Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 11 2023 01 10 662 669 EN Ahmad Khajeh-Mehrizi Department of Hematology and Medical Oncology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Seyed Amir Hossein Emami Department of Hematology and Medical Oncology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Seyed Reza Safaee Nodehi Department of Hematology and Medical Oncology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Zahra Jahangard-Rafsanjani Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Kamran Roudini Department of Hematology and Medical Oncology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Mohammad Reza Dabiri Department of Hematology and Medical Oncology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Seyed Amir Mahdi Emami School of Pharmacy, Tehran Branch of Azad University, Tehran, Iran 2022 03 20 2022 09 12 Adherence to capecitabine, an effective oral chemotherapy agent, is essential in achieving treatment response in cancer. In this study, we aimed to investigate factors associated with non-adherence to capecitabine in a sample of patients with gastrointestinal cancer. We enrolled 98 patients with colon, rectal or gastric cancers who were undergoing treatment with capecitabine as part of their single or multi-agent chemotherapy regimen. The patients were followed during cohort time up to four consecutive cycles of their chemotherapy. For adherence measurement, the participants were asked to bring back the leftover medicines at the time of follow-up visits and were considered adherent if they had taken ≥95% of their prescribed dose. The mean adherence rate was 97.7%, and the patients were adherent to capecitabine in 93.1% of their cycles. The patients who underwent neoadjuvant chemotherapy were significantly less adherent to capecitabine (60%) as compared with adjuvant (95.2%) and palliative chemotherapy (94.6%) [P=0.004]. Multivariable logistic regression revealed that neoadjuvant chemotherapy and the presence of nausea and mucositis were inversely associated with adherence rate. We did not find any association between adherence and any of our laboratory findings. Our findings suggest a high adherence rate to capecitabine among patients with gastrointestinal cancers. Neoadjuvant chemotherapy and the presence of nausea and mucositis may play a significant role in non-adherence to capecitabine.   https://acta.tums.ac.ir/index.php/acta/article/view/10051

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 11 2023 01 10 670 674 Hossien Hemmati Department of Vascular Surgery, Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran Mohammad Sadegh Esmaeili Delshad Department of Vascular Surgery, Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran Mohammad Taghi Ashoobi Department of Vascular Surgery, Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran Habib Eslami kenarsari Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran Mohaya Farzin Department of Physiology, Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran Seyedeh Maral Mousavi Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran 2022 03 28 2022 12 17 Hemodialysis access has been considered as a support for end-stage renal patients. We measured the hemodynamic changes of the distal part of the upper extremity immediately after providing the AVGs in each method mentioned above and then compared the results. This method is a novel one and hasn’t been used in any other studies before. We studied 32 patients referred to the vascular surgery department of Rasht Razi Hospital between 2019-2020 (using the Convenient Sampling method). This study is a case-control study. Out of 32 patients referred to the vascular surgery department of the hospital, 68.8% were male, and their mean age was 53.41±12.75 years, ranging from 28 to 78 years. Changes in distal arterial hemodynamics of the upper limb before and after clamping in dialysis venoarterial loop versus straight grafts are different in studied patients (P<0.05). The mean hemodynamic changes before and after clamping in loop venoarterial grafts (19.5000) are less than straight grafts. In dialysis patients who do not have any superficial vein suitable for venous, arterial fistula, surgical placement of artificial grafts in the upper limb is appropriate. Based on the results of this study, the loop method seems to have lesser ischemic Complications and can be applied to dialysis patients. https://acta.tums.ac.ir/index.php/acta/article/view/10063

