Isfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954380920250522Evaluation of Relevance of Sonographic Findings with Prognosis and Outcomes of Pregnancy in Preeclampsia Patients in Comparison with Control GroupEvaluation of Relevance of Sonographic Findings with Prognosis and Outcomes of Pregnancy in Preeclampsia Patients in Comparison with Control Group2642743292810.48305/jims.v43.i809.0264FAMahshidBahramiDepartment of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-0799-8059AliHekmatniaProfessor, Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-1145-4502FaribaAlikhaniDepartment of Radiology, Iran University of Medical Sciences, Iran, IranMinooMovahediAssociate Professor of Obstetrics and Gynecology, Department of Obstetrics & Gynecology, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-4035-2647MaryamRoshanDepartment of Radiology, Isfahan University of Medical Sciences, Isfahan, IranPooyaKianiDepartment of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-4545-5642Journal Article20240601<strong>Background:</strong> Preeclampsia is a multisystem disorder during pregnancy, affecting approximately 5–7% of pregnancies and leading to several complications in the mother, fetus and neonate. To date, no precise method has been discovered for the prevention and accurate screening of preeclampsia.<br /><strong>Methods:</strong><strong> </strong>One proposed method for predicting the occurrence of preeclampsia is placental sonography and color Doppler and spectral Doppler and assessment of Pulsatility Index (PI) of uterine and umbilical arteries. This study aimed to evaluate the relevance of grayscale sonography, color Doppler and spectral Doppler findings of the placenta and the associated vessels with prognosis and unpleasant outcomes of pregnancy in the mother, fetus and neonate, in two groups, pregnant women with preeclampsia and a healthy control group.<br /><strong>Findings:</strong><strong> </strong>The PI of uterine arteries (on each side, and the mean PI of bilateral uterine arteries), umbilical artery PI, and also presence of bilateral early diastolic uterine arteries notching on spectral Doppler study, had significantly higher incidence in the preeclampsia group. The Incidence of Preterm Birth, low fetal weight percentage, low fetal Abdominal Circumference, Low Birth Weight, rate of cesarean section, fetal and neonatal brain injuries, NICU admission and maternal ICU admission were significantly higher in the preeclampsia group. In addition, PI of uterine and umbilical arteries showed independent relevance with an increased rate of preterm birth.<br /><strong>Conclusion:</strong> The findings of this study suggest the prognostic usage of sonographic findings, particularly color and spectral Doppler studies, in predicting preeclampsia adverse outcomes of pregnancy in this setting.<strong>Background:</strong> Preeclampsia is a multisystem disorder during pregnancy, affecting approximately 5–7% of pregnancies and leading to several complications in the mother, fetus and neonate. To date, no precise method has been discovered for the prevention and accurate screening of preeclampsia.<br /><strong>Methods:</strong><strong> </strong>One proposed method for predicting the occurrence of preeclampsia is placental sonography and color Doppler and spectral Doppler and assessment of Pulsatility Index (PI) of uterine and umbilical arteries. This study aimed to evaluate the relevance of grayscale sonography, color Doppler and spectral Doppler findings of the placenta and the associated vessels with prognosis and unpleasant outcomes of pregnancy in the mother, fetus and neonate, in two groups, pregnant women with preeclampsia and a healthy control group.<br /><strong>Findings:</strong><strong> </strong>The PI of uterine arteries (on each side, and the mean PI of bilateral uterine arteries), umbilical artery PI, and also presence of bilateral early diastolic uterine arteries notching on spectral Doppler study, had significantly higher incidence in the preeclampsia group. The Incidence of Preterm Birth, low fetal weight percentage, low fetal Abdominal Circumference, Low Birth Weight, rate of cesarean section, fetal and neonatal brain injuries, NICU admission and maternal ICU admission were significantly higher in the preeclampsia group. In addition, PI of uterine and umbilical arteries showed independent relevance with an increased rate of preterm birth.<br /><strong>Conclusion:</strong> The findings of this study suggest the prognostic usage of sonographic findings, particularly color and spectral Doppler studies, in predicting preeclampsia adverse outcomes of pregnancy in this setting.https://jims.mui.ac.ir/article_32928_e3d45a69ec2fe85434bc276b0994e088.