Journal of Research in Medical Sciences最新文献

{"title":"Sonographic features of internal carotid artery in patients with opioid use disorder: Is opium a new risk factor for atherosclerosis of internal carotid artery?","authors":"Zahra Masoumi, Mohammad Amin Najafi, Amir Soroush Mohammadi, Mohammad Saadatnia","doi":"10.4103/jrms.jrms_706_24","DOIUrl":"10.4103/jrms.jrms_706_24","url":null,"abstract":"<p><strong>Background: </strong>Opium use disorder (OUD) is prevalent worldwide. Despite its traditional use, recent studies suggest that OUD may exacerbate atherosclerosis and ischemic stroke. This study investigates the effect of OUD on internal carotid artery sonographic findings using B-mode Doppler sonography.</p><p><strong>Materials and methods: </strong>A case-control study was conducted in Isfahan, Iran, from 2021 to 2023. A total of 295 patients, including 95 with OUD and 200 without, were evaluated through medical records and B-mode Doppler sonography to assess atherosclerotic plaques, vulnerability of plaques, carotid artery stenosis, and carotid artery intima-media thickness (CIMT). Data on age, sex, smoking, and medical history were also collected.</p><p><strong>Results: </strong>The OUD group had a higher prevalence of tobacco smoking (56% vs. 18%; <i>P</i> < 0.001). Atherosclerotic plaques were more common in OUD patients (83% vs. 65%; <i>P</i> = 0.001). Vulnerable plaques were more frequent in OUD patients (19% vs. 9%; <i>P</i> = 0.039). OUD patients were three times more likely to have carotid artery stenosis (85% vs. 65%; <i>P</i> < 0.001) and had a higher incidence of more than 70% stenosis (33.8% vs. 16%; <i>P</i> = 0.003). CIMT was significantly higher in the OUD group (0.95 mm vs. 0.87 mm; <i>P</i> < 0.001). Logistic regression analysis revealed that OUD was independently associated with atherosclerotic plaque, carotid stenosis, stenosis of more than 70%, and CIMT (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>This study highlights a significant association between OUD and sonographic markers of carotid atherosclerosis, including increased intima-media thickness, higher prevalence of atherosclerotic plaques, and stenosis of more than 70%. We suggest OUD as a potential risk factor for carotid artery atherosclerosis.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"21"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of complete blood count parameters in different severity of proteinuria among patients with type 2 diabetes mellitus.","authors":"Mahboubeh Neamatshahi, Aghil Keykhosravi","doi":"10.4103/jrms.jrms_715_24","DOIUrl":"10.4103/jrms.jrms_715_24","url":null,"abstract":"","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"24"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of nutritional status and associated factors among hemodialysis patients in Isfahan, Iran.","authors":"Elham Kabiri Naeini, Elahe Zakizade, Milad Maghsoudi, Mohammad Javad Tarrahi, Shirin Meshkinfar, Zahra Iraj, Narges Heydari","doi":"10.4103/jrms.jrms_26_25","DOIUrl":"10.4103/jrms.jrms_26_25","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the nutritional condition of individuals undergoing hemodialysis (HD) in Isfahan, Iran.</p><p><strong>Materials and methods: </strong>This cross-sectional study involved 201 HD patients. The modified quantitative subjective global assessment was employed to evaluate nutritional status, along with the collection of sociodemographic data, anthropometric measurements, and biochemical tests.</p><p><strong>Results: </strong>The participants had a mean age of 60.2 ± 16.24 years, with 70 (34.83%) being female. The prevalence of malnutrition was 63.18%, with 60.2% classified as mild-moderately malnutrition and 2.98% identified as severely malnutrition. The participants had a mean body mass index (BMI) of 24.6 ± 5.0 (kg/m²), while 7.96% of patients had a BMI below the normal range. Compared to patients who underwent HD for <5 years, patients who had been on dialysis for >5 years demonstrated 2.5 times higher odds of malnutrition (odds ratio: 2.47, 95% confidence interval: 1.25-4.9). Age, mid-arm circumference, education level, and comorbid diabetes mellitus were significantly associated with malnutrition. In addition, malnourished patients showed lower levels of serum albumin (Alb) (<i>P</i> < 0.001) and serum creatinine (Cr) (<i>P</i> < 0.001). Multivariate logistic regression demonstrated age, dialysis duration, upper diploma educational level, lower serum Alb, and lower serum Cr may independently be associated with malnutrition in HD patients.