Medical Journal of the Islamic Republic of Iran最新文献

{"title":"Aortic Calcification in Patients with Nephrolithiasis: A Cross-Sectional Case-Control Study.","authors":"Amir Reza Abedi, Saeed Montazeri, Morteza Sanei Taheri, Seyyed Ali Hojjati, Morteza Fallah-Karkan, Reza Soleimani, Amir Alinejad Khorram","doi":"10.47176/mjiri.38.115","DOIUrl":"https://doi.org/10.47176/mjiri.38.115","url":null,"abstract":"<p><strong>Background: </strong>Nephrolithiasis is a common condition that has been linked to various systemic diseases. Recent studies have suggested that young patients with nephrolithiasis are at increased risk of developing premature atherosclerosis. This study aims to investigate the relationship between nephrolithiasis and systemic disease by examining the association between aortic calcification and the severity of kidney stone disease.</p><p><strong>Methods: </strong>This study employed a matched case-control design involving 144 patients with kidney stones and 144 non-stone formers. All participants underwent non-contrast abdominal and pelvic CT scans. The Agatston score was used to quantify the severity of aortic calcification. The data were analyzed and compared between the two groups. Quantitative data were analyzed using Pearson's chi-square test. Non-parametric data were analyzed using the Mann-Whitney test.</p><p><strong>Results: </strong>The Agatston score was measured in both case and control groups, with mean values of 316±734 and 231±706, respectively. However, the difference between the two groups was not statistically significant (<i>P</i> = 0.122). Notably, a significant correlation was observed between Agatston score and stone size (<i>P</i> = 0.014). The value of the correlation coefficient is 0.23, which shows the increase in severity of aortic calcification with increasing stone size. A comparison of the Agatston score between male kidney stone formers patients aged 45 years or younger and controls revealed a statistically significant difference, with a p-value of 0.049, indicating more pronounced aortic calcification in the patient group.</p><p><strong>Conclusion: </strong>These results suggest that there may be a shared pathophysiological mechanism underlying both nephrolithiasis and atherosclerosis.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"115"},"PeriodicalIF":0.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950937","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":"Association of Obesity, Sarcopenia, and Functional Mobility with Risk of Fall: A Cross-Sectional Study from Ardakan Cohort Study on Aging (ACSA).","authors":"Ahmad Delbari, Amirali Azimi, Azin Pakmehr, Mohammad Saatchi, Mohammad Bidkhori, Fatemeh-Sadat Tabatabaei, Vahid Rashedi, Elham Hooshmand","doi":"10.47176/mjiri.38.114","DOIUrl":"https://doi.org/10.47176/mjiri.38.114","url":null,"abstract":"<p><strong>Background: </strong>Falls are considered one of the leading causes of accidental deaths and nonfatal accidental injuries in older adults. Previous research indicates a 1-in-5 yearly fall incidence among Iranian older adults. To examine specific risk factors within this population, our study aimed to evaluate fall risk factors such as obesity, sarcopenia, functional mobility, and activities of daily living (ADL) scores.</p><p><strong>Methods: </strong>This cross-sectional study used data from the first wave of the Ardakan Cohort Study on Aging (ACSA), involving participants ˃50 years who lived in Ardakan, Iran. The primary outcome was fall history in the past 12 months. The main biomechanical variables included body mass index (BMI), muscle strength, gait speed, static balance, and mobility-assisting devices. Sarcopenia was assessed based on the ratio of hand grip strength to BMI. Multiple logistic regressions assessed associations by odds ratio (OR) and 95% confidence interval.</p><p><strong>Results: </strong>The final analysis included 4983 participants, 994 of whom reported at least 1 fall. Participants had a mean age of 62.21 ± 4.47 years (50-86 years), with a 48% male distribution. The results of multivariable logistic regression indicated that obesity (OR, 1.02 [95% CI, 0.70- 1.47]; <i>P</i> = 0.910), waist-to-hip ratio (OR, 1.02 [95% CI, 0.74-1.40]; <i>P</i> = 0.903), hand grip strength (OR, 1.20 [95% CI, 0.87-1.66]; <i>P</i> = 0.255), and sarcopenia (OR, 1.11 [95% CI, 0.82- 1.51]; <i>P</i> = 0.474) did not have significant associations with falls. However, impaired standing balance test (OR: 1.64 [95% CI, 1.09-2.47]; <i>P</i> = 0.017) and dependency on ADL (OR, 1.94 [95% CI, 1.05-3.56]; <i>P</i> = 0.032) increased falling.