Medical Journal of the Islamic Republic of Iran最新文献

{"title":"Validation of Kazakh and Russian Generic Drug Questionnaire.","authors":"Zhandulla Nakipov, Ulugbek Musaev, Indira Smagylova, Karlygash Raissova, Zhanar Bukeyeva, Assiya K Turgambayeva, Gaukhar Dauletova, Zakira Kerimbayeva, Dinara Kaliyeva, Nabil Joseph Awadalla","doi":"10.47176/mjiri.39.101","DOIUrl":"10.47176/mjiri.39.101","url":null,"abstract":"<p><strong>Background: </strong>The widespread use of generic drugs (GDs) represents a key strategy for reducing medication costs for patients and the healthcare sector. Promoting the rational use of GDs requires a clear understanding of physicians' knowledge and attitudes, assessed through reliable and culturally validated instruments. This study aimed to adapt and validate the Kazakh and Russian versions of a standardized questionnaire designed to evaluate physicians' knowledge and attitudes toward GDs. The validated tool is intended to support future research, educational programs, and policy efforts aimed at enhancing the rational prescription and utilization of GD in the Republic of Kazakhstan.</p><p><strong>Methods: </strong>The questionnaire underwent a standardized forward-backward translation process in accordance with internationally accepted guidelines for cross-cultural adaptation of survey instruments. A pilot study was subsequently conducted among physicians in Shymkent, Republic of Kazakhstan, to evaluate its clarity and applicability in real-world conditions. To examine the psychometric properties of the Kazakh and Russian versions, Confirmatory Factor Analysis (CFA) was carried out using the Structural Equation Modeling (SEM) module in Jamovi software. In addition, descriptive statistics, standardized factor loadings, factor covariances, and model fit indices were calculated to assess the validity and internal structure of the instrument.</p><p><strong>Results: </strong>Confirmatory Factor Analysis (CFA) supported the hypothesized two-factor model comprising the latent constructs \"Information\" and \"Attitude\" in both the Kazakh and Russian versions of the questionnaire. The majority of items demonstrated statistically significant standardized factor loadings, with several exceeding the recommended threshold of 0.70, indicating strong associations with their respective latent variables. The estimated correlation between the two factors was moderate in the Kazakh version (r = 0.599) and strong in the Russian version (r = 0.780), suggesting a meaningful conceptual relationship between physicians' knowledge and attitudes toward generic drugs.</p><p><strong>Conclusion: </strong>The psychometric evaluation confirmed that the questionnaire has an adequate internal structure, with most items showing significant factor loadings and acceptable model fit. These findings support its use as a reliable tool for assessing physicians' awareness and attitudes toward generic medicines in Kazakhstan.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"101"},"PeriodicalIF":0.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292805","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":"Evaluation of Advanced Endoscopic Stents for Pancreatic Pseudocyst Drainage: A 2-Year Study.","authors":"Esmaeil Hamzehnava, Farhad Zamani, Hossein Ajdarkosh, Mahmoodreza Khoonsari, Amirhossein Faraji, Elham Sobhrakhshankhah, Masoumeh Nejatifar, Shahaboddin Dolatkhah, Mohadese Sedighi Pashaki, Fahimeh Safarnezhad Tameshkel, Roghayeh Sahraie, Mehdi Nikkhah","doi":"10.47176/mjiri.39.100","DOIUrl":"10.47176/mjiri.39.100","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic ultrasound (EUS)-guided drainage using lumen-apposing metal stents (LAMS) is the first line choice for treatment of pancreatic fluid collections (PFCs). This study evaluated the technical success, clinical success, and adverse events (AE) associated with the Hot AXIOS electrocautery-enhanced LAMS for pancreatic pseudocysts (PPs).</p><p><strong>Methods: </strong>This retrospective cohort study included 45 patients with PPs undergoing Hot AXIOS stent placement between 2019 and 2021. Clinical and technical success were assessed. AEs were graded based on severity and timing. Survival analysis and the Kaplan-Meier curve were used in the study.