Avicenna Journal of Medicine最新文献

{"title":"Clearing the Skepticism about Subclinical Hypothyroidism: Is It Beneficial to Treat Patients with Thyroid-Stimulating Hormone >4.5 and <10 mIU/L?","authors":"Hafsa Bushra, Murtaza Rashid","doi":"10.1055/s-0044-1788040","DOIUrl":"https://doi.org/10.1055/s-0044-1788040","url":null,"abstract":"Abstract Subclinical hypothyroidism (SCH) is a heterogeneous clinical condition ranging from asymptomatic to wide variety of clinical manifestations, which are often nonspecific. Being a common laboratory finding, clinicians often face the dilemma of whether to treat or not. Threshold of 10 mIU/L of thyroid-stimulating hormone (TSH) is often used as a cutoff limit to offer treatment. However, still, debate remains on whether to treat less than 10 mIU/L considering special clinical conditions like pregnancy. Whether SCH exists, is screening needed in asymptomatic individuals, is treating asymptomatic cases beneficial or harmful and what threshold level of TSH to be considered for treatment are all potential questions that need to be answered.","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680927","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":"Investigation of Correlation between Communication Skills and Self-Reported Elder Mistreatment in Family Abuse.","authors":"Sogra Zarei, Mohammad Esmaeilpour-Bandboni, Roya Mansour-Ghanaei, Iman Alizadeh","doi":"10.1055/s-0044-1787300","DOIUrl":"10.1055/s-0044-1787300","url":null,"abstract":"<p><p><b>Introduction</b>  In today's world, old age has become an important global phenomenon following the increase in life expectancy and the decrease in birth rates. Communication skills are an important requirement in old age. Changing role of the family and existing tensions, mental pressures, and modern life undermine the social position of the elderly and lead to abuse of the elderly by family members. The goal of the present study is to determine the relationship between communication skills and family self-reported domestic abuse among older adult in Iran. <b>Materials and Methods</b>  For this cross-sectional-analytical study, 153 elderly adult people admitted in hospitals of the Guilan province were randomly selected. The research instruments were the following questionnaires: demographic characteristics, abbreviated mental test (AMT), the Persian version of Domestic Elder Abuse Questionnaire, family mistreatment of the elderly (Heravy), and Queendom Communication Skill Test-Revise (QCSTR). The data were analyzed by SPSS software (version 22) using descriptive (frequency distribution tables, mean, and standard deviation [SD]) and analytical statistics (Mann-Whitney, Kruskal-Wallis, and Spearman's correlation tests) considering the significance level of 0.05. <b>Results</b>  A majority of the elderly were men (51%), were in the age group of 60 to 69 years (72.5%) and married (75.5%), did not hold high school diploma (88.8%), had four to five children (41.2%) with low income (75.9%), and suffered from chronic diseases (68.6%). The mean score of communication skills was 129.09 ± 12.60. The mean score of domestic elder abuse was 2.89 ± 3.97. Communication skills have a significant relationship with age and marital status, but not with sex, education level, income, and chronic disease. There is an inverse correlation between communication skills and domestic elder_abuse ( <i>p</i>  < 0.001, <i>r</i>  = -0.468). <b>Conclusion</b>  Communication skills are one of the influential factors of domestic violence. Therefore, to prevent or reduce the amount of violence, it is recommended that family members increase the communication skills of the elderly.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493716","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":"Burden of Chronic Hemodialysis on the Ability to Work: Time for Action.","authors":"Fayez AlHejaili, Muhammad N Hashmi, Abdulkareem Alsuwaida, Ghada A Ankawi, Shahad A ALMehaideb, Anas A Alsuwaida, Mohammed T AlZahrani, Ali E Shehadah, Hatem A AlNasser","doi":"10.1055/s-0044-1786869","DOIUrl":"10.1055/s-0044-1786869","url":null,"abstract":"<p><p><b>Background</b>  Understanding the factors that contribute to unemployment will help in the design of creative resolutions to enable hemodialysis patients to return to a productive life. <b>Methods</b>  We examined employment among 625 patients aged 18 to 60 years who were on hemodialysis in 8 dialysis units. <b>Results</b>  Overall employment was low among patients on chronic hemodialysis at 49.7%. Unemployment was significantly higher in women than in men (86.6% vs 17.1%, <i>p</i>  < 0.0001). The employment rate was 70.5% for those with no diabetes and hypertension, 29.5% for those with diabetes, and 25.9% for those with diabetes and hypertension. Furthermore, the results of the Cox regression showed that the variables of gender, level of education, capability of driving, and diabetes were related to employment of patients. <b>Conclusions</b>  The majority of patients on hemodialysis are unemployed or exit paid employment due to early retirement. Patients with diabetes and women are a vulnerable population with a higher unemployment rate.