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 11 2023 01 10 675 679 Ons Hamdi Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia. ANDFaculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia Meriem Sellami Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia . AND Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia Saoussen Miladi Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia. AND Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia Alia Fazaa Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia. AND Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia Kmar Ouenniche Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia. AND Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia Leila Souebni Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia. AND Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia Selma Kassab Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia. AND Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia Selma Chekili Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia. AND Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia Kaouther Ben Abdelghani Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia. AND Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia Ahmed Laatar Department of Rheumatology, Mongi Slim Hospital, Tunis, Tunisia. AND Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia 2021 12 15 2021 12 26 The pandemic caused by Coronavirus-19 Disease (COVID-19) is having negative effects on healthcare workers (HCW) mental health due to the tremendous amount of stress to which they are exposed to. We aimed to assess the number of mental health outcomes among HCW treating patients with COVID-19. This cross-sectional study collected demographic data and mental health measurements from HCW in different hospitals using an online questionnaire. Participants were asked to complete the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Insomnia Severity Index (ISI), and the 7-item Generalized Anxiety Disorder scale (GAD-7). One hundred and forty-one participants with a mean age of 30.6±25 years and a sex ratio of 0.3 completed the online questionnaire. Participants from major university-hospital centers of northern Tunisia were divided into two groups: 78% medical and 22% paramedical staff. Twenty-two participants (15.6%) had a chronic disease, and 21 (14.9%) had a history of depression. Nineteen (13.4%) of the participants were infected with COVID-19. Thirteen percent of participants experienced the same anxiety level as the first-time taking care of COVID-19 patients, while 65% were rather an at ease compared to the first time. Forty-seven percent of participants felt the need for psychological support, and 16.7% of them had consulted a psychiatrist. Mild depression was detected in 14.1% of cases, moderate depression in 4.2% of cases, and severe depression in 2.1% of cases. As for anxiety, 36.1% of participants suffered from mild anxiety, 14.9% from moderate anxiety, and 4.9% from severe anxiety. Mild insomnia was detected in 44.6% of cases, moderate insomnia in 14.9% of cases, and severe insomnia in 9.9% of cases. Female gender (depression: P=0.05; anxiety: P=0.05; insomnia: P=0.02), having friends or relatives with COVID (depression: P=0.01; anxiety: P=0.05), psychiatric illness (depression: P=0.05; anxiety: P=0.01; insomnia: P=0.01), and chronic disease (depression: P=0.02; anxiety: P=0.03) were significantly associated with more severe mental health symptoms. Tunisian HCW experienced psychological burdens and a high rate of anxiety, depression, and insomnia. HCW should be protected in order to promote mental well-being. https://acta.tums.ac.ir/index.php/acta/article/view/9858

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 11 2023 01 10 680 687 Nastaran Rahimi Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Behnam Behnoush Department of Forensic Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. AND Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran Hamed Hosseini Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran. Amir A Fakhrabadi Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Nina Javadian Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Nasrin Barzegari arzegari Dahaj Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran Adeleh Maleki Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Seyed Morteza Tabatabaei Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran Ahmad Reza Dehpour Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2022 09 14 2022 11 09 Accidental or intentional poisoning with Aluminum phosphide (AlP) is associated with severe complications such as metabolic acidosis, cardiac failure, and death. Previous animal experiments demonstrated that fresh-packed RBC is protective in an experimental model of AlP poisoning. The aim of this study was to assess the effect of fresh-packed RBC on survival in patients admitted to a referral hospital due to AlP poisoning in a randomized clinical trial. Eighty-two patients were admitted to Clinical Toxicology Unit at Baharloo Hospital due to acute AlP poisoning after approval by the Iranian Registry of Clinical Trials (registration reference: IRCT20180428039443N1). All patients received standard treatment, and forty-one of them received fresh-packed RBC. There was no significant difference between groups in the underlying characteristics, including vital signs and laboratory investigations. But interestingly, the mortality rate was meaningfully decreased (difference: 31.7%, 95% CI: 0.10-0.52) in patients receiving fresh-packed RBC (10 deaths/31 survived; 24.4% mortality) in comparison to standard treatment patients (23 deaths/18 survived; 56.1% mortality). Furthermore, fresh-packed RBC substantially improved the GCS, systolic/diastolic blood pressure, ST changes, and pH 12- and- 24 hours after admission. This study showed that fresh-packed RBC infusion alongside standard supportive treatment leads to a decrease in mortality rate; also, it provided evidence for a protective role of fresh-packed RBC in the management of patients with acute AlP poisoning. https://acta.tums.ac.ir/index.php/acta/article/view/10359