</p><p><strong>Conclusion: </strong>Malnutrition is prevalent among HD patients. Regular assessment of nutritional status may enhance nutritional outcomes and overall well-being in this patient population.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"23"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of sevoflurane and propofol for elderly patients: A systematic review and meta-analysis.","authors":"Qi Wang, Jing Luan, Wenli Yu","doi":"10.4103/jrms.jrms_154_24","DOIUrl":"10.4103/jrms.jrms_154_24","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the safety of propofol and sevoflurane for general anesthesia in elderly.</p><p><strong>Materials and methods: </strong>All studies on sevoflurane, propofol, and hyperamylasemia from the establishment of Embase, Ovid, Cochrane Library, and Google Scholar from database establishment to December 2024 were searched. Literatures were screened, and data were extracted on the grounds of inclusion and exclusion criteria. Review Manager (RevMan) (Version 5.4. The Cochrane Collaboration.) was used for statistical analysis. Outcomes assessed included time to spontaneous eye opening, extubation time, incidence rate of postoperative cognitive dysfunction (POCD), postoperative delirium, agitation, nausea and vomiting.</p><p><strong>Results: </strong>Fourteen trials were identified and included in this meta-analysis. The results showed no significant difference in time to spontaneous eye opening (<i>P</i> = 0.54), the incidence of POCD (<i>P</i> = 0.07), postoperative delirium (<i>P</i> = 0.37), and postoperative nausea and vomiting (<i>P</i> = 0.8) between the sevoflurane and propofol groups. Compared with propofol groups, extubation time (<i>P</i> < 0.0001) was significantly shortened by sevoflurane groups. Conversely, compared with sevoflurane, the incidence of postoperative agitation in the propofol group was significantly reduced (<i>P</i> = 0.04).</p><p><strong>Conclusion: </strong>There was no difference in time to spontaneous eye-opening, the incidence of POCD, postoperative delirium, postoperative nausea, and vomiting between the sevoflurane and propofol groups. However, compared with propofol, sevoflurane can significantly shorten intubation time. The incidence of postoperative agitation (<i>P</i> = 0.04) was significantly lower in the propofol group compared with sevoflurane.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"22"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using the power of artificial intelligence to improve the diagnosis and management of nonmelanoma skin cancer.","authors":"Fahimeh Abdollahimajd, Fatemeh Abbasi, Alireza Motamedi, Narges Koohi, Reza Mohamoud Robati, Mona Gorji","doi":"10.4103/jrms.jrms_607_24","DOIUrl":"10.4103/jrms.jrms_607_24","url":null,"abstract":"<p><p>Nonmelanoma skin cancer (NMSC), including basal cell carcinoma and squamous cell carcinoma, is the most prevalent type of skin cancer. While generally less aggressive than melanoma, early detection and treatment are crucial to prevent the complications. Artificial intelligence (AI) systems show promise in enhancing the accuracy, efficiency, and accessibility of NMSC diagnosis and management. These systems can facilitate early interventions, reduce unnecessary procedures, and promote collaboration among healthcare providers. Despite AI algorithms demonstrating moderate-to-high performance in diagnosing NMSC, several challenges remain. Ensuring the robustness, explainability, and generalizability of these models is vital. Collaborative efforts focusing on data diversity, image quality standards, and ethical considerations are necessary to address these issues. Building patient trust is also essential for the successful implementation of AI in the clinical settings. AI algorithms may outperform experts in controlled environments but can fall short in the real-world clinical applications, indicating a need for more prospective studies to evaluate their effectiveness in the practical scenarios. Continued research and development are essential to fully realize AI's potential in improving NMSC diagnosis and management by overcoming the existing challenges and conducting comprehensive studies.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"25"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the potential of diffusion tensor imaging biomarkers in prediction of white matter changes after brain radiation therapy: A systematic review.","authors":"Baranoosh Rahmani, Abdurrahim Rahimian, Mahsa Mansourian, Iraj Abedi","doi":"10.4103/jrms.jrms_234_24","DOIUrl":"10.4103/jrms.jrms_234_24","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to systematically review the use of diffusion tensor imaging (DTI) biomarkers in the early detection of radiation-induced white matter (WM) changes.</p><p><strong>Materials and methods: </strong>The PubMed and Scopus databases were searched for peer-reviewed articles published in English up to November 28, 2022, according to the PRISMA guidelines to identify studies that related to changes in DTI parameters after radiotherapy.</p><p><strong>Results: </strong>After reviewing the literature, eight studies met the inclusion criteria. The results indicated that changes in the late delay phase were completely related to changes in the acute phase. There was a difference in the sensitivity of the biomarkers between studies. Still, there was substantial evidence for the early detection of changes by axial diffusivity (AD), radial diffusivity (RD), and fractional anisotropy (FA). However, further research is still necessary on the potential of mean diffusivity (MD) sensitivity for detecting early changes. The majority of the included studies demonstrated progressive changes in DTI parameters over time and with dose.</p><p><strong>Conclusion: </strong>There is significant potential for DTI biomarkers to predict WM changes caused by radiation after brain radiation therapy by having significant predictive power.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"20"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of Iranian clinical practice guidelines: An experience in cardiovascular diseases-A policy brief.","authors":"Nizal Sarrafzadegan, Shahla Shahidi, Fahimeh Bagherikholenjani","doi":"10.4103/jrms.jrms_617_24","DOIUrl":"https://doi.org/10.4103/jrms.jrms_617_24","url":null,"abstract":"<p><p>In the wake of the dominance of evidence-based thinking, clinical practice guidelines (CPGs) within the country's health system have gained a key position in recent years and playing an important role in enhancing all functions of this system. However, the absence of a standard model, the inadequacy of existing documentation for designing clinical guidelines, data obtained from the national self-care project (IMPROVE-CARE), the Persian Registry of Cardiovascular Disease, the national priorities declared by the Iranian Network of Cardiovascular Research, and most importantly, the order from the Ministry of Health, all highlight the necessity of establishing a structure followed by the creating of a standard model for the development of guidelines, and subsequently, the creation of Iranian clinical guidelines. This policy brief article discusses the process of establishing the structure and the produced content and presents the necessary policies for the development of national clinical guidelines.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"16"},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing risk models for predicting incidence of diabetes and prediabetes in the first-degree relatives of Iranian patients with type 2 diabetes and comparison with the finnish diabetes risk score.","authors":"Parisa Khodabandeh Shahraki, Awat Feizi, Sima Aminorroaya, Heshmatollah Ghanbari, Majid Abyar, Massoud Amini, Ashraf Aminorroaya","doi":"10.4103/jrms.jrms_139_23","DOIUrl":"https://doi.org/10.4103/jrms.jrms_139_23","url":null,"abstract":"<p><strong>Background: </strong>We aimed to develop risk models for predicting the onset of developing diabetes and prediabetes in the first-degree relatives (FDRs) of patients with type 2 diabetes, who have normal glucose tolerance (NGT).</p><p><strong>Materials and methods: </strong>In this study, 1765 FDRs of patients with type 2 diabetes mellitus, who had NGT, were subjected to the statistical analysis. Diabetes risk factors, including anthropometric indices, physical activity, fast plasma glucose, plasma glucose concentrations 2-h after oral glucose administration, glycosylated hemoglobin (HbA1c), blood pressure, and lipid profile at the baseline were considered as independent variables. Kaplan-Meier, log-rank test, univariate, and multivariable proportional hazard Cox regression were used for the data analysis. The optimal cutoff value for risk score was created according to the receiver operating characteristic curve analysis.</p><p><strong>Results: </strong>The best diabetes predictability was achieved by a model in which waist-to-hip ratio, HbA1c, oral glucose tolerance test-area under the curve (OGTT-AUC), and the lipid profile were included. The best prediabetes risk model included HbA1c, OGTT-AUC, systolic blood pressure, and the lipid profile. The predictive ability of multivariable risk models was compared with fasting plasma glucose (FPG), HbA1c, and OGTT. The predictive ability of developed models was higher than FPG and HbA1c; however, it was comparable with OGTT-AUC alone. In addition, our study showed that the developed models predicted diabetes and OGTT-AUC better than the Finnish Diabetes Risk Score (FINDRISC).