Isfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954383120251023A Comparative Study of the Effect of Local Infiltration of Hydrocortisone Dose Preemptively on Pain and Nausea and Vomiting after Laparoscopic Cholecystectomy SurgeryA Comparative Study of the Effect of Local Infiltration of Hydrocortisone Dose Preemptively on Pain and Nausea and Vomiting after Laparoscopic Cholecystectomy Surgery112411323306710.48305/jims.v43.i831.1124FASeyed Mohammad RezaSafaviProfessor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-8975-7661AzimHonarmandProfessor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-2373-9241MasoodSayadishahrakiAssociated Professor of Surgery, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-3315-0251PartoDerakhshandehIsfahan University of Medical Sciences, Isfahan, Iran0000-0002-8439-1445Journal Article20250514<strong>Background:</strong> Laparoscopic cholecystectomy, while minimally invasive, often results in significant pain during the first 24 hours postoperatively. This study aimed to compare the preemptive local infiltration of two different doses of hydrocortisone on pain and postoperative nausea and vomiting (PONV) following this procedure.
<strong>Methods:</strong><strong> </strong>In a triple-blind clinical trial conducted between 2021 and 2022, patients undergoing elective laparoscopic cholecystectomy at Isfahan Al-Zahra Hospital were randomly assigned to three groups: Group A received 100 mg hydrocortisone, Group B received 50 mg hydrocortisone, and Group C received 20 mL normal saline as a placebo. Pain and nausea intensity were assessed using a Visual Analog Scale (VAS) in the recovery room and for 24 hours post-surgery.
<strong>Findings:</strong><strong> </strong>Pain intensity was significantly lower in the 100 mg hydrocortisone group compared to both the 50 mg group and the control group (P = 0.003). The control group required significantly more analgesic medication than both hydrocortisone groups (P < 0.001) and had a shorter time to first analgesic request (P < 0.001). However, no significant differences were observed among the three groups in terms of nausea severity (P = 0.40), vomiting frequency (P = 0.06), number of antiemetic doses (P = 0.06), or time to first antiemetic need (P = 0.09).
<strong>Conclusion:</strong> Preemptive local infiltration of hydrocortisone, particularly at a 100 mg dose, effectively reduces postoperative pain and analgesic requirements in patients undergoing laparoscopic cholecystectomy but does not significantly affect the incidence or severity of PONV.<strong>Background:</strong> Laparoscopic cholecystectomy, while minimally invasive, often results in significant pain during the first 24 hours postoperatively. This study aimed to compare the preemptive local infiltration of two different doses of hydrocortisone on pain and postoperative nausea and vomiting (PONV) following this procedure.
<strong>Methods:</strong><strong> </strong>In a triple-blind clinical trial conducted between 2021 and 2022, patients undergoing elective laparoscopic cholecystectomy at Isfahan Al-Zahra Hospital were randomly assigned to three groups: Group A received 100 mg hydrocortisone, Group B received 50 mg hydrocortisone, and Group C received 20 mL normal saline as a placebo. Pain and nausea intensity were assessed using a Visual Analog Scale (VAS) in the recovery room and for 24 hours post-surgery.
<strong>Findings:</strong><strong> </strong>Pain intensity was significantly lower in the 100 mg hydrocortisone group compared to both the 50 mg group and the control group (P = 0.003). The control group required significantly more analgesic medication than both hydrocortisone groups (P < 0.001) and had a shorter time to first analgesic request (P < 0.001). However, no significant differences were observed among the three groups in terms of nausea severity (P = 0.40), vomiting frequency (P = 0.06), number of antiemetic doses (P = 0.06), or time to first antiemetic need (P = 0.09).
<strong>Conclusion:</strong> Preemptive local infiltration of hydrocortisone, particularly at a 100 mg dose, effectively reduces postoperative pain and analgesic requirements in patients undergoing laparoscopic cholecystectomy but does not significantly affect the incidence or severity of PONV.https://jims.mui.ac.ir/article_33067_60289fc34f41ba0356d81db8d8dde70f.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954383120251023Frequency Distribution of Risk Factors in Various Types of Soft Tissue SarcomasFrequency Distribution of Risk Factors in Various Types of Soft Tissue Sarcomas113311393313510.48305/jims.v43.i831.1133FAAzarBaradaranProfessor, Department of Pathology, School of Medicine, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0001-7058-6367MotahareEbrahimi MeymandSchool of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-0590-6410Journal Article20250426<strong>Background:</strong> Soft tissue sarcomas (STSs) are rare neoplasms that account for approximately 1 to 2 % of all adult malignancies. In this regard, this study aimed to assess the frequency distribution of risk factors in various types of STSs.