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 11 2023 01 10 688 694 Hassan Hashemi Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran Reza Pakzad Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran Amir Asharlous Noor Ophthalmology Resrach Center, Noor Eye Hospital, Tehran, Iran Abbasali Yekta Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran Mohammad Mehdi Sadoughi Department of Ophthalmology, Shahid Labbafinezhad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hadi Ostadimoghaddam Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Mehdi Khabazkhoob Department of Basic Siences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2021 09 01 2022 06 09 To investigate the prevalence of Meibomian gland dysfunction (MGD) and its relationship with some determinants in underserved villages of Iran. This population-based cross-sectional study was conducted on 3850 subjects that were randomly selected from the villages of two underserved districts in the north and southwest of Iran using multistage cluster sampling. All participants underwent complete ophthalmic examinations, including visual acuity and refraction measurement. Then, slit-lamp biomicroscopy was done by an ophthalmologist to investigate MGD. Of 3850 subjects that were invited, 3314 participated in the study (participation rate=86.07%), of whom 1834 (55.34%) were women. The mean age of the participants was 37.7±21.4 years (range=2-93 years). The prevalence (95% CI) of MGD in at least one eye was 29.20% (27.35 to 31.06). According to the results of multiple regression analysis, MGD had a positive association with the male sex (OR: 1.75; CI 95%: 1.44 to 2.13), age 61-70 years (OR: 7.15; CI 95%: 3.65 to 14.01), and living in southern villages (OR: 1.82; CI 95%: 1.48 to 2.22) and an inverse association with education level (OR: 0.89; CI 95%: 0.80 to 0.98). The results of this study showed a lower prevalence of MGD even in Iranian rural regions compared to other Asian countries. This study found that older age, male sex, and low education level served as MGD risk factors. It seems that improved health conditions are an important factor in preventing MGD. https://acta.tums.ac.ir/index.php/acta/article/view/9639

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 2022 01 08 40 45 Somayeh Aslani Department of Biochemistry, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Saman Bahrambeigi Department of Basic Sciences, School of Veterinary Medicine, Urmia University, Urmia, Iran Davoud Sanajou Department of Biochemistry, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran 2020 07 25 2021 12 08 Despite dietary/lifestyle modifications as well as glycemic and lipid control, non-alcoholic fatty liver disease (NAFLD) imposes a considerable risk to the patients by advancing to non-alcoholic steatohepatitis (NASH). The present investigation aims to evaluate the protective potential of FPS-ZM1, a selective inhibitor for advanced glycation end products (RAGE), against circulating indices of liver injury in high fat diet-induced diabetic mice. FPS-ZM1 at 0.5. 1, and 2 mg/kg (orally) was administered for 2 months, starting 4 months after provision of the high-fat diet. Tests for glucose homeostasis, liver injury markers, and hepatic/plasma miR-21 expressions were performed. FPS-ZM1 attenuated diabetes-induced elevations in serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamate dehydrogenase (GLD), and alpha glutathione-S-transferase (α-GST) as well as alkaline phosphatase (ALP) and gamma-glutamyl transpeptidase (GGT). It also decreased diabetes-associated elevations in serum ferritin and plasma cytokeratin 18 fragments. Additionally, FPS-ZM1 down-regulated elevated expressions of miR-21 in the liver and plasma of diabetic mice. These findings highlight the benefits of FPS-ZM in alleviating liver injury in mice evoked by high-fat diet-induced type 2 diabetes and suggest FPS-ZM1 as a new potential adjunct to the conventional diet/lifestyle modification and glycemic control in diabetics. https://acta.tums.ac.ir/index.php/acta/article/view/8669

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 1 2022 01 08 46 55 Masoomeh Shahsavari Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran Fatemeh Karami Robati Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran Atefeh Ahmadi Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran. AND Department of Counselling in Midwifery, Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran Vahid Yazdi-Feyzabadi Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Bagher Amirheidari Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran Aliakbar Haghdoost Department of Epidemiology and Biostatistics, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran 2020 08 08 2021 12 08 The main indicators of higher education (HE) internationalization in the field of awarding degrees are the international development of disciplines and interdisciplinary sciences, new educational and learning methods, new and updated curricula, and their correct ways of sharing. This study aimed to examine the system of awarding degrees in health HE of Iran and the United Kingdom. This descriptive-comparative study focused on the field of medical sciences and its related disciplines. The vital information about the variables was collected by visiting the official websites of the UK universities and related or joint organizations. The related information to the Kerman University of Medical Sciences as a sample of Iran medical universities was obtained from the university’s Farabar system. All data extraction steps were performed manually. There were differences in the mechanism of setting up a new discipline and the process of students’ admission, diversity of degrees’ titles and curriculums, stability of disciplines over the time, creativity in creating competition between different disciplines, the reason for establishing a discipline and the requirements for certification and awarding of degrees in health sciences disciplines in Iran and the United Kingdom were described. Propelling of medical education in the health sciences area towards standard awarding degree systems can be responsible for the requirements of internationalization of higher education. https://acta.tums.ac.ir/index.php/acta/article/view/8707