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954380920250522Thromboembolic Risk in Patients with COVID-19 Admitted to ICU in Two Teaching Hospitals in MashhadThromboembolic Risk in Patients with COVID-19 Admitted to ICU in Two Teaching Hospitals in Mashhad2752823292010.48305/jims.v43.i809.0275FASaharRavanshadAssociate Professor, Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0003-1421-5339ArezooRikhtehgarInternal Residency, Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranSamanehSajadiAssociate Professor, Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0001-5250-4540SajjadAtaei AzimiAssociate Professor of Hematology-Oncology, Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranArefehMazhari- MSc, Department of Hematology and Blood Banking, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-1809-2148HassanMehrad-MajdAssociate Professor, Cancer Molecular Pathology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-8745-6558Journal Article20240616<strong>Background:</strong> Thromboembolic events are a common complication in critically ill patients, and the risk is particularly elevated in patients with COVID-19, especially those admitted to intensive care units (ICUs). This study aimed to investigate the incidence of thromboembolic events and their association with clinicopathological features in patients with COVID-19 admitted to ICUs of two teaching hospitals in Mashhad.<br /><strong>Methods:</strong><strong> </strong>This retrospective study included all patients with COVID-19 admitted to ICUs over a one-year period. Demographic, clinical, laboratory, and therapeutic information, including age and gender, history of thromboembolic events, underlying diseases, medications, laboratory parameters, anticoagulant therapy, and prophylactic or therapeutic dose before thromboembolic events, were extracted from patient records. Patients were divided into two groups based on the occurrence of thromboembolic events and compared and analyzed for the relevant variables.<br /><strong>Findings:</strong><strong> </strong>A total of 272 patients were included in the study, of whom 15 (6%) developed thromboembolic events, with the most common type being CVA (86.7%). No statistically significant differences were observed between the two groups regarding demographic, clinical, and laboratory characteristics.<br /><strong>Conclusion:</strong> The incidence of thromboembolic events in patients with COVID-19 admitted to ICUs was consistent with reported ranges in other studies. The elevated risk of thromboembolic events in these patients underscores the need for intensified monitoring and implementation of preventive measures to reduce this risk.<strong>Background:</strong> Thromboembolic events are a common complication in critically ill patients, and the risk is particularly elevated in patients with COVID-19, especially those admitted to intensive care units (ICUs). This study aimed to investigate the incidence of thromboembolic events and their association with clinicopathological features in patients with COVID-19 admitted to ICUs of two teaching hospitals in Mashhad.<br /><strong>Methods:</strong><strong> </strong>This retrospective study included all patients with COVID-19 admitted to ICUs over a one-year period. Demographic, clinical, laboratory, and therapeutic information, including age and gender, history of thromboembolic events, underlying diseases, medications, laboratory parameters, anticoagulant therapy, and prophylactic or therapeutic dose before thromboembolic events, were extracted from patient records. Patients were divided into two groups based on the occurrence of thromboembolic events and compared and analyzed for the relevant variables.<br /><strong>Findings:</strong><strong> </strong>A total of 272 patients were included in the study, of whom 15 (6%) developed thromboembolic events, with the most common type being CVA (86.7%). No statistically significant differences were observed between the two groups regarding demographic, clinical, and laboratory characteristics.<br /><strong>Conclusion:</strong> The incidence of thromboembolic events in patients with COVID-19 admitted to ICUs was consistent with reported ranges in other studies. The elevated risk of thromboembolic events in these patients underscores the need for intensified monitoring and implementation of preventive measures to reduce this risk.https://jims.mui.ac.ir/article_32920_440100b44ff391ac670eb590ea7f8a77.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954380920250522Comparison of the Effectiveness of Vestibular Rehabilitation and Venlafaxine in the Treatment of Patients with Persistent Postural-Perceptual Dizziness, a Randomized Clinical TrialComparison of the Effectiveness of Vestibular Rehabilitation and Venlafaxine in the Treatment of Patients with Persistent Postural-Perceptual Dizziness, a Randomized Clinical Trial2842923291910.48305/jims.v43.i809.0283FASeyed HamidrezaAbtahiAssociate Professor, Department of Otolaryngology, Isfahan University of Medical Sciences, Isfahan, Iran0000-0001-9531-2952NargesAskari SabzkouhiDepartment of Otolaryngology, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-6476-1947Mohammad HosseinNilforoushAssistant Professor, Department of Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran0000-0001-9422-8695NiloofarTarbiat NobariDepartment of Otolaryngology, Isfahan University of Medical Sciences, Isfahan, IranJournal Article20240528<strong>Background:</strong> This study aimed to investigate the efficacy of venlafaxine as a first-line treatment for patients with persistent postural-perceptual dizziness (PPPD) and compare the superiority of vestibulo-ocular rehabilitation versus venlafaxine in PPPD patients.<br /><strong>Methods:</strong><strong> </strong>A randomized clinical trial was conducted on sixty patients (31 males, 29 female) with a mean age of 43 ± 9.9 years, diagnosed with PPPD by Bárány criteria at Al-Zahra Hospital in Isfahan, Iran, from September 2023 to March 2024. Patients were randomly divided into two groups of 30 people each. One group received vestibulo-ocular reflex rehabilitation once a week for six weeks, and the other group received venlafaxine 37.5 mg daily for six weeks. Dizziness severity was measured pre/post-intervention using the Dizziness Handicap Inventory (DHI).<br /><strong>Findings:</strong><strong> </strong>In the vestibular-ocular rehabilitation group, the mean DHI score before intervention was 46.33 ± 13.65, which reduced to 28.26 ± 12.64 after intervention. In the medical treatment group, the mean DHI score was 47.86 ± 13.57, which dropped to 28.13 ± 10.58 after treatment. Both groups showed significant reductions in DHI scores after treatment (P < 0.001), with no superiority between treatments (P > 0.05).<br /><strong>Conclusion:</strong> Venlafaxine can be used as a first-line treatment for patients with PPPD. No superiority was found for vestibular-ocular rehabilitation over venlafaxine in treating PPPD.<strong>Background:</strong> This study aimed to investigate the efficacy of venlafaxine as a first-line treatment for patients with persistent postural-perceptual dizziness (PPPD) and compare the superiority of vestibulo-ocular rehabilitation versus venlafaxine in PPPD patients.<br /><strong>Methods:</strong><strong> </strong>A randomized clinical trial was conducted on sixty patients (31 males, 29 female) with a mean age of 43 ± 9.9 years, diagnosed with PPPD by Bárány criteria at Al-Zahra Hospital in Isfahan, Iran, from September 2023 to March 2024. Patients were randomly divided into two groups of 30 people each. One group received vestibulo-ocular reflex rehabilitation once a week for six weeks, and the other group received venlafaxine 37.5 mg daily for six weeks. Dizziness severity was measured pre/post-intervention using the Dizziness Handicap Inventory (DHI).<br /><strong>Findings:</strong><strong> </strong>In the vestibular-ocular rehabilitation group, the mean DHI score before intervention was 46.33 ± 13.65, which reduced to 28.26 ± 12.64 after intervention. In the medical treatment group, the mean DHI score was 47.86 ± 13.57, which dropped to 28.13 ± 10.58 after treatment. Both groups showed significant reductions in DHI scores after treatment (P < 0.001), with no superiority between treatments (P > 0.05).<br /><strong>Conclusion:</strong> Venlafaxine can be used as a first-line treatment for patients with PPPD. No superiority was found for vestibular-ocular rehabilitation over venlafaxine in treating PPPD.https://jims.mui.ac.ir/article_32919_db35739b2480ba8a3aadbbf1999a2382.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954380920250522The Effect of Aerobic Exercises with and Without Incline on the Expression of Some Genes Related to Muscle Atrophy in Mice with Chronic Kidney DiseaseThe Effect of Aerobic Exercises with and Without Incline on the Expression of Some Genes Related to Muscle Atrophy in Mice with Chronic Kidney Disease2923013294010.48305/jims.v43.i809.0292FAZahraGoliPhD Student, Department of Sports Physiology, Faculty of Sports Sciences, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, IranFarzanehTaghianAssociate Professor, Department of Sports Physiology, Faculty of Sports Sciences, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran0000-0001-9531-2952KhosroJalali DehkordiAssociate Professor, Department of Sports Physiology, Faculty of Sports Sciences, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran0000-0003-0210-5984Journal Article20241125<strong>Background:</strong> Chronic kidney disease is a catabolic disease, which leads to muscle atrophy. The purpose of the research was to compare the effect of uphill incline and zero incline training on improving of muscle atrophy and kidney function in C57bl6 female mice suffering from chronic kidney disease(CKD).
<strong>Methods:</strong><strong> </strong>A total of 24 two-month-old female C57b16 mice weighing 25 ± 1.26 grams, were randomly divided into four groups: healthy control, patient control, patient and aerobic exercise with zero incline, and patient and aerobic exercise with positive incline. To induce CKD, they received adenine powder at a concentration of 0.2% mg/kg orally for four weeks. The training groups performed eight weeks of treadmill training (five sessions per week) with one group exercising on a 20-degree incline and the other on a zero-degree incline. After the last training session, blood samples were collected to measure serum uric acid, urea and creatinine using the ELISA method. The expression levels of the Myod, Myogenin, Myf-5 genes were measured using real-time quantitative PCR (qPCR). For statistical analysis, a one-way ANOVA test and Tukey's post hoc test were employed, with a significance level set at P ≤ 0.05.
<strong>Findings:</strong><strong> </strong>The results showed that induction of CKD caused a significant increase in the amount of urea, uric acid and serum creatinine compared to the healthy control group (P < 0.05). On the other hand, there is a significant decrease in the values of urea, uric acid and serum creatinine in the training group (P < 0.05). The expression levels of Myod, Myogenin and Myf-5 increased significantly in the slope training group (P < 0.05).
<strong>Conclusion:</strong> Exercises performed on an incline controlled muscle atrophy and improves urea, uric acid and creatinine levels in mice with chronic kidney disease. Furthermore, the effects of incline exercise were found to be superior to those of exercise without incline.<strong>Background:</strong> Chronic kidney disease is a catabolic disease, which leads to muscle atrophy. The purpose of the research was to compare the effect of uphill incline and zero incline training on improving of muscle atrophy and kidney function in C57bl6 female mice suffering from chronic kidney disease(CKD).
<strong>Methods:</strong><strong> </strong>A total of 24 two-month-old female C57b16 mice weighing 25 ± 1.26 grams, were randomly divided into four groups: healthy control, patient control, patient and aerobic exercise with zero incline, and patient and aerobic exercise with positive incline. To induce CKD, they received adenine powder at a concentration of 0.2% mg/kg orally for four weeks. The training groups performed eight weeks of treadmill training (five sessions per week) with one group exercising on a 20-degree incline and the other on a zero-degree incline. After the last training session, blood samples were collected to measure serum uric acid, urea and creatinine using the ELISA method. The expression levels of the Myod, Myogenin, Myf-5 genes were measured using real-time quantitative PCR (qPCR). For statistical analysis, a one-way ANOVA test and Tukey's post hoc test were employed, with a significance level set at P ≤ 0.05.
<strong>Findings:</strong><strong> </strong>The results showed that induction of CKD caused a significant increase in the amount of urea, uric acid and serum creatinine compared to the healthy control group (P < 0.05). On the other hand, there is a significant decrease in the values of urea, uric acid and serum creatinine in the training group (P < 0.05). The expression levels of Myod, Myogenin and Myf-5 increased significantly in the slope training group (P < 0.05).