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493715","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":"Rheumatic Diseases Amidst Conflict in Northwest Syria: Unveiling Health Challenges and Implications","authors":"Wasim Zakaria, Yousef Ibrahim","doi":"10.1055/s-0044-1786826","DOIUrl":"https://doi.org/10.1055/s-0044-1786826","url":null,"abstract":"\u0000 Background The ongoing conflict in Syria has significantly affected the health care system, particularly in the realm of rheumatology. The purpose of this study is to assess the current state of rheumatic diseases in the northwestern region of Syria, where the health care infrastructure has been severely impacted.\u0000 Methods This was a retrospective study reviewing all patients with rheumatologic conditions seen in internal medicine clinics in northwest Syria between September 2019 and February 2022. Baseline demographic data and diagnoses were collected retrospectively, without any data duplication, from outpatient clinic records. The study also reviewed the availability of investigations and drugs in the northwestern region of Syria.\u0000 Results We analyzed data from 488 patients (average age: 37.4; 63% female) diagnosed with rheumatic diseases. The most prevalent condition was connective tissue disorders (25.6%), with osteoarthritis (12.1%) and rheumatoid arthritis (8.2%) following. The ongoing conflict has led to a significant shortage of rheumatologists, with only three serving a population of 5.5 million. Furthermore, the conflict has disrupted the provision and quality of rheumatology diagnostic tests, reducing patient accessibility. The dearth of medications and increased costs have compounded the complexity of health care for those with rheumatic diseases.\u0000 Conclusions This study highlights the urgent need for improved health care services and proposes solutions to address gaps in rheumatic care in northwest Syria.","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140969103","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":"Renal Cell Carcinoma Metastasizing to Oral Soft Tissues: Systematic Review","authors":"H. V. Prajapati, Ruchira Shreevats, Sonia Gupta, Harmanjit K. Sandhu, Jaskirat Kaur, Jasmine Kaur","doi":"10.1055/s-0044-1782202","DOIUrl":"https://doi.org/10.1055/s-0044-1782202","url":null,"abstract":"\u0000 Background Renal cancer metastasis to oral region is very rare. Studies have been published analyzing the cases of metastatic tumors to the oral cavity by many researchers. Very few research studies have been conducted till date to analyze the renal cancer metastasis as the sole primary source to the oral soft tissues. The goal of this study was to examine the published cases of oral soft tissue metastasis from renal cell carcinoma as the only primary source from 1911 to 2022.\u0000 Materials and Methods An electronic search of the published literature was performed without publication year limitation in PubMed/Medline, Scopus, Google Scholar, Web of Science, Science Direct, Embase, and Research Gate databases, using mesh keywords like (“Renal cancer,” or “Renal carcinoma” or “Renal cell cancer” or “Renal cell carcinoma”), and (“Metastasis” or “Metastases”), and (“Oral soft tissues” or “Tongue” or “Palate” or “Tonsil” or “Buccal mucosa” or “Salivary glands”). We also searched related journals manually and the reference lists.\u0000 Results Our research revealed a total of 226 relevant articles with 250 patients. Parotid glands and tongue were the most common sites of metastasis. 23% patients died with a survival time of 10 days to 4 years.\u0000 Conclusions Oral soft tissue metastasis from renal cell carcinoma has a bad prognosis. More cases need to be published in order to raise awareness of these lesions.","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141010459","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":"Bilateral Synchronous Testicular Cancer with Discordant Histopathology: A Case Report.","authors":"Mehmet Özen, İrem Yazıcıoğlu, Mustafa Koray Kırdağ, Mustafa Aydın","doi":"10.1055/s-0044-1786512","DOIUrl":"10.1055/s-0044-1786512","url":null,"abstract":"<p><p>Bilateral testicular tumors account for 1 to 5% of all testicular tumors. Most bilateral tumors are observed metachronously. Synchronous tumors usually present with the similar histological pattern. Bilateral synchronous testicular tumors with discordant pathology are extremely rare. Only 56 cases have been documented since Bidard first described synchronous testicular tumors with discordant pathology in 1853. To our best knowledge, this study will be the 57th case in the literature.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493714","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":"Prediction Pressure Ulcers in High Care Unit Patients: Evaluating Risk Factors and Predictive Scale Using a Prospective Cross-Sectional Study.","authors":"Anies Dewi Wirati Indraswari, Umi Aisyiyah, Kurniawan Kurniawan, Meircurius Dwi Condro Surboyo","doi":"10.1055/s-0043-1777420","DOIUrl":"https://doi.org/10.1055/s-0043-1777420","url":null,"abstract":"<p><p><b>Background</b>  The incidence of ulcer pressure in the high care unit (HCU) was relatively high and could be reliably predicted using tools such as the Norton and Jackson/Cubbin scales. However, other risk factors, such as age, gender, consciousness, systemic condition, duration of treatment, and use of restraint, may contribute to the occurrence of ulcer pressure. This study was conducted to analyze the relationship of various risk factors for pressure ulcers and prediction of ulcer pressure, using Norton and Jackson/Cubbin scale, to incident pressure ulcers in HCU patient. <b>Methods</b>  This study utilized a prospective cross-sectional study design to analyze various risk factors for ulcer pressure development in a patient admitted to the HCU, including age, gender, blood profile, consciousness, duration of treatment, and use of restraint. The Norton and Jackson/Cubbin scale was employed to predict pressure ulcers. The relationship between the risk factors and the prediction of pressure ulcer incidents was evaluated using multiple logistic binary regression analysis. <b>Result</b>  Both the Norton and Jackson/Cubbin scales predicted a lower risk of pressure ulcer development (60.98 and 99.02%, respectively). This prediction is consistent with the low incidence of pressure injuries found, which is only 4.39%. Furthermore, the relationship between the identified risk factor (gender, duration of treatment in HCU and use of restraint) and the prediction and incident of pressure ulcer was not significant ( <i>p</i>  > 0.05). Thus, it is suggested that these risk factors may not strong predictors of pressure ulcer development. <b>Conclusion</b>  This study's result indicated no significant relationship exists between possible identified risk factors and the development of pressure ulcers in HCU patients. However, the Norton and Jackson/Cubbin scales were reliable predictors of pressure ulcer occurrence, with both scales predicting a lower risk of pressure ulcer development.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855363","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":"Schmidt's Syndrome: An Uncommon Cause of Spontaneous Hypoglycemia.","authors":"George Sarin Zacharia, Anu Jacob, Binu Mary Bose","doi":"10.1055/s-0044-1779745","DOIUrl":"10.1055/s-0044-1779745","url":null,"abstract":"<p><p>Schmidt's syndrome, or autoimmune polyendocrine syndrome type 2 (APS-2), is an uncommon disorder characterized by the co-occurrence of autoimmune thyroiditis and adrenalitis. APS-2 is defined as a combination of Addison's disease, autoimmune thyroid disease, and/or type 1 diabetes mellitus. It is an autosomal dominantly inherited polygenic disorder with incomplete penetrance; the candidate genes include but are not limited to HLA-DR3, HLA-DR4, CTLA-4, PTPN22, and CD25-IL-2. Autoimmune thyroiditis, often Hashimoto's disease, results in hypothyroidism. Primary adrenal failure results in enhanced secretion of adrenocorticotrophic hormone melanocyte and co-secretion of melanocyte-stimulating hormone, contributing to hyperpigmentation. Mineralocorticoid deficiency results in salt wasting, fatigue and cramps, postural hypotension, and hyperkalemia. Cortisol, an insulin counter-regulatory hormone, plays a pivotal role in maintaining euglycemia; deficiency predisposes to the development of hypoglycemia. We here report a rare presentation of Schmidt's syndrome as hypoinsulinemic hypoglycemia in a middle-aged male patient. Management includes treatment of acute hypoglycemic episodes with glucose or glucagon, long-term glucocorticoids and mineralocorticoids for adrenal insufficiency, and thyroid hormone supplements for hypothyroidism. This case report and brief overview aim to contribute to the scientific understanding of Schmidt's syndrome/APS-2. Additionally, here we briefly outline the diagnostic challenges in hypoglycemia evaluation, including the utilization of Whipple's triad and the gold standard supervised 72-hour fast and evaluation for primary adrenal and thyroid insufficiencies.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493717","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":"Pancreatic Parenchymal Atrophy and Pancreatic Fat Accumulation Measured by Multidetector Computed Tomography as a Stable Marker of Chronic Progressive Type 2 Diabetes Mellitus-A Cross Sectional Observational Study.","authors":"Kshipra Devadiga, Khanak K Nandolia, Mahendra Singh, Pankaj Sharma, Udit Chauhan, Ravi Kant","doi":"10.1055/s-0044-1779667","DOIUrl":"https://doi.org/10.1055/s-0044-1779667","url":null,"abstract":"<p><p><b>Background</b>  The most crucial step in the management of type 2 diabetes is identifying its pathogenesis and progression. Fat accumulation in the pancreas and decreased parenchymal volume can influence pancreatic function due to insulin resistance or β-cell dysfunction. This study aims to find out the difference in pancreatic volume and fat content by using contrast-enhanced computed tomography (CECT) between normal subjects and patients with different durations of type 2 diabetes mellitus (T2DM). <b>Methods</b>  This was a cross-sectional study. Patients who underwent CECT abdomen for the evaluation of conditions other than pancreatic origin were included. The study group was divided into three subgroups according to the duration of diabetes as <5 years, 5 to 10 years, and >10 years. In total, 40 nondiabetic controls were included. Pancreatic fat volume and parenchymal volume were measured in cm ³ using CECT. Correlation between pancreatic parenchymal and fat volume with the duration of T2DM as well as with levels of hemoglobin A1c, random blood sugar, serum triglyceride, low-density lipoproteins, and high-density lipoproteins was done. <b>Results</b>  T2DM patients had significantly ( <i>p</i>  < 0.001) lower pancreatic parenchymal volume (mean value of 57.08 ± 8.26 cm ³ in diabetics and 72.23 ± 3.41 cm ³ in controls) and higher pancreatic fat volume (mean value of 3.08 ± 1.90 cm ³ in diabetics and 0.67 ± 0.27cm ³ in controls) as compared to nondiabetic controls. In patients with T2DM, as the duration of T2DM increased, pancreatic parenchymal volume decreased and pancreatic fat volume increased. <b>Conclusion</b>  Reduction in pancreatic volume and fat deposition may have a role in the onset and progression of diabetes. Determining the pancreatic volume and fat content would be useful for identifying high-risk patients and determining the pathogenesis of the development of diabetes.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852041","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":"Oral Soft Tissue Metastasis from Breast Cancer as the Only Primary Source: Systematic Review.","authors":"Nausheen Aga, Ruchira Shreevats, Sonia Gupta, Harman Sandhu, Muna E M Hassan, Harnisha V Prajapati","doi":"10.1055/s-0044-1779674","DOIUrl":"https://doi.org/10.1055/s-0044-1779674","url":null,"abstract":"<p><p><b>Background</b>  Breast cancer is one of the most lethal neoplasms causing death. Oral cavity is the rare site of distant metastasis from breast cancer. Very little research has been conducted to date to analyze breast cancer as the sole primary source of metastasis to the oral soft tissues. The goal of this study was to examine the published cases of oral soft tissue metastasis from breast cancer as the only primary source to date. <b>Methods</b>  An electronic search of the published literature was performed without publication year limitation in PubMed/Medline, Scopus, Google Scholar, Web of Science, Science Direct, Embase, and Research Gate databases, using mesh keywords like (\"Breast cancer\", OR \"Breast carcinoma\") AND (\"Metastasis\" OR \"Metastases\"), And (\"Oral soft tissues\" OR \"Tongue\" OR \"Palate\" OR \"Tonsil\" OR \"Buccal mucosa\" OR \"Floor of mouth\" OR \"Vestibule\" OR \"Salivary glands\"). We also searched all related journals manually. The reference list of all articles was also checked. <b>Results</b>  Our research revealed 88 relevant papers (September 1967-September 2023) with 96 patients in total. The most predominant oral soft tissues involved were salivary glands followed by the gingiva, tonsils, tongue, and buccal mucosa. A total of 23% of patients died with an average survival time of 1 to 15 months. <b>Conclusions</b>  Oral soft tissue metastasis from breast cancer is a rare event and has a bad prognosis. More cases need to be published to raise awareness of these lesions.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866476","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}