</p><p><strong>Conclusion: </strong>We recommend regular monitoring of risk factors for the FDRs of patients with type 2 diabetes as an efficient approach for predicting and prevention of the occurrence of diabetes and prediabetes in future. Our developed diabetes risk score models showed precise prediction ability compared to the FINDRISC in Iranian population.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"17"},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic effect of memantine on patients with posttraumatic headache: A randomized double-blinded clinical trial.","authors":"Fariborz Khorvash, Elham Bani, Rasool Soltani, Majid Rezvani, Mohammad Saadatnia, Noushin Maktoobian, Mohsen Kheradmand","doi":"10.4103/jrms.jrms_542_24","DOIUrl":"https://doi.org/10.4103/jrms.jrms_542_24","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) can result in different complications. Posttraumatic headache (PTH) is a disabling complication of TBI. We investigated the therapeutic effect of memantine on patients with PTH.</p><p><strong>Materials and methods: </strong>This randomized and double-blinded clinical trial was performed in 2020 in a hospital on 90 patients with head trauma. Patients were divided into two groups. The active group received 5 mg memantine tablet for 2 weeks followed by 10 mg tablet daily for up to 6 months. The control arm received identical placebo tablets. Patients were evaluated at 3 months and 6 months. Headache severity was measured with a Visual Analog Scale for Pain. Headache frequency (per week) and duration were also recorded.</p><p><strong>Results: </strong>After 3 months, the patients in the memantine group had significantly lower headache severity (<i>P</i> = 001) and frequency (<i>P</i> = 0.008) in comparison to baseline of the study. However, in the placebo group, there was only significant reduction in the headache duration (<i>P</i> = 0.001), and there was no significant reduction in headache intensity and frequency. After 6 months, there was a significant reduction in headache intensity and duration in both groups (<i>P</i> < 0.05), but only in the memantine group, headache frequency was significantly reduced (<i>P</i> < 0.001). Finally, patients in the memantine group had less headache intensity, frequency, and duration after 6 months of taking memantin than the placebo group.(<i>P</i> < 0.05 for all).</p><p><strong>Conclusion: </strong>The administration of memantine for 6 months could significantly lower the severity, duration, and frequency of PTHs.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"15"},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microenvironment of diabetic foot ulcers: Implications for healing and therapeutic strategies.","authors":"Jixue Wang, Xirui Yang, Tao Zhou, Haitao Ma, Xingxing Yuan, Shuxun Yan, Siqi Wang","doi":"10.4103/jrms.jrms_573_24","DOIUrl":"https://doi.org/10.4103/jrms.jrms_573_24","url":null,"abstract":"<p><p>Diabetic foot ulcers (DFUs) are a common yet serious complication in individuals with diabetes, often presenting as chronic, nonhealing wounds that significantly impair quality of life. The healing process of DFUs is largely influenced by the local microenvironment, which encompasses factors such as hypoxia, inflammation, and the involvement of various cell types. Poor blood circulation in the affected area results in hypoxia, compromising cellular function and restricting nutrient supply, thereby delaying wound healing. In addition, chronic inflammation disrupts immune system balance, with excessive pro-inflammatory cytokines not only failing to facilitate tissue repair but also exacerbating tissue damage. Moreover, key cell types, including fibroblasts, keratinocytes, and macrophages, play crucial roles at different stages of the healing process, contributing to collagen production and skin regeneration. A comprehensive understanding of the complex dynamics within the DFU microenvironment is essential for developing more precise therapeutic approaches, such as advanced drug delivery systems and bioactive materials, aimed at promoting wound healing and reducing the risk of recurrence.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"19"},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}