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 1 2022 01 08 56 61 Tolou Hasandokht Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Arsalan Salari Cardiovascular Disease Research Center, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran. ANDDepartment of Cardiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Salman Nikfarjam Cardiovascular Disease Research Center, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran .ANDDepartment of Cardiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Soheil Soltanipour Department of Community Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Mani Shalchizadeh Cardiovascular Disease Research Center, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran. ANDDepartment of Cardiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Alimohammad Sadeghi Meibodi Cardiovascular Disease Research Center, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran. ANDDepartment of Cardiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran 2020 08 15 2021 12 08 Cardiovascular disease (CVD) mortality has increased in the Iranian population. Word Health Organization (WHO) risk score was recently used in Iranian prevention and control of non-communicable disease programs for risk assessment. The purpose of the study was to compare the 10-year cardiovascular risk using atherosclerotic cardiovascular disease (ASCVD) and WHO risk score. In a cross-sectional study, data from patients with cardiac symptoms without any documents related to CVD were collected from the outpatient clinic. The proportion of subjects with high CVD risk according to ASCVD and WHO risk score and also agreement between two scores was presented. The sensitivity and specificity of ASCVD according to the WHO risk score as a national risk assessment tool were calculated. The study included 284 subjects with a mean age of 53.80 (8.78) years and 68 % of women. The frequency of subjects with high CVD risk based on ASCVD and WHO was 35% and 6%, respectively. The agreement between the two scores was moderate (κ=0.45), with the most agreement in identifying low-risk subjects. The sensitivity and specificity of ASCVD according to the WHO risk score was 95.3% and 75.1%, respectively. The present finding showed that Agreement between two risk scores was moderated, especially in stratifying low-risk subjects. But, the ASCVD risk score categorized more people as a high risk rather than the WHO tool. Assessment of the accuracy of the WHO risk score with comparing predicted risk with observed risk in a cohort study for the Iranian population is necessary. https://acta.tums.ac.ir/index.php/acta/article/view/8730

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 1 2022 01 11 62 63 EN Ahmet Halefoglu Department of Radiology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey 2020 11 07 2021 10 27 Vein of Galen aneurysm (VGAM) is a rare vascular malformation accounting for less than 1% of all intracranial abnormalities. In this case report, we performed computed tomography (CT) and magnetic resonance imaging (MRI) examinations for a 26-year-old female patient who presented with a severe headache. On these images, a right thalamo-choroidal arterio-venous malformation (AVM) with secondary aneurysmal dilatation of the vein of Galen was suspected, and a CT angiography was performed for further evaluation, which confirmed the diagnosis. The patient refused digital subtraction angiography (DSA) and probable endovascular treatment. Although it is rarely seen in the adult population, CT and MRI have a tremendous impact on the diagnosis of these patients. We should also emphasize the role of CT angiography in the diagnosis and further evaluation of these vascular malformations. Endovascular therapy is regarded as an effective and safe technique in the treatment of these patients. https://acta.tums.ac.ir/index.php/acta/article/view/8923

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 1 2022 01 08 64 66 Asiyeh Maleki Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Leila Pourali Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 2021 05 18 2021 11 08 Labial adhesion usually occurs in the infancy period and in prepubertal girls. It is a rare entity in reproductive age without any hypoestrogenism condition. Voiding dysfunction is a rare manifestation of these conditions. Here, we report a 19-year-old girl with complete labial adhesion presented with urinary retention. A 19-year-old virgin girl was referred to the obstetrics and gynecology department of Ghaem Hospital. She complained of urinary retention. Physical examination was normal except that was moderate hypogastric tenderness and a huge vesical globe. Genital examination revealed complete fusion of the labia minora in the midline, extended from the posterior fourchette to the region of the clitoris covering the entire vaginal introitus, urethral meatus, and clitoris. Despite the use of topical estrogen cream and surgical labial separation, re-adhesion occurred for the third time. Vulvar biopsy confirmed severe inflammation. Finally, topical anti-inflammatory medication improved the symptoms. Although labial adhesion is very rare in the post-pubertal period, it can successfully be managed by medical and surgical treatment. https://acta.tums.ac.ir/index.php/acta/article/view/9410

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 1 2022 01 11 67 70 Rahim Raofi Department of Infectious Disease, Jahrom University of Medical Sciences, Jahrom, Iran Yasaman Pourfarid Department of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran Navid Kalani Department of Anesthesioplogy, Research Center for Non-Communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran Mohsen Hojat Department of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran