ORIGINAL_ARTICLE
The Prevalence of Sleep Apnea in Iran: a Systematic Review and Meta-Analysis
Background: Sleep apnea is a common sleep disorder which is associated with cardiovascular diseases, diabetes and stroke. Different studies conducted in Iran have reported different prevalence for sleep apnea. The aim of the present study was to determine the prevalence of sleep apnea in Iran. Materials and Methods: In this study, 42 studies that have been published in Farsi and English languages were selected with no time limit up to the March of 2018. Article search was conducted using “prevalence”, “frequency”, “sleep apnea” and “obstructive sleep apnea” keywords in Scientific Information Database (SID), MagIran, Google Scholar, Science Direct, PubMed and Scopus databases. Data were analyzed using meta-analysis and random effect model methods. Heterogeneity between the studies was evaluated using I2 test. Data were analyzed using Stata software version 11.2. Results: The total prevalence of metabolic syndrome was 44% (95% CI: 35% to 53%). The highest prevalence of sleep apnea distinguished by the disease belonged to patients with sleep disorders (74%, 95% CI: 66%-82%), diabetes mellitus (61%; 95% CI: 46%-76%) and cardiovascular disease (55%; 95% CI: 47%- 63%). Conclusion: Given high prevalence of sleep apnea in Iran, identifying people at risk and providing instructional materials for controlling and treating sleep apnea is necessary.
https://www.tanaffosjournal.ir/article_239993_ce6928fca118f848106bd6bac6da7c65.pdf
2019-01-01
1
10
Sleep apnea
meta-analysis
Iran
Prevalence
Mandana
Sarokhani
1
Research Center for Prevention of Psychosocial Injuries, Ilam University of Medical Sciences, Ilam, Iran,
AUTHOR
Mitra
Goli
2
University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.,
AUTHOR
Shahin
Salarvand
3
Social Determinants of Health Research Center, Nursing and Midwifery Faculty, Lorestan University of Medical Sciences, Khorramabad, Iran.
AUTHOR
Reza
Ghanei Gheshlagh
4
Department of Nursing, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran.
LEAD_AUTHOR
ORIGINAL_ARTICLE
Vitamin D Deficiency among Patients with Tuberculosis: a Cross-Sectional Study in Iranian-Azari Population
Background: Vitamin D deficiency or insufficiency has been conducted with increased risk for tuberculosis (TB). Despite this association, discrepancies exist among different studies in different regions. The aim of this study was to evaluate the prevalence of vitamin D deficiency and its predictors in tuberculosis among the Iranian-Azari population. Materials and Methods: A total of 60 participants were enrolled in this study, 30 of which were newly diagnosed TB patients and 30 were healthy volunteers. At least two serum samples were collected, the first sample before the start of anti-TB treatment and the second sample 3 months after the effective treatment. Results: The prevalence of vitamin D deficiency (25 patients vs. 2 healthy individuals; p <0.001) and serum levels of the vitamin D (22.66±15.17 vs. 73.03±25.6 ng/mL; p <0.001) were significantly higher in patients with TB than healthy subjects. Likewise, the prevalence of vitamin D deficiency in the extrapulmonary TB group was higher than that of the pulmonary TB, but this difference was not statistically significant (P=0 .397). Moreover, there was no significant difference between mean levels of vitamin D in patients with tuberculosis before and after treatment (P = 0.787). Linear regression analysis showed there was no significant relationship between vitamin D levels after treatment and age, gender, body site of tuberculosis, and vitamin D levels before treatment, P≥0.68. Conclusion: Vitamin D deficiency is higher in patients with tuberculosis than healthy individuals.
https://www.tanaffosjournal.ir/article_239994_33955c5d4cc820db64440a34a21c9969.pdf
2019-01-01
11
17
Vitamin D Deficiency
25-hydroxyvitamin D
Mycobacterium tuberculosis
Epidemiology
Pulmonary
Masoud
Nouri-Vaskeh
1
Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
AUTHOR
Sepehr
Sadeghifard
2
Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,
AUTHOR
Parviz
Saleh
3
Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
LEAD_AUTHOR
Jafar
Farhadi
4
Molecular Medicine, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
Mahan
Amraii
5
Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,
AUTHOR
Khalil
Ansarin
6
Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,
AUTHOR
ORIGINAL_ARTICLE
Spatio-Temporal Analysis of Tuberculosis in Hamadan Province, West of Iran, from 1992 to 2013
Background: Tuberculosis (TB) despite being preventive and treatable still imposes a huge burden of morbidity and mortality in developing and developed countries. We aimed to investigate the spatial and geographical distribution of TB in Hamadan province during 1992-2013. Materials and Methods: This cross-sectional study was performed in Hamadan province, West of Iran using the surveillance database. We examined the trend for incidence rates of all TB forms including Smear Positive Pulmonary TB (SPPT), Smear Negative Pulmonary TB (SNPT) and Extra pulmonary TB (EPT) per 100,000 populations. Poisson regression model was used to estimate the standardized rates for incidence rate of all types of TB per each county. Results: In this study 3,602 TB patients including 1,359 SPPT, 987 SNPT, and 1,256 EPT were included during 1992-2013. Trend of all types of TB decreased from 1992 to 2013. The Average Annual Percent change (AAPC) for all types of TB was significantly (p <0.05) decreased, AAPC= -6.4 (95% CIs: -10.7, -1.9). Among SPPT, SNPT, and EPT incidence rates, the maximum change was related to SNPT (-11.6; 95% CIs: -24.2, 3), while it was -1.4 (-8.7, 6.4) for SPPT and -5.8 (-11.4, 0.1) for EPT. Conclusion: Our results showed that the incidence of TB in Hamadan province during a 22-year period has decreased 6.4% on average, somehow higher than the national average. Furthermore, our study showed that the risk of extrapulmonary occurrence in western parts of the province is higher than others parts.
https://www.tanaffosjournal.ir/article_239995_23bc6ebabc11f3460272fe825f9570d3.pdf
2019-01-01
18
24
tuberculosis
Spatio-temporal analysis
Incidence
Hamadan
Salman
Khazaei
1
Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran,
AUTHOR
Shahrzad
Nematollahi
2
Men`s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
AUTHOR
Amin
Doosti-Irani
3
Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
AUTHOR
Ali
Zahiri
4
Deputy of Health, Hamadan University of Medical Sciences, Hamadan, Iran.
AUTHOR
Arash
Mofarrah-Zat
5
Deputy of Health, Hamadan University of Medical Sciences, Hamadan, Iran,
AUTHOR
Erfan
Ayubi
6
Department of Community Medicine, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran,
AUTHOR
Elham
Hooshmand
7
Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
AUTHOR
Ensiyeh
Jenabi
8
Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
AUTHOR
Mohammad
Saatchi
9
Department of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
LEAD_AUTHOR
ORIGINAL_ARTICLE
The Importance and Place of Methemoglobin and Carboxyhemoglobin Levels in the Diagnosis and Prognosis of Pulmonary Embolism
Background: This is a retrospective study to investigate the effects of Carboxyhemoglobin (COHb) and Methemoglobin (MetHb) levels in the diagnosis and prognosis of Pulmonary Thromboembolism (PTE). Materials and Methods: Cases that were confirmed with PTE diagnosis using CT Pulmonary Angiography (CTPA) or Ventilation/Perfusion Scintigraphy were accepted as pulmonary embolism. And patients which were excluded using the same methods were accepted as the control group. Patients with carbon monoxide poisoning, Chronic Obstructive Pulmonary Disease (COPD), sepsis, pneumonia, asthma, idiopathic pulmonary fibrosis, bronchiectasis, decompensated cardiac failure or those who used drugs that cause methemoglobinemia (sulphanomides, dapson, phenacetin, primacine,benzocaine) were not included in the study. Results: In our study, 462 patients were examined with an initial PTE diagnosis. Among these patients, 107 patients who met the inclusion criteria were included in the study. The mean age of all patients was 56.44 ±17.3 years (21-86) and the mean age of patients with PTE diagnosis was 55.3 years and the mean age of excluded patients was 59 years (p:0.27). When the blood gas parameters of both groups were compared, COHb levels in the groups with PTE diagnosis were statistically significantly higher (p=0.001), and the PO2 levels in the group excluded for PTE diagnosis were statistically significantly higher (p=0.028). In our study, six of our patients (8.1%) died in the early stages because of PTE. Conclusion: In our study, COHb level was found to be statistically significant in the group with PTE. However, this value was not higher than the normal COHb level in the blood. We found that MetHb and COHb levels were not statistically significant in the prognosis of PTE.