</p><p><strong>Conclusion: </strong>Impaired balance tests and dependency on ADL increase the risk of falls in older adults. However, obesity indicators, sarcopenia, and gait speed were not associated with the risk of falls.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"114"},"PeriodicalIF":0.0,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950945","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 Effect of Balance-Based Interventions on Cognitive Functions of the Healthy and MCI Elderly: A Systematic Review and Meta-analysis.","authors":"Mahtab Azhdar, Alieh Daryabor, Pariya Parchini, Marzieh Pashmdarfard","doi":"10.47176/mjiri.38.112","DOIUrl":"https://doi.org/10.47176/mjiri.38.112","url":null,"abstract":"<p><strong>Background: </strong>Aging is an inseparable part of life, accompanied by mild to severe cognitive disorders. This study aimed to investigate the influence of balance-based interventions on cognitive function in older adults, encompassing both healthy individuals and those with mild cognitive impairment (MCI).</p><p><strong>Methods: </strong>A systematic review was conducted by searching multiple databases up to April 2023, and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist was followed for reporting. Sixteen studies, comprising 1148 participants aged 43 to 89 years, were analyzed. Balance exercises were administered 1 to 3 times per week, lasting 30 to 60 minutes per session. Methodological quality was assessed using the Downs and Black checklist. A meta-analysis was conducted for executive functions (Stroop Test) and complex attention (Trail-Making Test, TMT A&B), while other outcomes underwent qualitative analysis.</p><p><strong>Results: </strong>Qualitative analysis revealed positive effects on specific executive functions and complex attention aspects. However, the meta-analysis did not show significant differences in scores between balance training and control groups, which included healthy adults receiving nonbalance interventions or no intervention.</p><p><strong>Conclusion: </strong>Limited research and methodological constraints hinder conclusive findings on balance-based interventions for older adults' cognitive functions. Yet, these interventions show the potential to enhance executive function and complex attention, emphasizing the need for further research in disability and rehabilitation.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"112"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950931","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 the Efficacy of Triamcinolone Acetonide Versus Bleomycin in Hypertrophic Scars in Burn Patients: A Clinical Trial.","authors":"Siamak Farokh Forghani, Behnam Sobouti, Ardavan Shahbazi, Yaser Ghavami, Parinaz Ghanooni, Reza Vaghardoost","doi":"10.47176/mjiri.38.111","DOIUrl":"https://doi.org/10.47176/mjiri.38.111","url":null,"abstract":"<p><strong>Background: </strong>Treatment of hypertrophic burn scars is challenging. Intralesional injection of corticosteroids has been the first line of treatment. Triamcinolone Acetonide (TA) and Bleomycin (BLE) are standard therapeutic options. We conducted a comparative study to measure the effects of BLE and TA on hypertrophic burn scars.</p><p><strong>Methods: </strong>In this clinical trial, we enrolled 25 patients with hypertrophic burn scars in this study. In each patient, two adjacent affected areas on the body were randomly selected for intralesional injection of TA and BLE. The size of the burn scars was between 10 and 40 cm2 (square centimeter). The injections were repeated at intervals of four weeks for three periods. Follow-up of patients continued until the end of the fourth month of treatment. We used the Vancouver Scar Scale and Patient and Observer Scar Assessment Scale system to compare the recovery of each lesion. Means, standard deviation, and p-values comparing the treatment of lesions with BLE and TA using two different scales were reported. Independent samples t-test and paired sample t-test were used to find out a statistically significant difference between BLE and TA treated lesions.