Isfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954381620250622Practical Guide to Preventing and Managing Diabetic Foot Ulcers During Pilgrimage and Procession Tours: Recommendations for Patients with DiabetesPractical Guide to Preventing and Managing Diabetic Foot Ulcers During Pilgrimage and Procession Tours: Recommendations for Patients with Diabetes5335353301310.48305/jims.v43.i816.0533FASeyed MasoudShajari Pour MousaviIsfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, National Center for Health Insurance Research, Tehran, Iran0000-0001-7208-2779MansourSiavashIsfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.0000-0003-0590-6410MojtabaAkbariIsfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-5777-9612FatemehSokhanvariIsfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-3423-3323Journal Article20250417<strong>Background:</strong> Diabetic foot ulcers (DFUs) are a common complication of diabetes, worsened during pilgrimages and extended walks because of environmental and physical stress factors. This editorial letter examines effective approaches for managing and preventing DFUs in these situations.<br /><strong>Methods:</strong><strong> </strong>Suggestions comprise ongoing observation of blood sugar levels and foot health, wearing high-quality, properly fitted shoes and standardized socks, maintaining personal hygiene, and educating both patients and caregivers. It is also recommended to offer sanitary facilities, including clean water and hygienic restrooms, while minimizing waiting times at border crossings.<br /><strong>Findings:</strong><strong> </strong>Adopting these measures can greatly diminish the likelihood of infection and worsening of ulcers. Educating patients and supplying standardized footwear by organizers and donors, especially during major events such as the Arbaeen procession, is essential.<br /><strong>Conclusion:</strong> Effective and successful DFU management during processions and pilgrimages necessitates cooperation between patients, caregivers, and healthcare teams. Improved awareness and strong sanitary and medical systems can reduce complications, enhancing the quality of life for patients.<strong>Background:</strong> Diabetic foot ulcers (DFUs) are a common complication of diabetes, worsened during pilgrimages and extended walks because of environmental and physical stress factors. This editorial letter examines effective approaches for managing and preventing DFUs in these situations.<br /><strong>Methods:</strong><strong> </strong>Suggestions comprise ongoing observation of blood sugar levels and foot health, wearing high-quality, properly fitted shoes and standardized socks, maintaining personal hygiene, and educating both patients and caregivers. It is also recommended to offer sanitary facilities, including clean water and hygienic restrooms, while minimizing waiting times at border crossings.<br /><strong>Findings:</strong><strong> </strong>Adopting these measures can greatly diminish the likelihood of infection and worsening of ulcers. Educating patients and supplying standardized footwear by organizers and donors, especially during major events such as the Arbaeen procession, is essential.<br /><strong>Conclusion:</strong> Effective and successful DFU management during processions and pilgrimages necessitates cooperation between patients, caregivers, and healthcare teams. Improved awareness and strong sanitary and medical systems can reduce complications, enhancing the quality of life for patients.https://jims.mui.ac.ir/article_33013_f5e2e5bc65bce4f8d1c7c67acc428f8f.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954381620250622Comparative Study of the Preventive Effect of Two Different Doses of Intra-Cuff Dexamethasone on Sore Throat After Tracheal Tube Removal in Patients Undergoing Cesarean SectionComparative Study of the Preventive Effect of Two Different Doses of Intra-Cuff Dexamethasone on Sore Throat After Tracheal Tube Removal in Patients Undergoing Cesarean Section5365433300710.48305/jims.v43.i816.0536FAMitraJabalameliProfessor, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-1159-1574ReihanakTalakoubAssociate Professor, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-8975-7661BehzadNazemroayaAssociate Professor, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0001-6208-9053ParnaPanahiMedical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0009-0001-8702-0228AtefehGhosouriAssistant Professor, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0001-6714-7646Journal Article20240928<strong>Background:</strong> Postoperative sore throat (POST) is a common complication following endotracheal intubation during general anesthesia, often impacting patient comfort and recovery. Dexamethasone, a glucocorticoid known for its anti-inflammatory properties, has been studied for its role in reducing POST, though the optimal dosage and route of administration remain under debate.<br /><strong>Methods:</strong><strong> </strong>This prospective randomized triple-blind study compared the efficacy of intracuff dexamethasone at doses of 4 mg and 8 mg in reducing the incidence and severity of POST in women undergoing cesarean section. A total of 60 participants were randomly assigned to one of three groups: a control group receiving saline and two experimental groups receiving intracuff dexamethasone at 4 mg and 8 mg, respectively. The primary outcome measured was the severity of POST, assessed at 0, 6, 12, 18, and 24 hours postoperatively. Secondary outcomes included patient satisfaction and time to tolerate liquids and solids post-surgery.<br /><strong>Findings</strong>: According to the results, the mean severity of sore throat was significantly reduced in both the 8 mg and 4 mg dexamethasone groups (1.57 ± 1.15), (1.89 ± 1.47) (P < 0.05). Moreover, the 8 mg dexamethasone group demonstrated a significantly lower mean sore throat score compared with the control group (0.52 ± 0.24), (1.19 ± 0.88), (P < 0.01). Although the severity and intensity of sore throat were lower in the 8 mg group compared to the 4 mg group, this difference did not reach statistical significance (P = 0.78). Patient satisfaction was also higher in the 8 mg dexamethasone group compared with both the 4 mg and control groups (P < 0.01, P < 0.05).<br /><strong>Conclusion</strong>: Our findings suggest that while both dosages effectively reduce POST, higher doses may enhance patient comfort and satisfaction. Further studies are needed to explore the long-term implications of higher dexamethasone doses in various patient populations.<strong>Background:</strong> Postoperative sore throat (POST) is a common complication following endotracheal intubation during general anesthesia, often impacting patient comfort and recovery. Dexamethasone, a glucocorticoid known for its anti-inflammatory properties, has been studied for its role in reducing POST, though the optimal dosage and route of administration remain under debate.<br /><strong>Methods:</strong><strong> </strong>This prospective randomized triple-blind study compared the efficacy of intracuff dexamethasone at doses of 4 mg and 8 mg in reducing the incidence and severity of POST in women undergoing cesarean section. A total of 60 participants were randomly assigned to one of three groups: a control group receiving saline and two experimental groups receiving intracuff dexamethasone at 4 mg and 8 mg, respectively. The primary outcome measured was the severity of POST, assessed at 0, 6, 12, 18, and 24 hours postoperatively. Secondary outcomes included patient satisfaction and time to tolerate liquids and solids post-surgery.<br /><strong>Findings</strong>: According to the results, the mean severity of sore throat was significantly reduced in both the 8 mg and 4 mg dexamethasone groups (1.57 ± 1.15), (1.89 ± 1.47) (P < 0.05). Moreover, the 8 mg dexamethasone group demonstrated a significantly lower mean sore throat score compared with the control group (0.52 ± 0.24), (1.19 ± 0.88), (P < 0.01). Although the severity and intensity of sore throat were lower in the 8 mg group compared to the 4 mg group, this difference did not reach statistical significance (P = 0.78). Patient satisfaction was also higher in the 8 mg dexamethasone group compared with both the 4 mg and control groups (P < 0.01, P < 0.05).<br /><strong>Conclusion</strong>: Our findings suggest that while both dosages effectively reduce POST, higher doses may enhance patient comfort and satisfaction. Further studies are needed to explore the long-term implications of higher dexamethasone doses in various patient populations.https://jims.mui.ac.ir/article_33007_d978feca237e502810bbe54a398e1dac.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954381620250622Diffusion-Weighted Imaging for Glioma Grading: A Comparative Evaluation of Different Diffusion ModelsDiffusion-Weighted Imaging for Glioma Grading: A Comparative Evaluation of Different Diffusion Models5445513301110.48305/jims.v43.i816.0544FAHadiAkbari ZadehPhD Student, Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-9424-027XMarziyehMalekiResident, Department of Neurosurgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.0009-0004-8668-9263Mohammad ShayanMousazadehBS Student, Department of Radiation technology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0009-0009-7894-0864SedigheKhoshbashRadiology Expert, Ghaem Educational, Research and Treatment Center, Mashhad, Iran.0009-0007-9467-7133PegahLotfiMSc student, Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0009-0007-9615-8732AlirezaMontazerabadiAssociate Professor, Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Sciences AND Medical Physics Research Center, Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran0000-0001-6756-0318Journal Article20250205<strong>Background:</strong> This study evaluated the performance of mono-exponential, bi-exponential, and stretched exponential diffusion models in diffusion-weighted imaging (DWI) for grading gliomas.<br /><strong>Methods:</strong><strong> </strong>Thirty patients with confirmed gliomas underwent DWI using 10 b-values. We extracted apparent diffusion coefficient (ADC) from the mono-exponential model, D, f, and D* from the bi-exponential model, and DDC and α from the stretched exponential model. These parameters were compared between high- and low-grade tumors and normal tissue. Data normality was assessed, followed by statistical analysis (T-tests or Mann-Whitney U tests, P < 0.05). We also evaluated the sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) for significant parameters.<br /><strong>Findings:</strong><strong> </strong>The results of this study show that all parameters of the different models have the ability to create a significant difference in cancerous tissue, but none of them have this ability in normal tissue. Despite the small difference between the parameters of the different models, the parameter D has the highest area under the ROC curve, with approximately 78 percent. Also, these results show that if the numbers are divided by the normal region, the ability to differentiate between grades is lost.