Archives of Iranian Medicine最新文献

{"title":"Mortality Rates Among Individuals Diagnosed with Pemphigus: 12-Year Experience in Tehran, Iran.","authors":"Nastaran Namazi, Fahimeh Abdollahimajd, Ghazal Mardani, Zahra Razzaghi, Hamideh Moravvej","doi":"10.34172/aim.31996","DOIUrl":"10.34172/aim.31996","url":null,"abstract":"<p><strong>Background: </strong>Pemphigus consists of a group of rare autoimmune bullous diseases that affect the skin and mucous membranes. Pemphigus includes three major forms: pemphigus vulgaris (PV), pemphigus foliaceus, and paraneoplastic pemphigus. Before the advent of systemic corticosteroids (SCSs), pemphigus was usually a fatal disease. Rituximab (RTX), a monoclonal antibody against the CD20+B cells has been approved for the treatment of patients with pemphigus. Previous studies have confirmed the high efficacy and safety profile of RTX in pemphigus patients. We aimed to estimate the overall mortality and causes of death among pemphigus patients who were admitted to the hospitals of Shahid Beheshti University of medical Sciences, Tehran, Iran, before and after administering RTX.</p><p><strong>Methods: </strong>We included 480 patients admitted to Shahid Beheshti University of medical Sciences hospitals, Tehran, Iran, from October 2010 to October 2022. The diagnosis of all patients was confirmed by direct immunofluorescence and pathological studies. All variables such as age, sex, type of pemphigus, presence of comorbidities, medications, and cause of death were assessed.</p><p><strong>Results: </strong>The prevalence of pemphigus was 262 (54.58%) in women and 218 (45.41%) in men (<i>P</i> value=0.004). These included 474 (98.75%) PV, 4 (0.83%) pemphigus foliaceus and 2 (0.41%) paraneoplastic pemphigus cases. The most common comorbidities were hypertension and diabetes mellitus (98 [20.41%] and 93 [19.37%], respectively). The overall mortality was 20 (4.16%), including 15 (75%) patients under treatment with high dose SCSs and immunosuppressive agents, and 5 (25%) patients who received at least 500 mg of RTX and low dose SCSs.</p><p><strong>Conclusion: </strong>The mean age of the disease was found to be a decade earlier than other parts of the world, with a higher preponderance of women. The most common comorbidities were hypertension and diabetes mellitus. Most deaths were due to infectious and cardiovascular diseases. Mortality rate was 1/3 in patients who received RTX compared to those who were treated with high dose corticosteroids and other immunosuppressive agents.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 2","pages":"95-99"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588287","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":"Reply to Post-traumatic Stress Disorder: A Major Source of Concern Comment on \"Epidemiology of Post-traumatic Stress Disorder in Iranian Population From 2019 to 2024: A Systematic Review and Meta-analysis\".","authors":"Asad Imani, Shahram Molavynejad, Mojgan Khademi, Mohammad Adineh, Elham Shafiei, Mohsen Savaie","doi":"10.34172/aim.33531","DOIUrl":"10.34172/aim.33531","url":null,"abstract":"","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 2","pages":"134"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588347","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":"Pregestational Diabetes and Adverse Pregnancy Results: A Mendelian Randomization Study.","authors":"Sedigheh Hantoushzadeh, Majid Zaki-Dizaji, Danial Habibi, Leyla Sahebi, Amir Hesam Saeidian, Mohadese Dashtkoohi, Mostafa Saeedinia, Hanifeh Mirtavoos-Mahyar, Zohreh Heidary","doi":"10.34172/aim.33461","DOIUrl":"10.34172/aim.33461","url":null,"abstract":"<p><strong>Background: </strong>Hyperglycemia in pregnancy is believed to be associated with negative pregnancy outcomes. However, establishing a causal connection between diabetes mellitus (DM) and adverse pregnancy results is challenging due to the limitations inherent in traditional observational studies.</p><p><strong>Methods: </strong>Our study used a two-sample Mendelian randomization (MR) technique to examine the possible influence of pregestational diabetes mellitus (PGDM) on adverse pregnancy outcomes. Summary-level data were obtained from genome-wide association studies (GWAS) of European ancestry and FinnGen biobank. The primary analysis employed the random-effects multiplicative inverse variance weighted (IVW) technique to appraise causal relationships between PGDM and adverse outcomes. Heterogeneity and pleiotropy were assessed using Cochran's Q statistic, Rucker's Q statistic, and the I² statistic. Sensitivity analyses were conducted using MR-Egger and weighted median methods. Additionally, outlier detection techniques, including MR-PRESSO and RadialMR, were applied.