Archives of Iranian Medicine最新文献

{"title":"Endotracheal Surfactant and Budesonide Combination Therapy in Neonatal Acute Respiratory Distress Syndrome due to Late-Onset Sepsis.","authors":"Asli Okbay Gunes, Aydin Bozkaya","doi":"10.34172/aim.31725","DOIUrl":"10.34172/aim.31725","url":null,"abstract":"<p><strong>Background: </strong>Neonatal acute respiratory distress syndrome (NARDS) is an important cause of hypoxemic respiratory failure. This study aimed to investigate the short-term effects of endotracheal surfactant and budesonide combination therapy on NARDS secondary to late-onset neonatal sepsis (LONS).</p><p><strong>Methods: </strong>This was a retrospective, cross-sectional, and observational study. Newborns with NARDS due to LONS who received endotracheal surfactant and budesonide combination therapy between August 2022 and September 2023 were included in this study. Oxygenation status before endotracheal surfactant and budesonide treatment were compared with the values obtained two hours after treatment.</p><p><strong>Results: </strong>Among 20 neonates, 10 (50%) were diagnosed with severe NARDS, and 10 (50%) were diagnosed with moderate NARDS. The mean corrected gestational age was 33.3±2.9 w when endotracheal surfactant and budesonide were administered to the neonates. The need for the fraction of inspired oxygen (0.75 [0.57-1.00]% vs. 0.55 [0.44-0.80]%; mean difference [MD]: 17.50%, 95% confidence interval [CI]: 14.99 to 22.50) and oxygen saturation index (OSI; 8.03 [4.98-13.94] vs. 4.71 [4.11-8.93]; MD: 2.23, 95% CI: 1.22 to 3.24) decreased (<i>P</i>=0.001 and <i>P</i><0.001, respectively) after endotracheal surfactant and budesonide treatment. However, preductal oxygen saturation (SpO₂ ; 93 [91-94]% vs. 95 [94-96]%; MD: -3.50%, 95% CI: -5.00 to -2.00) increased significantly after endotracheal surfactant and budesonide treatment when compared to pre-treatment values (<i>P</i><0.001).</p><p><strong>Conclusion: </strong>The reduction in oxygen demand and OSI, along with an increase in SpO₂ after treatment compared to pre-treatment values, suggests that endotracheal surfactant and budesonide combination therapy could be an effective option to improve oxygenation in NARDS secondary to LONS.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 10","pages":"573-579"},"PeriodicalIF":1.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570389","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":"Challenges and Weaknesses of Leadership and Governance-related Health Policies in Iran: A Systematic Review.","authors":"Rahim Khodayari-Zarnaq, Khorshid Mobasseri, Shabnam Ghasemyani, Fatemeh Sadeghi-Ghyassi, Maryam Naghshi, Neda Kabiri","doi":"10.34172/aim.28907","DOIUrl":"10.34172/aim.28907","url":null,"abstract":"<p><strong>Background: </strong>A better understanding of health system performance requires evaluating achievements and challenges, thereby providing a basis for effective reforms. This systematic review aims to investigate the challenges and weaknesses of leadership and governance-related health policies in Iran.</p><p><strong>Methods: </strong>In this qualitative systematic review, we followed the instructions of the Joanna Briggs Institute (JBI). It encompassed qualitative studies assessing challenges and weaknesses of leadership and governance-related health policies. Thematic synthesis was conducted in three stages to identify common themes.</p><p><strong>Results: </strong>The primary database search yielded 1890 records, of which 152 were fully assessed, resulting in the inclusion of 57 studies in this review. Thematic synthesis produced 157 structured codes and identified 11 main descriptive themes of challenges in leadership and governance-related health policies. These themes included hospital autonomy policy, challenges to the entire health system, governance of medical universities, healthcare payment systems, sustainable universal health insurance coverage, informal payments, insurance systems, induced demand, strategic purchasing of health services, the family physician program, family physician and rural health insurance programs, and primary healthcare human resources.</p><p><strong>Conclusion: </strong>The identified challenges underscore the urgent need for strategic reforms and interventions to overcome the complex issues plaguing the healthcare system. By addressing these challenges, policymakers and top healthcare managers might ensure that the population have access to high-quality care in a more responsive healthcare system.