Archives of Iranian Medicine最新文献

{"title":"A Comprehensive Study on Peripartum Hysterectomy in Tehran, Iran: Causes and Clinical Outcomes.","authors":"Fahimeh Ghotbizadeh Vahdani, Sedigheh Hantoushzadeh, Zahra Panahi, Mohammad Haddadi, Mamak Shariat, Zahra Tavoli, Fatemeh Asadi, Arezoo Maleki, Zeinab Mansouri, Marjan Ghaemi","doi":"10.34172/aim.33449","DOIUrl":"10.34172/aim.33449","url":null,"abstract":"<p><strong>Background: </strong>Peripartum hysterectomy (PH) poses a notable public health challenge due to its correlation with severe maternal morbidity and mortality. Identifying the causes and risk factors associated with PH is crucial for enhancing preventive strategies and maternal health outcomes. This study investigates the indications, and outcomes of PH across healthcare settings.</p><p><strong>Methods: </strong>This is a retrospective analysis of all PH cases between March 2021 and March 2022 in Tehran, Iran. The study included cases where gestational age was greater than 24 weeks, with PH performed during delivery or within the first 24 hours postpartum. Data, including demographic and clinical variables, were collected from the Iranian Maternal and Neonatal Network (IMaN) system.</p><p><strong>Results: </strong>In total, 136 PH cases were identified. The average age of the women was 35.1 (±5.2) years. Cesarean section (C/S) was the predominant delivery method, comprising 93.4% of cases, with 44.9% having a medical indication, 7.4% without indications, and 41.2% performed as emergency C/S. Notably, a previous C/S was reported in 65.4% of cases. The main indications for PH were placenta abnormalities (75.6%), uterine atony (20.7%), uterine rupture (3%), and ovarian mass (0.7%). Placenta previa (42.6%) and placenta accreta (32.4%) were the most frequent placental abnormalities.</p><p><strong>Conclusion: </strong>The findings highlight key factors influencing PH that may inform health policies to mitigate risks. A national study could offer a comprehensive view, accounting for regional, socioeconomic, and cultural differences, emergency healthcare access, and resource availability, guiding targeted public health interventions.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 6","pages":"334-340"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769402","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":"Clinicopathological Perspectives of Liver Mass Biopsies: A Single Center Experience of 406 Cases.","authors":"Ömer Atmış, Hanife Seda Mavili, Fatma Seher Pehlivan, Ahmet Burak Ağaoğlu, Atike Pınar Erdoğan, Mustafa Faraşat, Semin Ayhan","doi":"10.34172/aim.34218","DOIUrl":"10.34172/aim.34218","url":null,"abstract":"<p><strong>Background: </strong>The increasing use of imaging techniques has led to a rise in the detection of liver masses, making it crucial to accurately diagnose their nature. While advances in radiology have reduced the need for liver biopsy in hepatocellular carcinoma (HCC), biopsy remains essential fo r diagnosing various liver lesions, including metastatic tumors. This study aims to evaluate the diagnostic role of liver core needle biopsies, with a particular focus on identifying the primary tumor in cases of liver metastases with an unknown primary.</p><p><strong>Methods: </strong>We reviewed a total of 406 liver core needle biopsies performed for liver masses between 2017 and 2022. Clinical, radiological, histopathological and immunohistochemical (IHC) data for primary and metastatic tumors were evaluated.</p><p><strong>Results: </strong>Of the 406 liver biopsy cases, a significant portion were diagnosed as metastatic lesions, with common primary sites identified as gastrointestinal (GI), lung, and breast cancers. IHC markers showed varying positivity rates across different tumor types, with GATA-3, CDX2, and TTF1 proving particularly useful in distinguishing the tumor origin. While some markers were highly specific, others exhibited variable expression, highlighting the complexity of diagnosing metastatic tumors with unknown primaries.</p><p><strong>Conclusion: </strong>Liver biopsy remains a crucial diagnostic tool in identification of primary and metastatic liver tumors, especially when the primary site is unknown. IHC analysis enhances the accuracy of diagnosis, though it should be used in conjunction with clinical and radiological data. This study underscores the importance of a multidisciplinary approach in managing liver masses, with further research needed to optimize diagnostic strategies and improve patient outcomes.