<strong>Methods:</strong><strong> </strong>This descriptive-analytical study was conducted on medical reports of 100 patients with a definitive diagnosis of STS in the pathology department of Al-Zahra Hospital. Data, including age, gender, previous history of radiotherapy, previous history of receiving high-dose radiation during cancer treatment, disease recurrence, family history in first-degree relatives, exposure to chemical compounds, primary site, and STS type, were extracted from medical records and interviews. The Chi-square test was used for data analysis.
<strong>Findings:</strong><strong> </strong>Among 100 patients, 46 were men and 54 were women. The most common STS types in men and women were myxoid liposarcoma and leiomyosarcoma, with frequencies of 9 and 8, respectively. The most frequent STS type and primary site were liposarcoma (n = 16) and the retroperitoneum (n = 24), respectively. High-grade STSs were observed in 64% of patients. No significant difference was found among STSs regarding gender, history of radiotherapy, genetic disease, immunodeficiency disease, exposure to chemical compounds, or trauma (P > 0.05). A significant difference was observed among the different types of STSs regarding age, primary site, tumor grade, and disease recurrence (P < 0.05).
<strong>Conclusion:</strong> According to these findings, liposarcoma was the most common STS type. In addition, the different types of STSs were influenced by age and involved specific primary sites. Furthermore, the STS type may affect tumor grade and recurrence. However, the types of soft tissue sarcomas do not appear to be associated with gender, history of radiotherapy, genetic disease, immunodeficiency disease, exposure to chemical compounds, or trauma.<strong>Background:</strong> Soft tissue sarcomas (STSs) are rare neoplasms that account for approximately 1 to 2 % of all adult malignancies. In this regard, this study aimed to assess the frequency distribution of risk factors in various types of STSs.
<strong>Methods:</strong><strong> </strong>This descriptive-analytical study was conducted on medical reports of 100 patients with a definitive diagnosis of STS in the pathology department of Al-Zahra Hospital. Data, including age, gender, previous history of radiotherapy, previous history of receiving high-dose radiation during cancer treatment, disease recurrence, family history in first-degree relatives, exposure to chemical compounds, primary site, and STS type, were extracted from medical records and interviews. The Chi-square test was used for data analysis.
<strong>Findings:</strong><strong> </strong>Among 100 patients, 46 were men and 54 were women. The most common STS types in men and women were myxoid liposarcoma and leiomyosarcoma, with frequencies of 9 and 8, respectively. The most frequent STS type and primary site were liposarcoma (n = 16) and the retroperitoneum (n = 24), respectively. High-grade STSs were observed in 64% of patients. No significant difference was found among STSs regarding gender, history of radiotherapy, genetic disease, immunodeficiency disease, exposure to chemical compounds, or trauma (P > 0.05). A significant difference was observed among the different types of STSs regarding age, primary site, tumor grade, and disease recurrence (P < 0.05).
<strong>Conclusion:</strong> According to these findings, liposarcoma was the most common STS type. In addition, the different types of STSs were influenced by age and involved specific primary sites. Furthermore, the STS type may affect tumor grade and recurrence. However, the types of soft tissue sarcomas do not appear to be associated with gender, history of radiotherapy, genetic disease, immunodeficiency disease, exposure to chemical compounds, or trauma.https://jims.mui.ac.ir/article_33135_87f9c777d67161957c24c0fc38861bd0.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954383120251023Review and Comparison of Peripheral Blood Smear for Children with COVID-19 Compared to Non-COVID ChildrenReview and Comparison of Peripheral Blood Smear for Children with COVID-19 Compared to Non-COVID Children114011503314710.48305/jims.v43.i831.1140FABehnooshMohammadi JaziAssistant Professor, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-5028-5126ShivaMohammadzadehIsfahan University of Medical Sciences, Isfahan, IranJournal Article20250420<strong>Background:</strong> Since the outbreak of COVID-19, laboratory findings, particularly patients' blood data, have been deemed crucial. This study compared peripheral blood smear changes in children with COVID-19 and controls.
<strong>Methods:</strong><strong> </strong>This cross-sectional study was conducted at Imam Hossein Pediatric Hospital in Isfahan. PBS and CBC data from 50 children with a positive PCR test or a MIS-C diagnosis were compared to a control group of 50 children hospitalized in non-infectious and non-COVID-19 wards. The data obtained from PBS and CBC, along with demographic information such as age and sex, were statistically analyzed.
<strong>Findings:</strong><strong> </strong>Children with COVID-19 exhibited higher red blood cell (RBC) counts and lower neutrophil and white blood cell (WBC) counts. Although they had more vacuolated neutrophils, the control group showed higher levels of hypersegmented neutrophils and dysplastic monocytes. The case group had normal RBC counts and low neutrophil counts, whereas the control group had low RBC counts and high neutrophil counts. Patients with positive PCR tests showed increased monocyte, eosinophil, and platelet counts. Common morphological forms observed in patients included atypical lymphocytes, large granular lymphocytes (LGL), hypersegmented and vacuolated neutrophils, toxic granulation, hypogranulation, a left shift, pseudo-Pelger-Huet anomaly, dysplastic monocytes, and schistocytes.