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 9","pages":"508-521"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513449","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":"Mortality Rate and Years of Life Lost Due to Ischemic Heart Disease in Southern Iran between 2004 and 2019: A Population-Based Study.","authors":"Mohammad Hossein Sharifi, Alireza Mirahmadizadeh, Jafar Hassanzadeh, Hamed Bazrafshan Drissi, Habibollah Azarbakhsh","doi":"10.34172/aim.28159","DOIUrl":"10.34172/aim.28159","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases (CVDs) account for one-third of all deaths worldwide.</p><p><strong>Methods: </strong>In this cross-sectional study, we extracted all death records from the Electronic Death Registration System categorized as ischemic heart disease (IHD) based on age, gender, and the year of death according to ICD-10 for this cross-sectional analysis. The Fars province is situated in southern Iran with a population of about 4 million. An analysis of years of life lost (YLL) resulting from premature death from IHD was conducted using the World Health Organization's 2015 YLL framework. The trend of the YLL rates was investigated using joinpoint regression.</p><p><strong>Results: </strong>In the Fars province, IHD was the cause of 46969 deaths throughout a 16-year study period, (2004 to 2019). Among these, 26,503 (56.4%) were men. The crude death rates per 100000 population for men and women were 84.2 and 66.5, respectively. The total YLL due to premature death due to IHD, during the 16-year study period, was 287625 in male, 209665 in female. The joinpoint regression showed a declining trend in the YLL rate associated with premature death. Annual Percent Change (APC) was -0.6% (95% CI -6.9 to 6.1, <i>P</i>=0.851) for males and -1.5% (95% CI -5.2 to 2.2, <i>P</i>=0.418) for females.</p><p><strong>Conclusion: </strong>The trends of the standardized mortality rate, YLL, and crude mortality rate held steady throughout a 16-year period. Planning for comprehensive primary and secondary prevention and increasing public knowledge of IHD are necessary.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 9","pages":"494-500"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513453","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":"Archives of Iranian Medicine Journal (2010-2024).","authors":"Mohammad Hossein Azizi, Shokoofeh Borzabadi","doi":"10.34172/aim.31751","DOIUrl":"10.34172/aim.31751","url":null,"abstract":"","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 9","pages":"468-469"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513448","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":"Preliminary Results of Iran Premature Coronary Artery Disease (IPAD study) and Implementation of IPAD Biobank: A Case-Control Study.","authors":"Ehsan Zarepur, Noushin Mohammadifard, Reza Nedaeinia, Masoumeh Sadeghi, Sedigheh Asgary, Mojgan Gharipour, Amirhossein Zarepur, Fateme Moslemi, Nizal Sarrafzadegan","doi":"10.34172/aim.26603","DOIUrl":"10.34172/aim.26603","url":null,"abstract":"<p><strong>Background: </strong>Iran Premature Coronary Artery Disease (IPAD) is one of the first and largest studies of its kind in Asia that investigates different aspects of premature coronary artery disease (PCAD) in different ethnic groups in multiple cities. In this paper, we aim to describe the IPAD biobank establishment and present some preliminary results of the IPAD study.</p><p><strong>Methods: </strong>This case-control study was conducted on patients with documented angiography from different ethnicities in more than ten cities of Iran (males aged 60 years and below and females aged 70 years and below). Patients with coronary artery stenosis of more than 75% in at least one vessel (or left-main stenosis of more than 50%) were defined as the case group and patients with normal coronary angiography were considered as the control group. In addition to completing questionnaires and performing physical measurements, samples of serum, buffy coat, plasma, whole blood, saliva, urine, and feces were stored in the freezer at -80 °C.</p><p><strong>Results: </strong>The mean age of patients was 51.1±8.2, of which 43% were women. There were 1221 people in the control group and 1702 in the case group. Our enrollment is completed and data entry and transferring biosamples from different cities is still ongoing. About 30000 biosamples of different ethnicities are saved in the IPAD biobank.</p><p><strong>Conclusion: </strong>This study aims to develop a high-quality biobank and facilitate research on different aspects of PCAD, especially gene-environment interaction regarding ethnicity.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 9","pages":"479-485"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513454","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":"Histopathological Patterns of Lung Cancer in Iran: A Single-Center Study.","authors":"Babak Salimi, Sharareh Seifi, Adnan Khosravi, Sara Shiari, Raana Moradi, Babak Daneshfard, Maryam Mabani","doi":"10.34172/aim.31133","DOIUrl":"10.34172/aim.31133","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer (LC) is one of the leading causes of cancer-related deaths worldwide. In Iran, it is the second most common cause of cancer-related deaths for men and the third most common for women. This study aimed to examine the clinicopathological characteristics of Iranian patients with LC.</p><p><strong>Methods: </strong>Clinicopathological data of 1382 patients with primary LC diagnosed over 11 years (2012‒2023) at the \"National Institute of Tuberculosis and Lung Disease\" (NRITLD), Tehran, Iran, were retrospectively reviewed.</p><p><strong>Results: </strong>Adenocarcinoma was the most common type of cancer found in the patients (42.44%). The median age was 59.69 years (mean: 60.41 years) ranging 24-88 years. The mean male-to-female ratio was 3.65. Additionally, 65.84% of patients were smokers. The majority of patients (82.69 %) were diagnosed at an advanced stage (stage IV) of cancer.</p><p><strong>Conclusion: </strong>Although some of our findings are consistent with those of previous LC studies, there are some discrepancies, especially concerning the smoking status and median age of the Iranian patients. Therefore, additional clinical and epidemiological studies are needed to determine the impact of non-smoking factors, such as environmental exposure and genetic predisposition, on the development of LC.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 9","pages":"501-507"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513450","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":"Spontaneously Corrected Hypoplastic Left Heart: A Case Report and Exceptional Opportunity to Discuss Etiology with Novel Therapeutic Vision.","authors":"Mohsen Shahidi","doi":"10.34172/aim.31185","DOIUrl":"10.34172/aim.31185","url":null,"abstract":"<p><p>Hypoplastic left heart syndrome (HLHS) is a relatively prevalent fetal echocardiography finding in complex congenital heart diseases. Current studies indicate that intrinsic and extrinsic mechanisms could be involved in the development of left heart hypoplasia. Left ventricular inflow or outflow disorders may cause left heart hypoplasia. Prenatal aortic valvuloplasty has become more common as a therapeutic strategy. Our case presentation provides an opportunity for a new vision toward the etiology, prevention, and treatment of HLHS. In our patient, prenatal progressive left heart hypoplasia associated with restrictive foramen oval (FO) suggested the likelihood of a flow-mediated mechanism. Additionally, postnatal improvement of the hypoplastic left heart in the presence of a functional perimembranous ventricular septal defect (PM-VSD) reinforced the suspicion of an extrinsic mechanism. Pre- or postnatal interventional creation of an atrial septal defect (ASD) or VSD is our proposed method for HLHS in selected patients.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 9","pages":"527-529"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513456","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 of Chronic Kidney Disease and Associated Factors among the Diabetic and Prediabetic Population in the Bandare-Kong Cohort Study; A Population-Based Study.","authors":"Masoumeh Kheirandish, Ebrahim Eftekhar, Abnoos Azarbad, Elaheh Salarpour, Mehdi Shahmoradi, Sara Ghazizadeh, Alireza Malektojari, Zohre Nikeghbali, Soheil Karimi Lengeh, Aghdas Dehghani","doi":"10.34172/aim.31194","DOIUrl":"10.34172/aim.31194","url":null,"abstract":"<p><strong>Background: </strong>This investigation aims to examine the relationship between diabetes and prediabetes with chronic kidney disease (CKD) while taking into account key risk factors such as gender, age, lifestyle, smoking habits, and blood pressure.</p><p><strong>Methods: </strong>Between November 17, 2016, and November 22, 2018, 4063 subjects aged 35 to 70 years were enrolled in the first phase of the Bandare-Kong Non-Communicable Disease (BKNCD) Cohort Study, which is part of the PERSIAN (Prospective Epidemiological Research Studies in IrAN) cohort and was conducted in a coastal region of the Hormozgan province in southern Iran. CKD was calculated using the Modification of Diet in Renal Disease (MDRD) formula based on glomerular filtration rate (GFR)<60 mL/min per 1.73 m² , or albumin/Cr>30 mg/g in random urine, self-reported kidney failure, or dialysis. Urine albumin and creatinine were determined by standard kits (Pars Azmoon, Tehran, Iran) and the BT1500 automatic chemistry analyzer (Biotecnica Instruments, Rome, Italy).