</p><p><strong>Results: </strong>The results from the IVW method indicated no significant causal association between PGDM and stillbirth (SB) (OR (SE)=0.99 (0.001); <i>P</i> value=0.992), miscarriage (MIS) (OR (SE)=0.97 (0.016); <i>P</i> value=0.125), and preterm birth (PTB) (OR (SE)=1.072 (0.028); <i>P</i> value=0.014). Pleiotropy and heterogeneity tests revealed no evidence of pleiotropy for SB, MIS, and PTB (MR-Egger intercept <i>P</i> value=0.296, 0.525, and 0.532, respectively), with no observed heterogeneity for SB, MIS, and PTB (Q- <i>P</i> values of IVW were 0.929, 0.999, and 0.069, and MR-Egger were 0.931, 0.999, and 0.065, respectively).</p><p><strong>Conclusion: </strong>Our findings indicate that there is no direct causal link between PGDM and the likelihood of MIS, SB, and PTB.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 2","pages":"81-87"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588341","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":"Predictors of 12-Month Recurrence of Hemoptysis after Bronchial Artery Embolization.","authors":"Sareh Sadidi, Farzin Roozafzai, Sirous Nekooei, Lida Jarahi, Farzaneh Khoroushi","doi":"10.34172/aim.33457","DOIUrl":"10.34172/aim.33457","url":null,"abstract":"<p><strong>Background: </strong>Despite the high success rate of bronchial artery embolization (BAE), hemoptysis probably recurs. This study investigated risk factors of 12-month hemoptysis recurrence after BAE in an Iranian population.</p><p><strong>Methods: </strong>In this prospective cohort, we followed up 101 patients for 12 months after BAE. Outcome of interest was recurrence of hemoptysis. Target arteries were super-selectively catheterized and embolized with non-spherical polyvinyl alcohol particles (150-700 µm). Success of BAE was confirmed using post-BAE angiography. Independent t-test, and chi-square and Fisher's exact test were used to compare variables between \"recurrence\" and \"non-recurrence\" groups. We investigated predictors of recurrent hemoptysis through univariate and multivariate logistic regression modeling. We analyzed receiver operating characteristic curve to find the optimal cutoff point for continuous risk factors. Recurrence-free rates stratified by risk factors were plotted against time using the Kaplan-Meier method.</p><p><strong>Results: </strong>BAE was immediately successful in all patients. During the 12-month follow-up, hemoptysis recurred in 13.9% (95% CI: 8.2-21.6) of participants. Mean (±standard deviation) recurrence-free time was 6.9 (±3.3) months. Lung destruction (OR=5.40 [95% CI: 1.41-20.58], <i>P</i> value=0.013) and arterial diameter≥2 mm (12.51 [1.51-103.59], <i>P</i> value=0.019) were independent predictors of 12-month hemoptysis recurrence.</p><p><strong>Conclusion: </strong>Patients with destroyed lungs and embolized arteries wider than 2.0 mm are at higher risk of hemoptysis recurrence in the first year after BAE.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 2","pages":"100-106"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588317","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":"FIB-4 Index Can Predict Mortality in Hospitalized Patients with COVID-19 Infection, Independent of CT Severity Score.","authors":"Faeze Salahshour, Sahar Karimpour Reyhan, Kazem Zendedel, Kiana Seifouri, Monireh Sadat Seyyedsalehi, Parnian Naghavi, Mahsa Abbaszadeh, Alireza Esteghamati, Manouchehr Nakhjavani, Soghra Rabizadeh","doi":"10.34172/aim.33514","DOIUrl":"10.34172/aim.33514","url":null,"abstract":"<p><strong>Background: </strong>The fibrosis 4 (FIB-4) index is typically used in assessing liver fibrosis, and has shown potential in predicting the outcome in various diseases. This study aims to evaluate the predictive power of the FIB-4 index for mortality in COVID-19 patients admitted to a reference hospital in Tehran, Iran.