</p><p><strong>Results: </strong>The results showed that the hypertrophic scar scores in BLE and TA lesions were statistically significant from the perspective of patients and physicians (<i>P</i> = 0.035). The mean score of hypertrophic scars in the BLE and TA groups was also statistically significant (<i>P</i> = 0.023). The proportion of individuals who had no side effects after taking BLE and TA was much higher than those who experienced skin pain or hypopigmentation.</p><p><strong>Conclusion: </strong>Intralesional BLE injection is more effective than TA in treating hypertrophic scars. Further studies with larger sample sizes are needed to approve these results.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"111"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950951","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":"Features of Physical and Psychomotor Development in Children with Brain Ischemia.","authors":"Guldana O Shoibekova, Mira N Turbekova, Farida A Iskakova, Gulmira B Altynbayeva, Elmira Ospanova, Maulen S Malgazhdarov","doi":"10.47176/mjiri.38.110","DOIUrl":"https://doi.org/10.47176/mjiri.38.110","url":null,"abstract":"<p><strong>Background: </strong>Brain ischemia is one of the leading causes of morbidity and mortality in infants. Currently, many factors influence the degree of development of ischemia and the consequences affecting the child's body. The purpose of this study was to find the characteristics of the physical and psychomotor development of children with brain ischemia.</p><p><strong>Methods: </strong>Based on empirical data, physical (centile tables were used) and psychomotor development (Griffiths scale was used) were studied in 246 full-term children who suffered mild and moderate brain ischemia (ICD-10 codes: 91.1-91.4). There was a frequency of physical disharmony and psychomotor dysfunction, association with each other and the modeling of prognostic characteristics. The following methods were used for the analysis: Pearson chi-square calculation, Kaplan-Meier method and logistic regression.</p><p><strong>Results: </strong>The prevalence of physical disharmony in the studied population of children who had cerebral ischemia is 19.5%, and that of psychomotor dysfunction is 35.0%. The results of the analysis indicate the presence of an association between physical development and psychomotor development of children with cerebral ischemia (<i>P</i> ≤ 0.001; %95 CI OR 1.961-7.270). The disharmony of physical development in children with cerebral ischemia is higher in female children (OR = 2.061, CI = 1.002-4.236), and it grows with an increase in the childbearing age of the mother (OR = 1.090, 95% CI = 1.018-4.236) and decreases with a decrease in the birth weight of the child (OR = 0.189, 95% CI = 0.104-0.345). The probability of occurrence of psychomotor dysfunction is higher in children whose mothers had a complicated birth (OR = 2.065, 95% CI = 1.209-3.527).</p><p><strong>Conclusion: </strong>In children who have suffered brain ischemia, 1/5 of cases develop physical disharmony, and 1/3 of cases develop psychomotor dysfunction. These long-term consequences studied are interrelated with such prognostic characteristics as childbearing age and complicated childbirth in the mother, as well as the sex and weight of the child. The incidence of a combination of physical disharmony and psychomotor dysfunction in children who have suffered cerebral ischemia is 11.8%.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"110"},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950889","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 Association of Neutrophil to Lymphocyte Ratio and Other Complete Blood Count Parameters with Global Registry of Acute Coronary Events Risk Score in Patients with Non-ST Segment Elevation - Acute Coronary Syndrome: A Single-Center Study.","authors":"Ali Safaa Abduljabbar, Muataz Fawzi Hussein","doi":"10.47176/mjiri.38.109","DOIUrl":"https://doi.org/10.47176/mjiri.38.109","url":null,"abstract":"<p><strong>Background: </strong>The involvement of inflammation in the start and advancement of atherosclerotic plaques in acute coronary syndrome has been clarified. White blood cell count and its differential are key inflammatory markers in cardiovascular disease, with the neutrophil-to-lymphocyte ratio (NLR) emerging as a marker of inflammation and a predictor of mortality in patients with acute coronary syndrome. The study aims to investigate the utility of neutrophil to lymphocyte ratio and other complete blood count parameters as a risk stratification tool and independent predictor of Global Registry for Acute Coronary Events (GRACE) risk score in Non-ST segment elevation acute coronary syndrome (NSTE-ACS).</p><p><strong>Methods: </strong>This was a cross-sectional retrospective single-center study conducted in Baghdad Teaching Hospital. A total of 110 patients diagnosed with NSTE-ACS were enrolled in this study. Demographic data and components that determine the GRACE risk score were recorded at admission to the emergency department alongside risk factors for coronary artery disease. Venous blood for relevant laboratory analysis was obtained from all patients. Patients were categorized into three risk groups according to the GRACE risk score. The study results were statistically analyzed using the one-way Analysis of Variance (ANOVA) test and the Kruskal Wallis test. Spearman test and multiple linear regression analysis were used for correlation and identification of independent predictors respectively.</p><p><strong>Results: </strong>The mean age of patients was 59.4 years with a standard deviation of 21.1 years. The majority of them were males (61.8%). The predominant portion (102) had non-ST elevation myocardial infarction (NSTEMI). The mean total white blood cell count, absolute neutrophil count, absolute lymphocyte count, and neutrophil to lymphocyte ratio of the patients were 11.1 ×103/ml, 8.7 ×103/ml, 1.7 ×103/ml, and 5.9 respectively. The mean admission left ventricle ejection fraction (LV EF) of the patients was 52.5 % with a standard deviation of 9.6 %. There is a significant positive correlation between NLR and GRACE risk score (r = 0.339, <i>P</i> < 0.001) and a statistically significant negative correlation between NLR and LV EF (r = -0.385, <i>P</i> = 0.005).</p><p><strong>Conclusion: </strong>This study showed a statistically significant association and positive correlation between neutrophil-to-lymphocyte ratio (NLR) and Global Registry of Acute Coronary Events (GRACE) risk score, so neutrophil-to-lymphocyte ratio (NLR) is a valuable marker for risk stratification and prognosis in NSTE-ACS patients, serving as an independent predictor of the GRACE risk score.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"109"},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950928","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":"Colorectal Cancer and Its Microenvironment: A Brief Review.","authors":"Nauryzbay M Imanbayev, Arip K Koyshybaev, Nurgul M Kereyeva, Marzhan A Aitmagambetova, Azamat B Zharylgapov","doi":"10.47176/mjiri.38.108","DOIUrl":"https://doi.org/10.47176/mjiri.38.108","url":null,"abstract":"<p><strong>Background: </strong>The narrative review aims to explore CRC pathogenesis by deciphering genetic-environmental interactions, analyzing the tumor microenvironment's role, and assessing treatment responses. These objectives seek to enhance clinical decision-making and improve CRC patient care through a comprehensive understanding of the disease.</p><p><strong>Methods: </strong>A narrative review from 2019 to 2024 on colorectal cancer (CRC) pathogenesis and treatment strategies was conducted. Systematic literature searches were performed on PubMed, using CRC-related keywords (\"Colorectal Neoplasms\"[Mesh]) AND \"Tumor Microenvironment\"[Mesh]. Screening yielded 233 eligible studies, with 14 highly relevant ones included. PRISMA guidelines were followed for transparency and reproducibility.</p><p><strong>Results: </strong>This narrative review spanning 2019-2024 shows diverse study designs (5 clinical studies, 4 randomized controlled trials, 2 cohort studies, and 3 systematic literature reviews) with varied sample sizes (from 14 to 4000 participants). Genetic mutations like KRAS and BRAF are significant in colorectal cancer pathogenesis, with 8% exhibiting MMR proficiency. Immune cells and paracrine signaling are influential, and therapeutic responses vary, with limited efficacy reported in certain combinations.</p><p><strong>Conclusion: </strong>This narrative review highlights CRC's multifactorial nature and complex tumor dynamics. Integrating genetic, environmental, and immune factors, personalized therapies are pivotal for efficacy. Continued research is crucial for optimizing treatments and improving patient outcomes, emphasizing the need for multifaceted, patient-tailored approaches in CRC management.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"108"},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950948","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 Effects of Manual Therapy with TECAR Therapy, on Pain, Disability and Range of Motion in Women with Non-specific Chronic Neck Pain.","authors":"Atena Bameri, Marzieh Yassin, Reza Salehi, Soheil Mansour Sohani","doi":"10.47176/mjiri.38.107","DOIUrl":"https://doi.org/10.47176/mjiri.38.107","url":null,"abstract":"<p><strong>Background: </strong>This study was designed to compare the effectiveness of manual therapy alone and a combination of it and TECAR (Transfer Energy Capacitive and Resistive) therapies on the conditions of pain, disability, and neck range of motion (ROM) in patients with non-specific chronic neck pain (NCNP).</p><p><strong>Methods: </strong>In this Randomized controlled study, 30 women with non-specific chronic neck pain were randomly divided into two groups: Manual therapy along with TECAR therapy (intervention group) and single manual therapy (control group). The participants were homogenized in terms of age, height, and weight. Both groups received manual therapy for two weeks and a total of 8 sessions. Furthermore, self-stretching the scalene muscles, upper trapezius, and suboccipital muscles was taught to the participants. After the treatment ended, patients were followed up for two weeks. The primary outcomes in this study were pain and disability. The pain was measured with the VAS index, and disability was measured with two questionnaires, namely the neck disability index (NDI) and neck pain disability scale (NPDS). The secondary outcomes in this study were neck flexion and extension AROM measured with a goniometer. Pain was evaluated in four stages, including before the treatment onset, at the end of session 4, at the end of treatment and after a two-week follow-up, and other conditions were measured in three stages including before the treatment onset, at the end of treatment and after a two-week follow-up. The Repeated Measure ANOVA (2*3), the Wilcoxon test, and the Paired Student's t-test were used. The significance level was set at <i>P</i> ˂ 0.05.</p><p><strong>Results: </strong>The comparison of the two groups indicated that at the end of the treatment period and after the follow-up, the average pain level in the intervention group was lower than that of the control group. The effect size also revealed that the combination of manual and TECAR therapies acts effectively in pain reduction. Furthermore, the combinatorial treatment compared to the single manual therapy was preferable to improving the disability, while after the two-week follow-up period, no statistically significant difference was observed between the two groups. The comparison of neck flexion and extension AROM did not reveal any difference between the two groups. The intragroup comparison also revealed that both the control and intervention groups experienced a significant decrease in pain intensity and disability level and a significant increase in neck flexion and extension AROM after the end of treatment and after a two-week follow-up compared to before the treatment (<i>P</i>> 0.05).</p><p><strong>Conclusion: </strong>Based on the results of this study, TECAR seems to be able to increase the effectiveness of manual treatments as a thermal modality.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"107"},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142951223","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":"Cost Effectiveness Analysis Rivaroxaban Plus Aspirin versus Aspirin alone in Treatment Cardiovascular Diseases: A Systematic Review.","authors":"Asma Rashki Kemmak, Leila Etemad, Atoosa Haghighizadeh, Nadia Saniee, Omid Rajabi","doi":"10.47176/mjiri.38.106","DOIUrl":"https://doi.org/10.47176/mjiri.38.106","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases (CVDs) are one of the chronic diseases and the leading cause of death worldwide. More people die from CVDs worldwide than from any other cause each year. The effects of CVDs are not limited to mortality and morbidity but also have important health and economic outcomes.</p><p><strong>Methods: </strong>This was a systematic review that evaluated the economic evaluation of rivaroxaban plus aspirin compared with aspirin alone for the treatment of CVDs. The present study reviewed articles that performed a complete economic evaluation, including cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis related to the economic evaluation of rivaroxaban compared to enoxaparin for knee replacement patients during the years 2007 and 2023. In order to find relevant studies, databases including Pubmed, Web of Science, Embase, Scopus, Economic Evaluations Database, and Proquest were searched. Inclusion criteria included Studies that carried out a complete economic evaluation including cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis in relation to the economic evaluation of rivaroxaban plus aspirin compared to aspirin alone for CVD patients, economic evaluation studies carried out using decision analysis models based on the economic evaluation approach, full-text studies, English studies, and were studies published between 2007 and 2023. Exclusion criteria also included partial economic evaluation (such as effectiveness evaluation, cost evaluation, and quality of life evaluation), studies of low methodological quality based on the CHEERS checklist, non-English studies and all protocols, conference abstracts, and letters-to-the-editor.</p><p><strong>Results: </strong>After searching various databases, all retrieved articles were entered into EndNote software, and duplicates were removed. The remaining studies were reviewed independently by two relevant researchers. At this stage, preferred reporting items for systematic reviews (PRISMA) were used to retrieve the final articles. Out of 1048 studies, nine studies met the inclusion criteria. The economic evaluation studies included in the present study were conducted between 2018 and 2023. Cost-effectiveness analysis (CEA) was used in all studies.</p><p><strong>Conclusion: </strong>The findings of the present study showed that rivaroxaban plus aspirin is more cost-effective than aspirin alone in the patient with CVDs, But to generalize the results to other countries of the world, more studies are needed.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"106"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950954","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 Impact of Empagliflozin on Inflammatory Markers in Adults with Type 2 Diabetes: A Retrospective Cohort.","authors":"Hossein Samadanifard, Zahra Barati, Amir Hossein Ghanooni, Delaram Eskandari, Amir Ziaee, Haleh Chehrehgosha, Fatemeh Sarv, Shadi Zahraei","doi":"10.47176/mjiri.38.x","DOIUrl":"https://doi.org/10.47176/mjiri.38.x","url":null,"abstract":"<p><strong>Background: </strong>Inflammation plays a significant role in the development and progression of type 2 diabetes (T2D). Empagliflozin, an SGLT2 inhibitor, has shown some anti-inflammatory effects in patients with T2D. This study aimed to evaluate the impact of empagliflozin on some inflammatory markers in T2D.</p><p><strong>Methods: </strong>This retrospective single-arm cohort study included 40 patients with T2D who were treated with empagliflozin. Inflammatory markers such as serum level of erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and serum albumin were evaluated at baseline and 12 weeks after empagliflozin treatment. Statistical analysis used paired samples t test, and the statistically significant level was considered <i>P</i> < 0.05.</p><p><strong>Results: </strong>After 12 weeks, a significant reduction was found in ESR (17.75 ± 15.7 mm/hr to 14.72 ± 10.93 mm/hr; <i>P</i> = 0.025). However, the decrease in hs-CRP did not reach significance (<i>P</i> = 0.936). NLR did not show a significant reduction (<i>P</i> = 0.962), but there was a trend toward a significant decrease in PLR (107 ± 33 to 100 ± 35; <i>P</i> = 0.053). The neutrophil count did not change significantly (<i>P</i> = 0.247), but the lymphocyte count significantly increased (2.43 ± 7.85 to 2.57 ± 7.45 109/l; <i>P</i> = 0.014). Serum albumin showed a significant increase (42.8 ± 3.4 to 45.6 ± 3.2 g/l; <i>P</i> < 0.001), indicating a decrease in inflammation.</p><p><strong>Conclusion: </strong>Empagliflozin showed anti-inflammatory effects by reducing ESR and PLR and increasing serum albumin and lymphocyte count in adults with T2D. Monitoring inflammatory markers can serve as an indicator of treatment effectiveness in T2D patients.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"38 ","pages":"x"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142951227","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}