</p><p><strong>Results: </strong>The prevalence of CKD was found to be 15.3%, with 29.6% identified in diabetic individuals and 16.5% in prediabetic patients. So, the prevalence of CKD in diabetics was higher than prediabetics and normal people. Increased age, dysglycemia (diabetes or prediabetes), hypertension, and use of angiotensin receptor blockers were markedly associated with an elevated risk of CKD in adults.</p><p><strong>Conclusion: </strong>The study emphasizes the importance of early detection and management of CKD risk factors, particularly among high-risk individuals, to mitigate CKD progression and associated complications. By addressing modifiable risk factors, proactive screening, and enhanced awareness, significant strides can be made in reducing CKD burden and improving patient outcomes.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 9","pages":"470-478"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513455","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":"A Village in the Southeastern Region of Iran Harboring the c.716T>A (p.Val239Asp) Mutation in <i>SLC26A4</i>.","authors":"Farzane Zare Ashrafi, Saeed Dorgaleleh, Raziye Rezvani Rezvandeh, Negar Kazemi, Nasrin Azizi, Masoud Edizadeh, Mohammad Hossein Azizi, Kimia Kahrizi, Hossein Najmabadi, Reza Najafipour, Marzieh Mohseni","doi":"10.34172/aim.28745","DOIUrl":"10.34172/aim.28745","url":null,"abstract":"<p><p>After <i>GJB2, SLC26A4</i> is the second most common contributor to autosomal recessive nonsyndromic hearing loss (ARNSHL) worldwide. In this study, we used Exome Sequencing (ES) to present a village with 31 individuals affected by hereditary hearing loss (HHL) in southeastern Iran near the border of Pakistan. The village harbored the known pathogenic missense <i>SLC26A4</i> (NM_000441.2):c.716T>A (p.Val239Asp) mutation, which has a founder effect attributed to Pakistan, Iran's southeastern neighbor. Our findings, in addition to unraveling the molecular cause of non-syndromic hearing loss in these patients and further confirming the common ancestry and migration story between the people of this region and Pakistan, provide further insight into the genetic background of this region and highlight the importance of understanding the mutation spectrum of <i>GJB2</i> and <i>SLC26A4</i> in different regions to choose cost-effective strategies for molecular genetic testing.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 9","pages":"522-526"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513447","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":"In Commemoration of Dr. Farrokh Modabber: An Iranian Pioneer of Cellular Immunology, and Leishmaniases Vaccine Research in Iran and the World.","authors":"Fariborz Bahrami, Ehsan Mostafavi","doi":"10.34172/aim.28959","DOIUrl":"10.34172/aim.28959","url":null,"abstract":"<p><p>Born in 1940 in Rasht, Iran, Dr. Farrokh Modabber earned his B.A. in Bacteriology and Ph.D. in Microbiology from University of California, Los Angeles (UCLA). He joined the Harvard Medical School as a fellow before transitioning to a faculty role at Harvard School of Public Health (HSPH) and played a pivotal role in advancing Cellular Immunology. In the early 1970s, he returned to Iran as an Associate Professor at Pahlavi University in Shiraz. Subsequently, he rejoined HSPH before embarking on a tenure at Tehran University. As the head of the Pathobiology Department at Tehran University School of Public Health, he initiated the Tehran/Harvard joint M.Sc. program in Immunology, which played a crucial role in shaping the careers of numerous Iranian immunologists over the following decades. Dr. Modabber went on to hold esteemed positions such as Director General of the Pasteur Institute of Iran, visiting immunology lecturer at various universities, Coordinator of Research Capability Strengthening of WHO's Special Program for Research and Training in Tropical Diseases (TDR), Director of the Infectious Disease Research Institute (IDRI), and Senior Advisor of Drugs for Neglected Diseases initiative (DNDi), to name a few. This article highlights Dr. Modabber's impactful career, focusing on his efforts to combat global leishmaniasis.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 9","pages":"530-537"},"PeriodicalIF":1.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513451","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}