an extensive level and could be applicable for measuring the SES in a broader range of populations.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"37"},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Vitamin D and Zinc Levels in Children with Urinary Tract Infection without Confounding Factors: A Case-Control Study.","authors":"Mohsen Seifollahi, Marzieh Heidarzadeh Arani, Rozita Hoseini Shamsabadi, Shahrbanoo Nakhaie, Maesoumeh Karimi Aghche, Mohammad Javad Azadchehr, Amin Sadat Sharif","doi":"10.47176/mjiri.38.36","DOIUrl":"10.47176/mjiri.38.36","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) are extremely prevalent bacterial infections among children. They have numerous potential causes. Without proper diagnosis and treatment, UTIs can lead to serious complications in children, including impaired growth, high blood pressure, protein in urine, and eventual chronic kidney disease. Zinc and vitamin D in sufficient concentrations help to maintain the health of the immune system. Therefore, their deficiency can cause various infections. Several factors can contribute to the development of UTIs. This article deals with the role of zinc and vitamin D as immune markers in UTI in children without other risk factors.</p><p><strong>Methods: </strong>In this case-control study, serum zinc and vitamin D levels without any other risk factors were examined in 40 healthy children and 40 children with UTIs. Data analysis was done through SPSS 26 using the chi-square, the Fisher's exact, and independent t tests.</p><p><strong>Results: </strong>The study findings demonstrated a statistically significant distinction between the 2 groups regarding serum vitamin D and zinc levels (<i>P</i> < 0.001); 80% of children with UTIs and 17.5% in the healthy group had vitamin D deficiency. Also, 60% of the urinary infection group had zinc deficiency, whereas 17.5% of the healthy group had it.</p><p><strong>Conclusion: </strong>Low serum zinc and vitamin D levels may increase susceptibility to pediatric UTI. Given the data, supplementation with zinc and vitamin D could play a significant role in treating active infections and preventing recurrence in susceptible children.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"36"},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrocardiogram Abnormality in Poisoned Patients with Tricyclic Antidepressant.","authors":"Mansoureh Javadipour, Elham Keshtzar, Parivash Parvasi, Seyed Farzad Hosseini, Ali Hassan Rahmani","doi":"10.47176/mjiri.38.35","DOIUrl":"10.47176/mjiri.38.35","url":null,"abstract":"<p><strong>Background: </strong>A wide variety of electrocardiogram (ECG) changes can manifest with antidepressant drugs, occurring at both therapeutic doses and toxic levels. Notably, ECG abnormalities like wide QRS and QT prolongation may be observed in poisoned patients with tricyclic antidepressants (TCAs), indicating severe conditions that necessitate the implementation of cardiac monitoring systems. This study aimed to investigate ECG Abnormality in poisoned patients with tricyclic antidepressants.</p><p><strong>Methods: </strong>This retrospective patient record study was conducted at Razi Hospital in Ahvaz, Iran, from 2006 to 2009. Patient information was extracted from hospital medical records after the established protocol. The chi-square test was employed for initial analysis; subsequently, logistic regression was applied to identify risk factors associated with abnormal ECG findings. We analyzed the data using SPSS (Version 19; IBM) statistical software. <i>P</i> < 0.05 was defined as statistically significant.</p><p><strong>Results: </strong>Among the 210 poisoned patients, comprising 88 men (41.9%) and 122 women (58.1%), the majority fell within the age range of 15 to 25 years. In our study, the most commonly ingested drugs by poisoned patients were amitriptyline in 134 patients (63.8%) and nortriptyline in 42 patients (20%). A significant portion of 137 patients (65.2%) exhibited poisoning symptoms within ˂ 6 hours, while 73 patients (34.8%) showed symptoms between 6 and 24 hours. Our findings indicated that the initial symptoms in poisoned patients included a decreased level of consciousness in 168 patients (80%), nausea and vomiting in 20 patients (9.5%), and various other symptoms. Notably, our results revealed ECG changes in 70 patients, with 32 patients (15.2%) showing a QRS widening (> 0.1sec), 5 patients (2.4%) displaying a tall R wave in aVR, 5 patients (2.4%) exhibiting right axis deviation, and other observed changes.</p><p><strong>Conclusion: </strong>QRS widening in poisoned patients with tricyclic antidepressants is more frequently observed in symptomatic patients, highlighting the importance of ECG screening in these patients.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"35"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}