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 6","pages":"347-355"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769405","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":"Bilateral Mydriasis in a Post-parotidectomy Patient: A Case Report.","authors":"Ahmad Daneshi, Saleh Mohebbi, Milad Shemshadi, Hadi Ghanbari","doi":"10.34172/aim.34254","DOIUrl":"10.34172/aim.34254","url":null,"abstract":"<p><p>Anticholinergic agents, such as atropine and glycopyrrolate, are commonly utilized during anesthesia for their effects on secretion reduction and vagal activity. However, substantial dosages can induce mydriasis, which poses diagnostic challenges, particularly in head and neck surgeries. Despite their clinical relevance, limited studies explore these effects. A 35-year-old female presented with a left parotid mass and scheduled for a left superficial parotidectomy. Preoperatively, the patient exhibited normal ocular and neurological function. Postoperatively, fine bilateral ptosis, predominantly on the left side, and bilateral unresponsive mydriasis were noted. Anticholinergic-induced pupillary changes may mimic neurological pathology, underscoring the necessity for meticulous postoperative evaluation and awareness among clinicians.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 6","pages":"367-369"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769403","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":"Global Burden of Dental Caries and Oral Disorders: A 31-Year Comparative Analysis of Trends in Iran, North Africa and Middle East.","authors":"Saeed Asgary, Alireza Akbarzadeh Baghban, Fatemeh Mahmoudi Afsah","doi":"10.34172/aim.33209","DOIUrl":"10.34172/aim.33209","url":null,"abstract":"<p><strong>Background: </strong>The Global Burden of Disease (GBD) studies highlight oral health as a significant global concern, particularly in regions such as Iran, the Middle East and North Africa (MENA). This study synthesizes GBD data on the incidence, prevalence, and disability-adjusted life years (DALYs) associated with dental caries and oral disorders to inform targeted interventions aimed at alleviating their burden and improving outcomes in these regions.</p><p><strong>Methods: </strong>This study employs estimation techniques to comprehensively assess the occurrence and impact of dental caries in deciduous and permanent teeth, along with oral disorders across Iran, MENA, and globally. Data were drawn from the GBD site. We analyzed incidence, prevalence, and DALYs, utilizing disability weights with joinpoint regression models to inform public health interventions.</p><p><strong>Results: </strong>From 1990 to 2021, global and regional trends in dental caries and oral disorders were examined. Descriptive statistics illustrate significant regional disparities in incidence, prevalence, and DALYs. Globally, the incidence rate of caries in deciduous teeth decreased at an average annual percent change (AAPC) of -0.25% (95% CI: -0.30 to -0.20), while the MENA region and Iran showed AAPCs of -0.57% (-0.65 to -0.49) and -0.08% (-0.15 to -0.01), respectively. These trends highlight both progress and persistent disparities. The models reveal temporal changes in disease burden, with notable declines and fluctuations over time. These findings underscore persistent challenges in oral health, particularly in regions such as Iran and MENA, where socioeconomic conditions and healthcare access vary significantly.</p><p><strong>Conclusion: </strong>This study underscores considerable regional variation in dental caries and oral disorders, emphasizing ongoing public health challenges. Demographic shifts and reduced sugar intake, influenced by sociopolitical factors like war, have significantly decreased the global burden of oral conditions since 1990. The findings underscore the urgency of integrating oral health into primary care systems, expanding subsidized fluoride programs in rural areas, and addressing socioeconomic barriers to dental access in MENA. Community-driven initiatives, such as school-based screenings and mobile dental clinics, should be prioritized in underserved regions.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 6","pages":"324-333"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769338","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":"Illegal Abortion in Iran: Challenges, Consequences, Recommendations.","authors":"Habibollah Azarbakhsh, Mahdiyeh Rashedi","doi":"10.34172/aim.34080","DOIUrl":"10.34172/aim.34080","url":null,"abstract":"","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 6","pages":"372-373"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769339","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":"Serum Uric Acid Levels and Bone Mineral Density in Peri- and Postmenopausal Korean Women: A Cross-sectional Study on 3,566 Cases.","authors":"Ki-Bong Park, Minsu Han, Su Jin Choi, Gyung-Min Park, Young-Jee Jeon, Doo-Ho Lim","doi":"10.34172/aim.34066","DOIUrl":"10.34172/aim.34066","url":null,"abstract":"<p><strong>Background: </strong>Uric acid (UA) may influence bone health through its antioxidant and pro-oxidant properties. While previous studies have investigated the relationship between serum UA levels and bone mineral density (BMD), their findings have been conflicting. This study aimed to examine the impact of serum UA levels on BMD in peri- and postmenopausal Korean women.