<strong>Conclusion:</strong> Exercises performed on an incline controlled muscle atrophy and improves urea, uric acid and creatinine levels in mice with chronic kidney disease. Furthermore, the effects of incline exercise were found to be superior to those of exercise without incline.https://jims.mui.ac.ir/article_32940_3f79b257665694a9cf76fbd806f58e72.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954380920250522The Prescription Rate of SGLT Inhibitors and GLP1 Receptor Agonists in Patients with Type 2 DM, According to the ADA and ESC Criteria in Three Diabetes Centers in IranThe Prescription Rate of SGLT Inhibitors and GLP1 Receptor Agonists in Patients with Type 2 DM, According to the ADA and ESC Criteria in Three Diabetes Centers in Iran3023093292610.48305/jims.v43.i809.0302FARaheleh SadatSajadAssistant Professor of Endocrinology, Isfahan Endocrine and Metabolism Research Center, Isfahan, Iran0000-0001-8823-3623MahbubeBaghbanResident of Endocrinology, Isfahan Endocrine and Metabolism Research Center, Isfahan, Iran0000-0003-0590-6410MansourSiavashProfessor of Endocrinology, Isfahan Endocrine and Metabolism Research Center, Isfahan, Iran0000-0003-0590-6410HassanRezvanianIsfahan Endocrine & Metabolism Research center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-4524-6744MojtabaAkbariIsfahan Endocrine & Metabolism Research center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-5777-9612MojganGolbidiIsfahan Endocrine & Metabolism Research center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-4159-2084RoyaAdelniaIsfahan Endocrine & Metabolism Research center, Isfahan University of Medical Sciences, Isfahan, IranTaherehSadeghiIsfahan Endocrine & Metabolism Research center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-4101-4161Journal Article20250124<strong>Background:</strong> This study aimed to determine the prescription rates of SGLT2 inhibitors (SGLT2i) and GLP-1 receptor agonists (GLP-1 RA) in type 2 diabetes (T2D) patients according to European Society of Cardiology (ESC) and American Diabetes Association (ADA) guidelines at three Iranian diabetes centers.<br /><strong>Methods:</strong><strong> </strong>A cross-sectional analysis was conducted on the medical records of T2D patients (n = 303) from three centers: the Isfahan Endocrine Research Center (n = 129), the Isfahan Social Security Clinic (n = 30), and the Qom Social Security Clinic (n = 144), between 2019 and 2021.<br /><strong>Findings:</strong><strong> </strong>According to ESC and ADA criteria, 84% and 68% of patients were eligible for SGLT2i and GLP-1 RA, respectively. However, only 13.5% received these medications. Key reasons for non-prescription included: high cost, insurance non-coverage due to concurrent insulin pen use (28 patients), injection aversion, and physicians’ unfamiliarity with these drug classes.<br /><strong>Conclusion:</strong> The overall utilization of SGLT2i and GLP-1 RA among eligible patients remains low. Our findings highlight opportunities to optimize the use of these drugs for preventing future cardiovascular complications, such as periodic training for primary care physicians and expanding insurance coverage to ensure equitable access.<strong>Background:</strong> This study aimed to determine the prescription rates of SGLT2 inhibitors (SGLT2i) and GLP-1 receptor agonists (GLP-1 RA) in type 2 diabetes (T2D) patients according to European Society of Cardiology (ESC) and American Diabetes Association (ADA) guidelines at three Iranian diabetes centers.<br /><strong>Methods:</strong><strong> </strong>A cross-sectional analysis was conducted on the medical records of T2D patients (n = 303) from three centers: the Isfahan Endocrine Research Center (n = 129), the Isfahan Social Security Clinic (n = 30), and the Qom Social Security Clinic (n = 144), between 2019 and 2021.<br /><strong>Findings:</strong><strong> </strong>According to ESC and ADA criteria, 84% and 68% of patients were eligible for SGLT2i and GLP-1 RA, respectively. However, only 13.5% received these medications. Key reasons for non-prescription included: high cost, insurance non-coverage due to concurrent insulin pen use (28 patients), injection aversion, and physicians’ unfamiliarity with these drug classes.<br /><strong>Conclusion:</strong> The overall utilization of SGLT2i and GLP-1 RA among eligible patients remains low. Our findings highlight opportunities to optimize the use of these drugs for preventing future cardiovascular complications, such as periodic training for primary care physicians and expanding insurance coverage to ensure equitable access.https://jims.mui.ac.ir/article_32926_2240136c6caf3b4075577449deda3728.pdf