</p><p><strong>Results: </strong>Technical success was achieved in 97.78% (44/45) cases and clinical success in 95.56% (43/45). Patients with a previous history of PP intervention were significantly more likely to experience moderate to severe AE (<i>P</i> = 0.009). Removal time of stent was significantly longer in patients with moderate or severe AE (median 70 vs 34.5 days, <i>P</i> = 0.005). Transition of PP to walled-off necrosis was associated with moderate or severe AE in comparison with mild or no AE (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Hot AXIOS stents demonstrated high clinical and technical success rates for PP drainage. Patients with a history of prior interventions for PPs were at significantly higher risk of AE. Closer monitoring is recommended in patients with delayed removal. Future studies should incorporate a multicenter design and control groups with standardized success rates and AE definitions.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"100"},"PeriodicalIF":0.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292732","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":"Managing the Psychosocial Aftermath of the Rajaee Port Blast in Southern Iran: Quick Emergency Response in the First Month After the Blast.","authors":"Hadi Zarafshan, Hamid Reza Fathi, Bita Seddigh, Alireza Raeisi, Ali Bahramnejad, Yahya Mirzadeh, Ali Asadi, Mohammad Reza Ghaffarzadeh Razzaghi, Mohammadreza Shalbafan","doi":"10.47176/mjiri.39.99","DOIUrl":"10.47176/mjiri.39.99","url":null,"abstract":"","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"99"},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292800","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":"Effectiveness of Transcranial Direct Current Stimulation on Cognitive Function: A Pilot Study.","authors":"Mehrnaz Afsharipoor, Mahnaz Hejazi-Shirmard, Minoo Kalantari, Alireza Akbarzade Baghban","doi":"10.47176/mjiri.39.98","DOIUrl":"10.47176/mjiri.39.98","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment, which is one of the debilitating consequences of traumatic brain injury (TBI), leads to long-term adverse outcomes that disrupt an individual's participation in daily activities. This study aimed to investigate the effects of combining occupational therapy with transcranial direct current stimulation (tDCS)-a non-invasive and safe electrical method for targeting specific areas of the brain-on the cognitive function of individuals with TBI.</p><p><strong>Methods: </strong>This semi-experimental study utilized convenience sampling, resulting in the inclusion of 24 patients with moderate to severe TBI. We then randomly assigned them to one of two groups: an experimental group (n = 12) or a control group (n = 12). Both groups underwent 10 sessions of daily occupational therapy, but the experimental group also received 20 minutes of tDCS during their occupational therapy sessions. Cognitive functions, such as working memory, divided attention, problem solving, and planning, were assessed using computer-based versions of the Wisconsin Card Sorting Test (WCST), Tower of London, N-back, and Stroop tests at the baseline and the day after the intervention's conclusion. To implement the data analysis phase, we used SPSS Version 27. Depending on the normality of data distribution, either independent samples t-tests or Mann-Whitney U tests were used to compare the outcomes between the experimental and control groups.</p><p><strong>Results: </strong>After the 10-session intervention, executive functions improved in both groups (<i>P</i> < 0.05). When comparing the groups, the experimental group demonstrated significant improvements in working memory (<i>P</i> = 0.002), planning (<i>P</i> = 0.002), and problem-solving (<i>P</i> = 0.001); however, no significant difference was observed in selective attention (<i>P</i> = 0.310).</p><p><strong>Conclusion: </strong>The findings suggest that employing tDCS techniques plays a pivotal role in enhancing specific executive functions, such as working memory, problem-solving, and planning, in patients with traumatic brain injuries. tDCS can be considered a complementary treatment option in the rehabilitation of TBI patients.According to the findings, the use of tDCS can improve executive functions, including working memory, problem-solving, and planning, in TBI patients. As a complementary treatment, tDCS can be utilized in the rehabilitation of TBI patients.