</p><p><strong>Methods: </strong>We evaluated 3,566 women aged 50-80 years who voluntarily underwent laboratory tests and BMD measurements as part of a general health examination between March 2014 and March 2020. Participants were stratified into quartiles according to their serum UA levels. Univariate and multivariate analyses were performed to assess the association between serum UA levels and BMD.</p><p><strong>Results: </strong>The mean age of the participants was 56.9±5.8 years. BMD at the lumbar spine and hip was significantly higher in women with elevated serum UA levels, showing a continuous increase across the quartiles. Furthermore, after adjusting for covariates, the mean total lumbar spine BMD increased from 0.892 g/cm² (95% CI: 0.884-0.900) in the lowest UA quartile to 0.918 g/cm² (95% CI: 0.909-0.927) in the highest quartile (<i>P</i><0.001). Similarly, the adjusted total hip BMD was higher in the highest UA quartile at 0.847 g/cm² (95% CI: 0.840-0.854) compared with 0.828 g/cm² (95% CI: 0.821-0.834) in the lowest quartile (<i>P</i>=0.001).</p><p><strong>Conclusion: </strong>Our results suggest that elevated serum UA levels are associated with higher BMD in peri- and postmenopausal Korean women, indicating a potential protective role in bone metabolism.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 6","pages":"341-346"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769340","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":"Burden of Breast Cancer Attributable to a Diet High in Red Meat at Global, Regional, and National Levels: An Analysis of the Global Burden of Disease Study 2021.","authors":"Fang Zhou, Jincheng Tang, Renyi Yang, Puhua Zeng, Jianxiong Cao","doi":"10.34172/aim.34079","DOIUrl":"10.34172/aim.34079","url":null,"abstract":"<p><strong>Background: </strong>Dietary factors are a key risk for breast cancer. This study examines the global burden of breast cancer attributed to a high red meat diet from 1990 to 2021.</p><p><strong>Methods: </strong>Using Global Burden of Disease Study (GBD) 2021 data, deaths and disability-adjusted life-years (DALYs) were analyzed globally, regionally, and nationally. Trends were assessed through estimated annual percentage changes (EAPCs) in age-standardized mortality (ASMR) and DALY (ASDR) rates. A decomposition analysis quantified the contributions of population growth, aging, and epidemiological changes. The relationship between sociodemographic index (SDI) and burden was examined using Spearman rank test. Health inequalities were assessed using the Slope Index of Inequality for absolute inequality and the Concentration Index for relative inequality.</p><p><strong>Results: </strong>By 2021, breast cancer deaths and DALYs linked to high red meat intake had increased significantly compared to 1990, despite a decline in ASMR [EAPC: -0.77 (95% CI -0.82 to -0.72)] and ASDR [EAPC: -0.65 (95% CI -0.70 to -0.60)]. These trends were driven by population growth and aging, with regional variability in the pace of demographic transitions. North Africa and the Middle East experienced the largest rise in ASMR [EAPC: 2.03 (95% CI 1.79 to 2.26)], while Pacific Island nations had the highest ASMR and ASDR. High-SDI regions had the highest ASMR [1.14 per 100000 (95% UI -0.01‒2.43)] and ASDR [33.07 per 100000 (95% UI -0.02‒69.90)], with a positive SDI-burden correlation in low- and middle-SDI regions (<i>P</i><0.05), but a negative correlation in high-SDI regions (<i>P</i><0.05). From 1990 to 2021, absolute inequality [35.79 (95% CI 29.13‒42.46) vs. 4.99 (95% CI -1.59-11.56)] and relative inequality [0.18 (95% CI 0.16‒0.21) vs. 0.02 (95% CI -0.01‒0.05)] decreased.</p><p><strong>Conclusion: </strong>Although ASMR and ASDR have declined, the absolute burden of breast cancer due to high red meat intake remains significant, particularly in aging and rapidly urbanizing populations. Policy interventions should include taxation on red meat, restrictions on processed meat, and public health campaigns promoting dietary modifications. Targeted screening programs in high-risk regions, especially for middle-aged and elderly populations, are critical for mitigating the future disease burden.