https://www.tanaffosjournal.ir/article_239996_407599e8fbc1b38dae97b75345f3399c.pdf
2019-01-01
25
33
Carboxyhemoglobinemia
Methemoglobinemia
Pulmonary embolism
Fatih
Uzer
1
Kastamonu State Hospital, Department of Respiratory Medicine, Kastamonu, Turkey
LEAD_AUTHOR
Omer
Ozbudak
2
Akdeniz University Faculty of Medicine, Department of Respiratory Medicine, Antalya, Turkey
AUTHOR
ORIGINAL_ARTICLE
The Relationship between Electrocardiographic Changes and Prognostic Factors in Severely Symptomatic Pulmonary Hypertension
Background: The prognostic role of the electrocardiogram (ECG) in PH is not fully known. We aimed to evaluate ECG abnormalities in severe PH, the association of ECG patterns with known prognostic factors and to determine whether ECG abnormalities were associated with decreased survival in patients with severe PH. Materials and Methods: Fifty-two patients with severe PH were included. Clinical assessment included basic demographics, complete physical examination, determination of WHO FC, measurement of N-terminal pro-BNP, 12-lead electrocardiography, transthoracic echocardiography, right heart catheterization (RHC) and six minute walk test (6MWT). Results: Heart rate was correlated with NT-proBNP (r=0.54; p-value: 0.0001) and was higher in patients with severe RV dysfunction (93±12 vs. 83±4 bpm in moderate RV dysfunction). P-pulmonale was present in 51.9% of the patients and was significantly associated with severe RV dysfunction. qR in V1 (48.1%) was significantly associated with 6MWT and severe RV dysfunction. Overall, 10 patients died. Based on Kaplan-Meier results, median survival time was 38 months and estimated survival at 1 year, 3 years, and 5 years was 88%, 80% and 71 % respectively. In Cox regression analysis WHO FC, 6MWT, pericardial effusion, NT-pro BNP, heart rate, ST depression in V1 to V3, and presence of qR in V1 were predictors of mortality. After controlling for covariates, only NTproBNP was independently associated with decreased survival. Conclusion: ECG changes including P-pulmonale, qR pattern in V1, and heart rate indicative of right ventricular dysfunction are associated with prognostic factors in severe PH and may be a useful tool in the follow-up.
https://www.tanaffosjournal.ir/article_239997_f6c0657c4f6dce9d46126daba33f8883.pdf
2019-01-01
34
40
Electrocardiography
Pulmonary hypertension
Prognosis
Pulmonary
Seyed Reza
Seyyedi
1
1 Lung Transplantation Research Center, Department of Cardiology, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran,
AUTHOR
Babak
SharifKashani
2
Tobacco Prevention and Control Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
Makan
Sadr
3
Virology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran
LEAD_AUTHOR
Mandana
Chitsazan
4
1 Lung Transplantation Research Center, Department of Cardiology, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran,
AUTHOR
Majid
Malekmohammad
5
Tracheal Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
AUTHOR
Fateme
Monjazebi
6
Tracheal Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
AUTHOR
Farah
Naghashzadeh
7
1 Lung Transplantation Research Center, Department of Cardiology, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran,
AUTHOR
ORIGINAL_ARTICLE
Comparison of the Factors Influencing Pulmonary Arterial Pressure in Smoker and Non-smoker COPD Patients with Pulmonary Hypertension
Background: There are several prognostic factors in patients with Chronic Obstructive Pulmonary Disease (COPD) that include Forced expiratory volume in one second (FEV1), Body Mass Index (BMI), dyspnea severity, exercise capacity and Pulmonary Hypertension (PH). PH is one of the most important factors. PH pathogenesis in patients with COPD has not been clarified thoroughly and factors such as alveolar hypoxemia, polycythemia, acidosis and pulmonary vessels obstruction have been suggested. The authors assessed some of these contributing factors in smoker and non-smoker patients with COPD. Materials and Methods: This comparative-descriptive study included COPD patients suspected to have cor pulmonale without exacerbation in the last four weeks. Echocardiographic evaluation of Pulmonary Arterial Pressure (PAP) was done and Pulmonary Hypertension (PH) was defined as systolic Pulmonary Arterial Pressure (PAP) greater than 40 mmHg. Complete Blood Count (CBC) and Arterial Blood Gas (ABG) were also studied in all patients. Results: Echocardiography was done for 142 patients who were suspected to have PH and 110 patients had measurable PAP. All of the patients were in stage II - IV of COPD according to GOLD criteria. 90 patients had PH of which 47 were smokers and 43 were non-smokers. In smoker patients, significant correlation between PAP and PaO2 was seen (r=-0.291, p-value=0.047). But in non-smoker patients, this correlation was absent. A significant correlation between PAP and FEV1 (r=-0.341, P value=0.025) was seen in non-smoker patients. This correlation was absent in smoker patients. There was no correlation between PAP and hemoglobin, hemoglobin and FEV, and also PaO2 and FEV1 in smoker and non-smoker COPD patients. Conclusion: In non-smoker patients with COPD, degree of pulmonary parenchymal lesions and bronchial obliteration plays a more important role than hypoxia in the pathogenesis of pulmonary hypertension.
https://www.tanaffosjournal.ir/article_239998_add7ece3d3e2ae77d18e12c365d5d08c.pdf
2019-01-01
41
46
Pulmonary hypertension
Smoker
COPD
Non-smoker
Abolhasan
Halvani
1
Department of Internal Medicine, School of Medicine, Yazd Medical Science Branch, Islamic Azad University, Yazd, Iran.
LEAD_AUTHOR
Hamidreza
Haddad
2
Department of Internal Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.
AUTHOR
ORIGINAL_ARTICLE
Comparative Analysis of Mean Pleural Fluid D-dimer Level in Malignant and Non-Malignant Pleural Effusion Patients
Background: Malignant Pleural Effusion (MPE) is a condition that mostly presents with dyspnea. There are some ways to distinguish it from NonMalignant Pleural Effusion (NMPE).The aim of this study was to compare serum and pleural D-dimer levels between MPE and NMPE patients. Materials and Methods: Patients diagnosed with Pleural Effusion (PE) were selected to participate in this study. They were allocated in 2 groups of MPE and NMPE according to the etiology. Serum and pleural fluid D-dimer level were measured and statistically analyzed between two groups. Results: 32 MPE patients and 32 NMPE patients participated in this study. The mean age was 61.3 ± 12 years and M/F ratio was 35/29. The mean pleural and serum D-dimer levels were 3472± 1312 ng/dl and 3259±1220 ng/dl in patients with MPE, and 3425 ± 32.5ng/dl and 2425 ± 1311ng/dl in patients with NMPE, respectively. The serum D-dimer levels were not statistically different between 2 groups; while the pleural D-dimer levels were higher in MPE group in comparison with NMP patients (p <0.05). Conclusion: This study showed that pleural D-dimer levels were significantly different between two groups and therefore pleural D-dimer can be considered as a non-invasive tool for diagnosis of MPE.
https://www.tanaffosjournal.ir/article_239999_a9359e5acb05eb8e40759d6bce1faece.pdf
2019-01-01
47
51
Pleural effusion
Malignancy
D-Dimer
Mohammad
Emami Ardestani
1
Departments of Pulmonology, Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran,
AUTHOR
Mohammad
Modaemzadeh
2
Internal Medicine Department, Isfahan University of Medical Sciences, Isfahan, Iran,
AUTHOR
Ali Reza
Mohammadi
3
Isfahan University of Medical Sciences, Isfahan, Iran
LEAD_AUTHOR
ORIGINAL_ARTICLE
Association of Bile Acid and Pepsin Micro-aspiration with Chronic Obstructive Pulmonary Disease Exacerbation
Background: Chronic Obstructive Pulmonary Disease (COPD) is one of the most common chronic diseases all around the world. One of suggested risk factors for COPD is Gastroesophageal Reflux Disease (GERD). The aim of this study was investigation of the association between micro-aspiration of bile acid and pepsin with exacerbation attacks in COPD patients. Materials and Methods: The present study was a descriptive cross-sectional study. Fifty-two COPD patients were selected by simple sampling from patients referring to the Bessat Lung Clinic. Participants were divided into two groups of with and without COPD exacerbation history in the past year. The severity of the disease was determined based on the GOLD criteria (mild, moderate, severe and very severe). Then, all patients underwent bronchoscopy and the concentrations of bile acid and pepsin were compared in Broncho-Alveolar Lavage Fluid (BALF) of two groups. Results: The mean of bile acids in the group without COPD exacerbations was lower (27.38±3.26 μmol/Lit) than the group with COPD exacerbations (32.31±5.35 μmol/Lit) and this difference was not significant (P=0.436). The mean of pepsin in the first group was higher (118.46 ±15.44 ng/ml) than the second group (107.88±10.7 ng/ml) and this difference was also not significant (P=0.577). Conclusion: According to the results of this study, there is no association between disease severity and number of exacerbations with micro-aspiration of bile acid and pepsin in COPD patients.
https://www.tanaffosjournal.ir/article_240000_8f4a77a702e7b8b72fcf8dd2d50297ab.pdf
2019-01-01
52
57
COPD
Aspiration
Bile acid
Pepsin
Seyed-Mehdi
Hashemi-Bajgani
1
Department of Internal Medicine, School of Medicine, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran,
AUTHOR
Fatemeh
Abbasi
2
Imam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran,
AUTHOR
Ahmad
Shafahi
3
Department of Internal Medicine, School of Medicine, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran,
AUTHOR
Rostam
Yazdani
4
Department of Internal Medicine, School of Medicine, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran.
LEAD_AUTHOR
Mitra
Samareh Fekri
5
Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
AUTHOR
ORIGINAL_ARTICLE
Quality of Life and Work Productivity Impairment of Patients with Allergic Occupational Rhinitis
Background: Several studies demonstrated the negative impact of allergic rhinitis on Quality of Life (QOL) and occupational activities. Similar studies on allergic Occupational Rhinitis (OR) are rare. The aim of this study was to evaluate the QOL and work productivity of patients diagnosed with allergic occupational rhinitis. Materials and Methods: We conducted a cross-sectional study from January 2005 to December 2015 at the Department of Occupational Medicine in Farhat Hached Teaching Hospital-Tunisia including patients diagnosed with allergic OR. QOL was assessed by the Mini-RQLQ (Rhinitis quality of life questionnaire) and Work impairment was measured by WPAI (Work Productivity and Activity Impairment) questionnaire. Results: a total of 414 patients was enrolled in the study with a mean age of 37.82±8.08 years and a sex ratio = 0.33. Textile and clothing industry was the most represented sector (65.7%). The mean percent work time missed (absenteeism) due to allergic OR was 9.98±20.86% with a median of 0% and the mean presenteeism score was 46.7±32.67%. Overall QOL was 2.71±1.31. The most affected domains were practical problems and activity limitations. Absenteeism was positively correlated with age and eye symptoms scores. Both presenteeism and percent overall activity impairment were positively correlated with severe nasal obstruction and activity limitations score. Conclusion: Allergic OR impairs QOL and work productivity. Although it doesn’t seem to be associated with an important absenteeism, work productivity is reduced by an important rate of presenteeism. QOL and work productivity seem to interact significantly.
https://www.tanaffosjournal.ir/article_240001_49d22111f2cbcb626b098316e7f842b0.pdf
2019-01-01
58
65
Allergic occupational rhinitis
Quality of Life
productivity
impairment
Maher
Maoua
1
Department of Occupational Medicine – Teaching Hospital Farhat Hached, Avenue Ibn El Jazzar, Sousse, 4000, Tunisia,
AUTHOR
Olfa
El Maalel
2
Department of Occupational Medicine – Teaching Hospital Farhat Hached, Avenue Ibn El Jazzar, Sousse, 4000, Tunisia,
AUTHOR
Imène
Kacem
3
Department of Occupational Medicine – Teaching Hospital Farhat Hached, Avenue Ibn El Jazzar, Sousse, 4000, Tunisia
AUTHOR
Sana
Guedri
4
Department of Occupational Medicine – Teaching Hospital Farhat Hached, Avenue Ibn El Jazzar, Sousse, 4000, Tunisia
AUTHOR
Maha Ben
Kacem
5
Department of Occupational Medicine – Teaching Hospital Farhat Hached, Avenue Ibn El Jazzar, Sousse, 4000, Tunisia
AUTHOR
Sana
Aissa
6
University of Sousse, Faculty Of Medicine Ibn El Jazzar, Avenue Mohamed Karoui, 4002, Sousse, Tunisia,
AUTHOR
Monia
Ghammem
7
University of Sousse, Faculty Of Medicine Ibn El Jazzar, Avenue Mohamed Karoui, 4002, Sousse, Tunisia,
AUTHOR
Aicha
Brahem
8
Department of Occupational Medicine – Teaching Hospital Farhat Hached, Avenue Ibn El Jazzar, Sousse, 4000, Tunisia
AUTHOR
Houda
Kalboussi
9
Department of Occupational Medicine – Teaching Hospital Farhat Hached, Avenue Ibn El Jazzar, Sousse, 4000, Tunisia,
AUTHOR
Omid Moradi
Moghaddam
10
Trauma and Injury Research Center, Department of Critical Care, Iran University of Medical Sciences, Tehran, Iran,
AUTHOR
Mohammad
Niakan Lahiji
11
Trauma and Injury Research Center, Department of Critical Care, Iran University of Medical Sciences, Tehran, Iran,
AUTHOR
Mahshid
Talebi-Taher
12
Department of Infectious Disease, School of Medicine, Iran University of Medical Sciences, Tehran, Iran,
AUTHOR
Behnam
Mahmoodiyeh
13
Department of Anesthesiology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
LEAD_AUTHOR
ORIGINAL_ARTICLE
Effect of Inhaled Colistin on the Treatment of VentilatorAssociated Pneumonia due to Multi-drug Resistant Acinetobacter
Background: Ventilator-Associated Pneumonia (VAP) is a hospital pneumonia that is considered in patients on mechanical ventilation for at least 48 hours with symptoms of new lower respiratory tract infections being reported in them. The present study reviews the effect of adding inhaled colistin in the treatment of ventilator-induced pulmonary infections in Intensive Care Unit (ICU) patients. Materials and Methods: In this single blind clinical trial, patients admitted to the ICU with diagnosis of pulmonary infections caused by ventilator were investigated. In the treatment group, patients received 150 mg of colistin plus 1,000,000 units inhaled colistin every eight hours and in the control group only 300 mg of colistin every eight hours intravenously was given. Patients were followed up in terms of clinical findings for seven days after the initial diagnosis of infection. Results: The results of this study showed that administration of inhaled colistin in patients admitted in ICU significantly improved culture indices, leukocyte, white blood cell count, chest X-ray, chest secretion, CPIS score and saccharification (SpO2) on the third and seventh days after treatment compared to the first day. Conclusion: Considering the positive effect of adding inhaled colistin to the treatment of patients admitted to ICU with pulmonary infections caused by ventilator with multi-drug resistant Acinetobacter, the use of combination drug therapy is recommended.
https://www.tanaffosjournal.ir/article_240002_c1acf83f8c13437156ea30ac0bc019f3.pdf
2019-01-01
66
73
Pulmonary infection
ICU
Inhaled colistin
Omid Moradi
Moghaddam
1
Trauma and Injury Research Center, Department of Critical Care, Iran University of Medical Sciences, Tehran, Iran.
AUTHOR
Mohammad
Niakan Lahiji
2
Trauma and Injury Research Center, Department of Critical Care, Iran University of Medical Sciences, Tehran, Iran.
AUTHOR
Mahshid
Talebi-Taher
3
Department of Infectious Disease, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
AUTHOR
Behnam
Mahmoodiyeh
4
Department of Anesthesiology, School of Medicine, Arak University of Medical Sciences, Arak, Iran.
LEAD_AUTHOR
ORIGINAL_ARTICLE
The Ability of Polyuria in Prediction of Weaning Outcome in Critically Ill Mechanically Ventilated Patients
Background: Fluid balance and oliguria influence outcome in critically ill patients. Although, osmotic dieresis with hypernatraemia is a predictor of mortality in critically ill patients, the purpose of this study was to demonstrate the effect of polyuria as an independent predictor on weaning outcome in mechanically ventilated patients. Materials and Methods: This retrospective, single center, cohort study was carried out at Imam Teaching Hospital Intensive Care Unit (ICU) on 263 adult mechanically ventilated patients. We collected data of these patients during the mean seven consecutive days before weaning from mechanical ventilator. Patients with polyuria (sustained urine output greater than 3000 ml/day) were compared with patients without polyuria. The primary endpoint was successful weaning and the secondary endpoints were the mechanical ventilation duration, post weaning length of ICU stay, post weaning length of hospitalization and rate of mortality. Results: In 93 patients with polyuria, the mean age was 45.14±19.47 years in comparison of 170 patients without polyuria with mean age of 52.9±21.37 years (P=0.004). Fluid intake, urine output and temperature were significantly higher in patients with polyuria, but there were no statistical differences in systolic and diastolic blood pressure, serum electrolytes, urea and creatinine. No significant differences were found in primary and secondary endpoints including successful weaning, post weaning length of ICU stay, post weaning hospital duration and mortality, except for duration of mechanical ventilation (P=0.014). The area under the ROC curve for variables showed only seven days mean creatinine level before weaning which may act as a predictor of successful weaning (ROCAUC=0.67, 95% CI 0.61-0.73, P=0.0002). Serum creatinine level of 0.8 provided best overall combination of sensitivity and specificity for successful weaning (sensitivity 72.22%, 95% CI 54.8-85.8; specificity 61.19%, 95% CI 54.1-68.0). Conclusion: Polyuria cannot predict weaning outcome but maybe considered as a predictor of longer duration of mechanical ventilation and is probably associated with a subclinical renal dysfunction.
https://www.tanaffosjournal.ir/article_242161_7be111d42586156c8a8852a197b98d97.pdf
2019-01-01
74
78
Fluid balance
Polyuria
Weaning
Mechanical ventilation
Masoud
Aliyali
1
Internal Medicine Department, Pulmonary and Critical Care Division, Mazandaran University of Medical Sciences, Sari, Iran,
LEAD_AUTHOR
Ali
Sharifpour
2
Internal Medicine Department, Pulmonary and Critical Care Division, Mazandaran University of Medical Sciences, Sari, Iran,
AUTHOR
Siavash
Abedi
3
Internal Medicine Department, Pulmonary and Critical Care Division, Mazandaran University of Medical Sciences, Sari, Iran,
AUTHOR
Fatemeh
Spahbodi
4
Internal Medicine Department, Nephrology Division, Mazandaran University of Medical Sciences, Sari, Iran,
AUTHOR
Narges
Namarian
5
Internal Medicine Department, Mazandaran University of Medical Sciences, Sari, Iran
AUTHOR
Adel
Zarea
6
Internal Medicine Department, Mazandaran University of Medical Sciences, Sari, Iran
AUTHOR
Ahad
Alizadeh
7
Internal Medicine Department, Mazandaran University of Medical Sciences, Sari, Iran
AUTHOR
ORIGINAL_ARTICLE
Effect of Intrapleural Meperidine on Post-Operative Pain after Open Cholecystectomy
Background: Post-operative pain after open cholecystectomy can result in increased oxygen consumption, atelectasis, pneumonia, decreased vital capacity, and increased morbidity and mortality. The aim of this study was to compare the analgesic effects of intrapleural meperidine and intravenous morphine in controlling post-cholecystectomy pain. Materials and Methods: In a double-blinded randomized clinical trial, 72 patients who were candidate for elective open cholecystectomy, were divided randomly into two groups based on accidental randomized numbers. Anesthesia technique was precisely the same for all patients. At the end of surgery, 50 mg of meperidine (diluted in 20 cc normal saline) was injected intrapleurally for meperidine group patients; whereas, 0.1 mg/kg intravenous morphine was injected intravenously in control group. Onset of pain and total dose of rescue analgesic were measured. Results: In order to obtain a Numerical Rating Scale (NRS) <3, the difference in morphine consumption up to 12 hours in two groups (4.4 ±1.7 mg in meperidine group & 5±2 mg in control group) was not statistically different. However, the first request for analgesia in meperidine group was delayed significantly longer than the control group (146.6 ±6.8 minutes in meperidine group & 40 ±1.8 minutes in control group). Conclusion: A single injection of intrapleural meperidine can delay the first request for analgesia in open cholecystectomy compared to intravenous morphine.
https://www.tanaffosjournal.ir/article_242162_9a307cb01ef3e9e36c4cbef96f3ae1df.pdf
2019-01-01
79
83
Cholecystectomy
Pain
Intrapleural
Meperidine
Kamran
Mottaghi
1
Anesthesiology Research Center, Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
Farhad
Safari
2
Anesthesiology Research Center, Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
Parisa
Sezari
3
Anesthesiology Research Center, Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
Alireza
Salimi
4
Anesthesiology Research Center, Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
Masoud
Nashibi
5
Anesthesiology Research Center, Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
ORIGINAL_ARTICLE
Removing an Entrapped Pigtail Catheter by Re-enforcing a Traditional Method
Right heart catheterization is the main step in the evaluation of pulmonary hypertension including Chronic Thromboembolic Pulmonary Hypertension (CTEPH) and is considered a relatively safe procedure. Complications can occur including perforation, tamponade, bleeding, etc. requiring different types of interventions such as manipulation or surgery. Here, we have described a case of pigtail catheter entrapment and the method we used to free it without invasive measures.
https://www.tanaffosjournal.ir/article_242163_6a744e3296c89b897102d1668066d073.pdf
2019-01-01
84
87
Pulmonary artery catheterization
Cardiac catheter
Chordae tendineae
Alireza
Serati
1
Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
AUTHOR
Babak
Sharif-kashani
2
Tobacco Prevention and Control Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
LEAD_AUTHOR
Zargham Hossein
Ahmadi
3
Lung Transplantation Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
Farah
Naghashzadeh
4
Lung Transplantation Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
Neda
Behzadnia
nedabehzadnia@yahoo.com
5
Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
AUTHOR
Mandana
Chitsazan
6
Tobacco Prevention and Control Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
AUTHOR
Payam
Abbasi
7
Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
AUTHOR