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"98"},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292738","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":"Development of the Pediatric Emergency Medicine Subspecialty in Iran.","authors":"Shabahang Jafarnejad, Somayeh Esmaeilian, Parsa Ghabousi, Hamidreza Khoshnezhad Ebrahimi","doi":"10.47176/mjiri.39.97","DOIUrl":"10.47176/mjiri.39.97","url":null,"abstract":"<p><p>Pediatric emergency medicine (PEM) emerged as a subspecialty of both emergency medicine and pediatrics to address the specific needs of children requiring urgent care. Originating in the United States (US) in the late 20th century, PEM was formally recognized following collaborative efforts by pediatricians, notably Dr. Foster Jerry, and the establishment of fellowships and certification boards. Since its inception, the subspecialty has significantly advanced pediatric emergency services, with over 29 fellowship programs active in the US by 2021. In Iran, the need for specialized pediatric emergency care led to the first formal request to develop PEM in 2021. Following approval from the Medical Education and Specialization Council and endorsement, Iran University of Medical Sciences initiated the implementation of this vital subspecialty. This article explores the global and national development of PEM and outlines the rationale, progress, and institutional efforts toward its establishment in Iran.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"97"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292760","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":"Impact of COVID-19 Pneumonia on Chest Computed Tomography Scan and Spirometry During Six Months.","authors":"Mahdi Yadollahzadeh, Manizhe Ataee Kachuee, Neda Rahimian, Nahid Hashemi-Madani, Rana Shahabi, Seyed Ali Javad Mousavi, Mojtaba Malek","doi":"10.47176/mjiri.39.96","DOIUrl":"10.47176/mjiri.39.96","url":null,"abstract":"<p><strong>Background: </strong>Approximately a third of patients with SARS-CoV-2 have shown changes in respiratory function, impaired diffusion capacity for carbon monoxide, and persistent lung damage, one year after discharge. In severe COVID-19, patients may have a restrictive or obstructive defect in spirometry during and after recovery. One hypothesis is that respiratory symptoms in survivors might be attributable to pulmonary fibrosis. In this context, we evaluate spirometry and chest computed tomography (CT), 3 and 6 months after discharge, to further investigate the improvement of respiratory function in discharged patients with COVID-19.</p><p><strong>Methods: </strong>This cohort study was conducted on 260 Iranian COVID-19 patients with a COVID-19 PCR-positive pneumonia. A chest CT scan was done at admission and 6 months after discharge. Also, a spirometry test was done 3 and 6 months after discharge. We used the Chi-Square test, t-test, Pearson's coefficient, and linear regression multivariate analysis by SPSS version 26.0 to analyze the data.</p><p><strong>Results: </strong>We identified that the most common chest CT scan abnormalities at presentation were ground glass opacities (GGO) (206 (79.23%)) and consolidation (183 (70.4%)). However, these sequelae were improved retrospectively 6 months after discharge to 17 (6.53%) and 16 (6.2%). The present study revealed abnormal spirometry in 81 (30.8%) cases in the 3rd month and 61 (23.9%) cases in the 6th month after acute COVID-19 pneumonia. There was a negative correlation between GGO score and spirometry parameters in both follow-ups (<i>P</i> values were < 0.016).</p><p><strong>Conclusion: </strong>In summary, our study indicated that abnormal spirometry in the post-COVID-19 recovery phase is associated with a higher risk of long-term parenchymal lung disease, characterized by fibrotic-like changes in chest CT scans and smoking status, hypertension, and chronic kidney disease.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"96"},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292759","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 Study Protocol for the Macro-analysis of Iran's Health System with System Dynamics Approach.","authors":"Mozhgan Emami, AliAkbar Haghdoost, Vahid Yazdi-Feyzabadi, Esmaeil Khedmati Morasae, Mohammad Hossein Mehrolhassani","doi":"10.47176/mjiri.39.95","DOIUrl":"10.47176/mjiri.39.95","url":null,"abstract":"<p><strong>Background: </strong>The health system (HS) is characterized by its complexity and the interconnectivity of its various components, which can lead to unpredictable outcomes when faced with changes in the environment. Understanding these interactions is crucial for effective management and improvement of the system. To navigate this complexity, this study emphasizes the importance of adopting a real-world perspective and utilizing system modeling techniques. These approaches allow for a thorough analysis of the current state of the HS and enable the testing of different policy alternatives to identify potential improvements. Ultimately, the aim of the research is to pinpoint the key components and drivers within the HS. By modeling the dynamics of these elements, the study aims to provide insights that can inform better decision-making and enhance the overall effectiveness of health care delivery.</p><p><strong>Methods: </strong>We designed a mixed methods study in 4 phases, consisting of sequential quantitative and qualitative analyses. In the first phase, to create a comprehensive and holistic view, we will identify key variables and indicators in the HS within the framework of the Balanced Scorecard framework (BSC), which includes population & population health; service delivery; financing; growth & development; and governance & leadership, through a review of documents and a scoping review. In the second and third phases of the study, using a foresight and systemic approach, expert opinions will be purposefully gathered through cross-impact analysis (CIA) and scenario writing to identify key drivers and levers of Iran's HS and obtain compatible future scenarios. Finally, in the quantitative phase of the study, based on the outputs of the previous phases, a dynamic model of the HS will be designed in the Vensim software, and the current situation along with other possible scenarios for the system will be examined for a period of 10 years.</p><p><strong>Conclusion: </strong>It is anticipated that the results of this study could offer a methodological foundation for formulating the health component of the Islamic Republic of Iran's economic, social, and cultural development plan, intended for use by the Ministry of Health, Treatment, and Medical Education.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"95"},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292567","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":"Long Segment Midaortic Stenosis in Williams Syndrome: Report of a Very Rare Presentation.","authors":"Hamzeh Al-Momani, Yazan Al-Mashakbeh, Majd Zidan, Yasmeen Jum'ah","doi":"10.47176/mjiri.39.94","DOIUrl":"10.47176/mjiri.39.94","url":null,"abstract":"<p><strong>Background: </strong>Midaortic syndrome (MAS) is a rare medical condition characterized by thoracoabdominal aortic stenosis or occlusion, resulting in decreased blood supply to the organs and tissues in the lower half of the body. We report a very rare presentation of MAS in a 14-year-old female that was found to have severe stenosis extending from the descending aorta to the level above the bifurcation.</p><p><strong>Case presentation: </strong>A 14-year-old female with Williams syndrome presented with complaints of headache and chest discomfort on mild exertion. Examination revealed dysmorphic features of William syndrome and different blood pressure between the upper and lower limbs with weak femoral pulses. An ECG showed sinus rhythm with left ventricular hypertrophy. 2-D color flow Doppler echocardiogram revealed mild central mitral regurgitation, minimal aortic regurgitation, and concentric left ventricular hypertrophy. CT angiogram revealed a hypoplastic descending thoracic aorta, an aberrant right subclavian artery, and an arterio-venous fistula communicating between the bronchial artery and the left brachiocephalic vein. The patient was started on two antihypertensive medications, and vascular surgery was consulted for possible future intervention.</p><p><strong>Conclusion: </strong>Management of midaortic syndrome necessitates a holistic approach customized to the specific patient's requirements and risk assessment. Early detection and intervention are critical in averting severe complications and enhancing long-term prognoses. Continuous investigation and advancement of novel therapies may present supplementary possibilities for addressing this complex and rare ailment.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"94"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292756","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":"Dietary Intakes of Omega-3, Omega-6 and Fiber and Risk of Rectal Cancer: A Case-Control Study.","authors":"Payam Hosseinzadeh, Ali Gholami, Mahdi Alemrajabi, Hasan Ghodsi, Yasamin Mohammadzade, Bahareh Amirkalali, Farhad Zamani","doi":"10.47176/mjiri.39.93","DOIUrl":"10.47176/mjiri.39.93","url":null,"abstract":"<p><strong>Background: </strong>Rectal cancer (RC) is one of the most commonly occurring cancers in Iran in recent years. Dietary intakes of Omega-3 (ω-3), Omega-6 (ω-6), and fiber have been thought to diminish the risk of RC. Therefore, this study was conducted to evaluate the association of dietary ω-3, ω-6, and fiber with the risk of RC.</p><p><strong>Methods: </strong>In this case-control study, dietary intakes of ω-3 and ω-6 were estimated using a 148-item food frequency questionnaire (FFQ) between 363 people (162 cases, 201 control) aged 20-80 years old. Cases were patients with RC, and controls were healthy people. Odds ratios (OR) and 95% confidence intervals (CI) were assessed using logistic regression models.</p><p><strong>Results: </strong>According to the multiple logistic regression model with the backward method, dietary fiber intake was inversely associated with RC as a protective factor (OR=0.3; 95%CI= 0.1-0.9; <i>P</i>=0.038). Also, it was observed that dietary ω-3 had an inverse borderline association with RC (OR= 0.5; 95%CI= 0.3-1.02; P=0.060), after adjusting for other studied variables. However, the association of ω-6 with RC was not statistically significant (OR=1.1; 95%CI= 0.7-1.8; <i>P</i>=0.730).</p><p><strong>Conclusion: </strong>Although no association between ω-3 and ω-6 intake was observed with the risk of RC, adequate daily intake of dietary fiber may protect us against RC risk.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"93"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292711","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 Role of Preemptive Perioperative Analgesia in Prevention of Chronic Phantom Pain: A Systematic Review and Meta-analysis.","authors":"Ramin Abrishami, Nima Azh, Mehri Farhang Ranjbar, Nogol Motamedgorji","doi":"10.47176/mjiri.39.92","DOIUrl":"10.47176/mjiri.39.92","url":null,"abstract":"<p><strong>Background: </strong>Phantom limb pain (PLP) is a debilitating condition leading to the experience of pain in a limb that has been amputated. Pharmacological interventions have been proposed to prevent chronic PLP. However, results of these interventions are still controversial. This systematic review and meta-analysis clarifies the effectiveness of preemptive pharmacological interventions in prevention of chronic phantom pain by evaluating incidence and intensity of PLP, residual limb pain (RLP), quality of life (QoL), depression, and anxiety.</p><p><strong>Methods: </strong>We systematically searched the PubMed, Embase, Scopus, Web of Science, and Cochrane Library databases for published randomized clinical trials with the outcomes of incidence and intensity for PLP, RLP, QoL, depression, and anxiety in amputation candidates due to any reason. We used the Risk of Bias tool (ROB2) to assess the quality of evidence. Relative risks and mean differences were calculated by a fixed-effects model, and sensitivity analysis was conducted post-hoc for risk of bias. We presented the results using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) tables.</p><p><strong>Results: </strong>Overall, 20 studies were found to address outcomes of interest at 6 months or longer. In 18 studies, intervention was planned for lower limb amputations. Peripheral vascular disease was the most studied cause for amputation. Intervention showed a mean reduction of 0.63 (0.10- 1.15) in 6-month intensity of PLP with low certainty of evidence. Evidence for Ketamine, Gabapentin, Valproic Acid, Calcitonin, Amide local anesthetics such as bupivacaine via epidural and perineural catheters did not support reduction in PLP.</p><p><strong>Conclusion: </strong>Imprecision due to small sample sizes, inadequate blinding, and publication bias downgraded the quality of evidence in this clinical scenario. Overall, preemptive perioperative pharmacological interventions do not seem to prevent phantom pain or stump pain compared with conventional perioperative pain control methods. Further robust studies are required for the effectiveness of Memantine in the prevention of chronic PLP.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"92"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292795","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}