<br /><strong>Conclusion:</strong> Our results show that DWI technique with each model can provide valuable information about tissue without contrast agent, and all parameters of models can differentiate between high- and low-grade tumors. The mono-exponential method is the most practical option if rapid imaging and calculations are essential. However, the bi-exponential method is better suited when accurate absolute values are required.<strong>Background:</strong> This study evaluated the performance of mono-exponential, bi-exponential, and stretched exponential diffusion models in diffusion-weighted imaging (DWI) for grading gliomas.<br /><strong>Methods:</strong><strong> </strong>Thirty patients with confirmed gliomas underwent DWI using 10 b-values. We extracted apparent diffusion coefficient (ADC) from the mono-exponential model, D, f, and D* from the bi-exponential model, and DDC and α from the stretched exponential model. These parameters were compared between high- and low-grade tumors and normal tissue. Data normality was assessed, followed by statistical analysis (T-tests or Mann-Whitney U tests, P < 0.05). We also evaluated the sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) for significant parameters.<br /><strong>Findings:</strong><strong> </strong>The results of this study show that all parameters of the different models have the ability to create a significant difference in cancerous tissue, but none of them have this ability in normal tissue. Despite the small difference between the parameters of the different models, the parameter D has the highest area under the ROC curve, with approximately 78 percent. Also, these results show that if the numbers are divided by the normal region, the ability to differentiate between grades is lost.<br /><strong>Conclusion:</strong> Our results show that DWI technique with each model can provide valuable information about tissue without contrast agent, and all parameters of models can differentiate between high- and low-grade tumors. The mono-exponential method is the most practical option if rapid imaging and calculations are essential. However, the bi-exponential method is better suited when accurate absolute values are required.https://jims.mui.ac.ir/article_33011_9eee785759c110d74ac2653eae4c0791.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954381620250622Comparison of the Frequency Distribution of Vascular-Lymphatic, Neural, and Cutaneous Invasion in Molecular Subtypes of Breast CancerComparison of the Frequency Distribution of Vascular-Lymphatic, Neural, and Cutaneous Invasion in Molecular Subtypes of Breast Cancer5525583300610.48305/jims.2025.45167.2433FAAzarBaradaranProfessor, Infectious Diseases and Tropical Medicine Research Center, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0001-7058-6367MaryamDerakhshanAssistant, Professor of Pathology, Department of Pathology, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-0939-1848Mohammad JavadEslamiSchool of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-0590-6410Journal Article20250426<strong>Background:</strong> Breast cancer is a very diverse disease in terms of clinical manifestations, biological behavior and response to treatment. Local invasion of vascular-lymphatic, neural and cutaneous tissues is one of the most important factors that can be effective in predicting tumor behavior, response to treatment and prognosis. In this regard, the study was conducted with the aim of comparing the frequency distribution of vascular-lymphatic, neural and cutaneous invasion in molecular subgroups of breast cancer.
<strong>Methods:</strong><strong> </strong>In a cross-sectional study, breast cancer samples that were examined and reported in the pathology laboratory of Al-Zahra Hospital in Isfahan between 2013 and 2018 were included in the study, and clinicopathological information, tissue invasion and their subtypes were determined and extracted. Chi square test was performed to determine the presence of significant differences in types of tissue invasion.
<strong>Findings:</strong><strong> </strong>Lymphovascular invasion was the most common type of invasion (80.4%) followed by perineural and cutaneous invasion (28.4% and 26.8%, respectively). Lymphovascular invasion was significantly higher in the basal like subgroup (P = 0.04) and lower in the Luminal A subgroup (P = 0.01). Perineural and cutaneous invasion were not significantly different among subgroups.
<strong>Conclusion:</strong> Lymphovascular invasion was significantly higher in basal like subgroup and less in the Luminal A subgroup. Also, Perineural, cutaneous and nipple invasion showed no significant difference among subgroups. The findings of this study are applicable for the health system.<strong>Background:</strong> Breast cancer is a very diverse disease in terms of clinical manifestations, biological behavior and response to treatment. Local invasion of vascular-lymphatic, neural and cutaneous tissues is one of the most important factors that can be effective in predicting tumor behavior, response to treatment and prognosis. In this regard, the study was conducted with the aim of comparing the frequency distribution of vascular-lymphatic, neural and cutaneous invasion in molecular subgroups of breast cancer.
<strong>Methods:</strong><strong> </strong>In a cross-sectional study, breast cancer samples that were examined and reported in the pathology laboratory of Al-Zahra Hospital in Isfahan between 2013 and 2018 were included in the study, and clinicopathological information, tissue invasion and their subtypes were determined and extracted. Chi square test was performed to determine the presence of significant differences in types of tissue invasion.