</p><p><strong>Methods: </strong>In this prospective cohort study, 387 patients with COVID-19 without diabetes, were categorized into deceased and surviving groups. We compared anthropometric and demographic data, liver function tests, CT scores, and FIB-4 indices between the groups. Multivariate logistic regression assessed the independent association of FIB-4 with mortality.</p><p><strong>Results: </strong>Among the 387 patients, (all non-diabetics), 58 (15%) died, with a higher mortality rate observed in patients with a FIB-4 index≥2.6 (63.4%) compared to those with FIB-4<2.6 (29.7%). Deceased patients were considerably older and more likely to be hypertensive (<i>P</i> values<0.001). After adjustment of confounding factors, a FIB-4 index≥2.6 was found to be independently associated with increased mortality (OR: 13.511, 95% CI: 1.356-134.580, <i>P</i>=0.026).</p><p><strong>Conclusion: </strong>The FIB-4 index, calculable by routine laboratory tests, may be a valuable prognostic factor for COVID-19 mortality. This easily obtainable marker could help identify high-risk patients early, potentially allowing for more rapid intervention and treatment prioritization.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 2","pages":"88-94"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588271","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":"Oral Focal Mucinosis.","authors":"Varsha Vimal Kumar, Savita Jangal Krishanappa, Girish Hemdal Channabasaviah, Mamata Sharad Kamat, Smitha Gowdara Prakash","doi":"10.34172/aim.31273","DOIUrl":"10.34172/aim.31273","url":null,"abstract":"","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 2","pages":"129-131"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588308","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":"Post-traumatic Stress Disorder: A Major Source of Concern Comment on \"Epidemiology of Post-traumatic Stress Disorder in Iranian Population From 2019 to 2024: A Systematic Review and Meta-analysis\".","authors":"Vitorino Modesto Santos, Andressa Plaça Tedeschi, Laura Campos Modesto","doi":"10.34172/aim.33448","DOIUrl":"10.34172/aim.33448","url":null,"abstract":"","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 2","pages":"132-133"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588309","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":"From Conventional Detection to Point-of-care Tests (POCT) Method for Pediatric Respiratory Infections Diagnosis: A Systematic Review.","authors":"Reza Azizian, Setareh Mamishi, Erfaneh Jafari, Mohammad Reza Mohammadi, Fereshteh Heidari Tajabadi, Babak Pourakbari","doi":"10.34172/aim.33505","DOIUrl":"10.34172/aim.33505","url":null,"abstract":"<p><p>Bacterial respiratory infections pose significant health risks to children, particularly infants susceptible to upper respiratory tract infections (URTIs). The COVID-19 pandemic has further exacerbated the prevalence of these infections, with pathogens such as <i>Mycoplasma pneumoniae, Streptococcus pneumoniae, Legionella pneumophila, Staphylococcus aureus, Haemophilus influenzae,</i> and <i>Klebsiella species</i> commonly implicated in pediatric cases. The critical need for accurate and timely detection of these bacterial agents has highlighted the importance of advanced diagnostic techniques, including multiplex real-time PCR, in clinical practice. Multiplex real-time polymerase chain reaction (PCR) offers several advantages, including rapid results, high sensitivity, and specificity. By accelerating the diagnostic process, this approach enables early intervention and targeted treatment, ultimately improving patient outcomes. In addition to PCR technologies, rapid and point-of-care testing (POCT) play a crucial role in the prompt diagnosis of bacterial respiratory infections. These tests are designed to be user-friendly, sensitive, and deliver quick results, making them particularly valuable in urgent clinical settings. POCT tests are often categorized into two main groups: those aimed at determining the cause of infection and those focused on confirming the presence of specific pathogens. By utilizing POCT, healthcare providers can make rapid and informed treatment decisions, leading to more effective management of bacterial respiratory infections in children. As the medical community continues to explore innovative diagnostic approaches, the integration of molecular and rapid testing methods offers significant promise in the realm of bacterial respiratory infections. By adopting these cutting-edge technologies, healthcare professionals can enhance their ability to accurately diagnose these infections, tailor treatment strategies, and ultimately improve patient care.