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 5","pages":"275-285"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769392","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 Medical Associations in Iran with Europe and America.","authors":"Nasim Hatefimoadab, Pegah Matourypour, Noredin Mohamadi, Alireza Nikbakht Nasrabadi, Hamid Peirovi, Shahrzad Ghiyasvandian, Hamid Reza Eshraghi, Mohammad Ali Cheraghi, Ali Mohammad Mosadegh Rad, Masoud Fallahi Khoshknab","doi":"10.34172/aim.20125","DOIUrl":"10.34172/aim.20125","url":null,"abstract":"<p><strong>Background: </strong>A comparative study of the structure, characteristics, background, and functions of scientific associations of medical sciences in Iran with other leading countries in the field of medical sciences can serve as a way forward for the future planning of these associations. This research was conducted to compare the status of medical associations in Iran and European and American countries.</p><p><strong>Methods: </strong>This is a descriptive-comparative study. After selecting scientific associations in Iran, Europe, and America, data were collected by triangulation. To validate the study's findings, the results of the comparisons were discussed in a meeting attended by ten medical association's representative.</p><p><strong>Results: </strong>The structure of medical associations in Iran reveals significant differences compared to their counterparts in European and American countries. The primary mission of medical associations in Iran is focused on professional development; however, their roles in policymaking are not clearly defined. All analyzed associations, whether in Iran, Europe, or the US, operate as private, non-profit entities. In terms of performance, Iranian medical associations display the highest activity levels in education (66.6%), social engagement (70%), and research (76.6%). However, they lack engagement in advisory services and advocacy-related activities. Conversely, medical associations in the US are active across all these domains, playing a significant role in healthcare.</p><p><strong>Conclusion: </strong>The results of the present study show that in Iran, most scientific associations are limited to activities in the field of education and research, while in European and American countries, they play a role in policy making and as advocates for their members.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 5","pages":"296-302"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769395","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":"Efficacy Of N-Acetyl-Cysteine as Adjuvant Therapy for Diabetic Foot Osteomyelitis: An Open-Label Randomized Controlled Trial.","authors":"Laya Hooshmand Gharabagh, Mehdi Heydaroghli, Ayda Esmaeili","doi":"10.34172/aim.33355","DOIUrl":"10.34172/aim.33355","url":null,"abstract":"<p><strong>Background: </strong>Biofilm formation by bacteria on the lower limb arises from reduced peripheral arterial blood flow, which can lead to the failure of antibiotic therapy or require longer duration of intravenous antibiotic therapy in diabetic foot infection-associated osteomyelitis. N-acetyl cysteine (NAC), an agent known to prevent and treat biofilm-related infections, was used as a novel strategies beside antibiotic therapy in osteomyelitis of diabetic foot with the aim of accelerating the response to antibiotic therapy regimen.</p><p><strong>Methods: </strong>To assess the synergistic effect of NAC with antibiotic therapy, patients with diabetic foot osteomyelitis (DFO) (grade III or IV Wagner) were randomly assigned to either NAC 600 mg effervescent tablet twice daily for 2 weeks or the control group. Clinical and laboratory data, including white blood cell with differentiation and inflammatory factors (ESR and CRP) were measured at baseline (time 0), after one week and after three weeks of initiating the intervention.</p><p><strong>Results: </strong>Fifty-three eligible patients completed the study. All evaluated infectious-related laboratory parameters showed significant reductions in the NAC group compared to control (<i>P</i><0.05), except for lymphocyte proportion and NLR (P; 0.11 and 0.84, respectively). The drop rate of ESR and CRP were accelerated by NAC compared to the control group (-49.44±6.04 vs -7.17±3.99; -44.43±4.21 vs -14.02±4.05, respectively, <i>P</i><0.05).</p><p><strong>Conclusion: </strong>In order to accelerate antibiotic responses and the trend of reduction in infectious inflammatory markers during the therapy, oral NAC 600 mg twice daily may be considered in the treatment protocol of patients with DFO.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 5","pages":"257-263"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769397","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":"Correction: Typhus Disease in Iran during the Qajar Period (1796 to 1925 AD); a Brief Historical Review.","authors":"Seyyed Alireza Golshani, Ghobad Mansourbakht","doi":"10.34172/aim.34549","DOIUrl":"10.34172/aim.34549","url":null,"abstract":"","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 5","pages":"323"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769396","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}