<strong>Findings:</strong><strong> </strong>Lymphovascular invasion was the most common type of invasion (80.4%) followed by perineural and cutaneous invasion (28.4% and 26.8%, respectively). Lymphovascular invasion was significantly higher in the basal like subgroup (P = 0.04) and lower in the Luminal A subgroup (P = 0.01). Perineural and cutaneous invasion were not significantly different among subgroups.
<strong>Conclusion:</strong> Lymphovascular invasion was significantly higher in basal like subgroup and less in the Luminal A subgroup. Also, Perineural, cutaneous and nipple invasion showed no significant difference among subgroups. The findings of this study are applicable for the health system.https://jims.mui.ac.ir/article_33006_b225f92ace98bb942488b1996b2d6c27.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954381620250622A Review of the Therapeutic Potential of the Amniotic Membrane in Peripheral Nerve RegenerationA Review of the Therapeutic Potential of the Amniotic Membrane in Peripheral Nerve Regeneration5595693300810.48305/jims.v43.i816.0559FAZahraChegninejadMSc Student in Human Genetics, Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0009-0007-1574-2022ZohreChegninezhadMSc Student in Human Genetics, Department of Genetics, School of Advanced Technologies in Medical Sciences, Golestan, Iran0009-0000-7045-7872BehnazHamami KhorasganiPhD. Candidate in Medical Genetics, Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranMohammadKazemiAssistant Professor of Molecular Medicine, Department of Genetics and Molecular Biology, School of Medicine, Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-6794-6891Journal Article20241003<strong>Background:</strong> Peripheral nerve injury is a common clinical problem that can have serious consequences for patients. These injuries are usually caused by factors such as trauma, crush, infection, or ischemia, and can result in sensory and motor dysfunction, muscle atrophy, and even complete limb paralysis. The process of peripheral nerve repair is strongly influenced by factors such as scar formation and fibrosis at the site of injury, which impede axonal growth and the restoration of nerve function.<br /><strong>Methods:</strong><strong> </strong>This article explores the unique properties of the amniotic membrane and its therapeutic potential in the regeneration of peripheral nerves. The analysis will encompass the biological structure of the amniotic membrane, the characteristics of the stem cells it contains, and the underlying mechanisms involved in tissue repair. Furthermore, this study will include a comprehensive review of existing clinical and laboratory research on the application of the amniotic membrane for the repair of peripheral nerves.<br /><strong>Findings:</strong><strong> </strong>Several methods are currently being used to facilitate peripheral nerve repair, including drugs, autologous tissues, and biomaterials; however, each approach has its limitations. As a result, the amniotic membrane, as a prenatal tissue, has attracted significant attention due to its beneficial biological properties that that can aid the neural repair process. This membrane is composed of mesenchymal and epithelial stem cells, possessing the capability to secrete growth factors and cytokines. The membrane demonstrates anti-inflammatory, antimicrobial, and antifibrotic effects, which can facilitate the healing process and help mitigate side effects.<br /><strong>Conclusion:</strong> Given its unique properties, the amniotic membrane could serve as a promising therapeutic option for repairing peripheral nerve injuries.<strong>Background:</strong> Peripheral nerve injury is a common clinical problem that can have serious consequences for patients. These injuries are usually caused by factors such as trauma, crush, infection, or ischemia, and can result in sensory and motor dysfunction, muscle atrophy, and even complete limb paralysis. The process of peripheral nerve repair is strongly influenced by factors such as scar formation and fibrosis at the site of injury, which impede axonal growth and the restoration of nerve function.<br /><strong>Methods:</strong><strong> </strong>This article explores the unique properties of the amniotic membrane and its therapeutic potential in the regeneration of peripheral nerves. The analysis will encompass the biological structure of the amniotic membrane, the characteristics of the stem cells it contains, and the underlying mechanisms involved in tissue repair. Furthermore, this study will include a comprehensive review of existing clinical and laboratory research on the application of the amniotic membrane for the repair of peripheral nerves.<br /><strong>Findings:</strong><strong> </strong>Several methods are currently being used to facilitate peripheral nerve repair, including drugs, autologous tissues, and biomaterials; however, each approach has its limitations. As a result, the amniotic membrane, as a prenatal tissue, has attracted significant attention due to its beneficial biological properties that that can aid the neural repair process. This membrane is composed of mesenchymal and epithelial stem cells, possessing the capability to secrete growth factors and cytokines. The membrane demonstrates anti-inflammatory, antimicrobial, and antifibrotic effects, which can facilitate the healing process and help mitigate side effects.<br /><strong>Conclusion:</strong> Given its unique properties, the amniotic membrane could serve as a promising therapeutic option for repairing peripheral nerve injuries.https://jims.mui.ac.ir/article_33008_3707a6adbeb137bfde132463d77ac17d.pdf