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 2","pages":"112-123"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588273","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":"Prevalence and Factors Associated with Kidney Stones in the Elderly Iranian Population: Findings from the Ardakan Cohort Study on Aging (ACSA).","authors":"Ahmad Delbari, Mehrdad Farrokhi, Ahmad Mehri, Mehran Saberian, Mohadeseh Sadri, Mohammad Saatchi","doi":"10.34172/aim.33337","DOIUrl":"10.34172/aim.33337","url":null,"abstract":"<p><strong>Background: </strong>The incidence of kidney stones has been rising globally, particularly among the elderly. This study aims to determine the prevalence of kidney stones and its associated factors in Iran.</p><p><strong>Methods: </strong>This cross-sectional study was conducted using the data collected in the first phase of Ardakan Cohort Study on individuals aged 50 years and above, in the Yazd province, Iran. Baseline data was collected using a comprehensive checklist and kidney stone occurrence was ascertained through participants' self-reported response to the question \"Have you ever been diagnosed with kidney stones?\" Logistic regression analysis was used due to the binary nature of the outcome.</p><p><strong>Results: </strong>Period prevalence of kidney stone was 22.79 (95% CI=19.41 to 24.12). Thus, out of the total sample of 4,884 individuals, 1113 participants had a history of kidney stones. Among these, 412 (37%) were female and 701 (63%) were male. Significant associations were observed between a history of kidney stones and factors such as self-reported poor health, alcohol consumption, dysuria, higher education level, male gender, and presence of calcium oxalate crystals.</p><p><strong>Conclusion: </strong>This study shows the high prevalence of kidney stones compared to other studies. Considering the relationship between kidney stones and some preventable disorders in the elderly, such as high blood pressure and alcohol consumption, it seems that paying attention to kidney stone disorders can be part of preventive health and treatment interventions for this population group.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 2","pages":"73-80"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588344","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":"Blood Product Management: A Comprehensive Analysis in a Trauma Center Hospital.","authors":"Tarannom Mohammadtaghi Kashi, Mohammad Taher Hojjati, Ali Asghar Ayatollahi","doi":"10.34172/aim.31324","DOIUrl":"10.34172/aim.31324","url":null,"abstract":"<p><strong>Background: </strong>Today, excessive demand for blood products is a common issue across various medical departments. This demand can lead to improper distribution, waste of blood products, and poor availability for emergency patients. Additionally, it increases costs and the workload of blood banks, disrupting the proper distribution of products among medical centers. Ultimately, all these factors contribute to a decrease in the quality of blood products. This study was conducted to investigate the pattern of blood requests and utilization at 5-Azar Educational Hospital in the Golestan province in 2022.</p><p><strong>Methods: </strong>This cross-sectional study was conducted from June to August 2022. The study population comprised all patients who requested blood product reservations upon admission to the hospital.</p><p><strong>Results: </strong>In the present study, 514 patients with requests for blood product reservations were included, resulting in 739 cross-matches and ultimately 677 transfusions. The cross-match to transfusion (C/T) ratio for this study was 1.09, while the probability of transfusion (T %) was 91.6%. The highest incidence of blood reservation wastage was associated with the neurosurgery department.</p><p><strong>Conclusion: </strong>By addressing the identified challenges and promoting adherence to guidelines, healthcare institutions can improve patient outcomes and ensure responsible use of blood resources.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 2","pages":"107-111"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588268","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}