<strong>Conclusion:</strong> Elevated RBC counts and reduced neutrophil and WBC counts in infected children, along with increased monocytes, eosinophils, and platelets in patients with positive PCR tests, as well as specific cellular forms, particularly dysplastic monocytes, and neutrophil anomalies, are instrumental in diagnosing these patients.<strong>Background:</strong> Since the outbreak of COVID-19, laboratory findings, particularly patients' blood data, have been deemed crucial. This study compared peripheral blood smear changes in children with COVID-19 and controls.
<strong>Methods:</strong><strong> </strong>This cross-sectional study was conducted at Imam Hossein Pediatric Hospital in Isfahan. PBS and CBC data from 50 children with a positive PCR test or a MIS-C diagnosis were compared to a control group of 50 children hospitalized in non-infectious and non-COVID-19 wards. The data obtained from PBS and CBC, along with demographic information such as age and sex, were statistically analyzed.
<strong>Findings:</strong><strong> </strong>Children with COVID-19 exhibited higher red blood cell (RBC) counts and lower neutrophil and white blood cell (WBC) counts. Although they had more vacuolated neutrophils, the control group showed higher levels of hypersegmented neutrophils and dysplastic monocytes. The case group had normal RBC counts and low neutrophil counts, whereas the control group had low RBC counts and high neutrophil counts. Patients with positive PCR tests showed increased monocyte, eosinophil, and platelet counts. Common morphological forms observed in patients included atypical lymphocytes, large granular lymphocytes (LGL), hypersegmented and vacuolated neutrophils, toxic granulation, hypogranulation, a left shift, pseudo-Pelger-Huet anomaly, dysplastic monocytes, and schistocytes.
<strong>Conclusion:</strong> Elevated RBC counts and reduced neutrophil and WBC counts in infected children, along with increased monocytes, eosinophils, and platelets in patients with positive PCR tests, as well as specific cellular forms, particularly dysplastic monocytes, and neutrophil anomalies, are instrumental in diagnosing these patients.https://jims.mui.ac.ir/article_33147_414a17613b27acc54d1ee7d56cc7346f.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954383120251023Evaluation of the Performance of BCG with Synthetic Nano Selenium as a Booster in the Formulation of a Vaccine Candidate Against Staphylococcus Aureus Based on IsdE in a Mouse ModelEvaluation of the Performance of BCG with Synthetic Nano Selenium as a Booster in the Formulation of a Vaccine Candidate Against Staphylococcus Aureus Based on IsdE in a Mouse Model115111633314610.48305/jims.v43.i831.1151FAFatemehKhosravanipourPhD Student, Department of Microbiology, TeMS.C., Islamic Azad University, Tehran, IranSetarehHaghighatAssociate Professor, Department of Microbiology, TeMS.C., Islamic Azad University, Tehran, Iran0000-0002-6605-5245Mohammad HosseinYazdiAssociate Professor, Biotechnology Research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0001-8567-8555Seyed MehdiHassanzadehAssistant Professor, R&D Department, Research & Production Complex, Pasteur Institute of Iran, Tehran0000-0001-6110-4215Journal Article20250201<strong>Background:</strong> <em>Staphylococcus aureus</em> causes various hospital-acquired infections and contributes to increased mortality. Vaccination is an effective method to combat these infections. Iron plays an essential role in bacterial pathogenesis. The IsdE protein, an iron (heme) transporter, is a promising vaccine development candidate. This study investigates the effect of BCG performance along with synthetic nano selenium as a booster in formulating a candidate vaccine against <em>Staphylococcus aureus</em> based on IsdE protein and the role of MF59 adjuvant.
<strong>Methods:</strong><strong> </strong>After expressing the IsdE protein using IPTG, a one-millimolar nickel column was used for purification. The vaccine formulation, incorporating the adjuvants MF59, BCG, and synthetic nano-selenium, was prepared and administered subcutaneously in three doses, with two-week intervals, to five groups of Balb/C mice. The levels of total IgG and IgG1 and IgG2a isotypes were measured using ELISA. The mice were challenged with a bacterial dose of 5 × 10⁸ CFU. The bacterial load in internal organs was counted, and animal survival was monitored for 30 days
<strong>Findings:</strong><strong> </strong>Total IgG and the IgG1 and IgG2a isotypes showed a significant increase in all groups receiving the vaccine candidate compared to the control group. The bacterial load in internal organs (liver, kidneys, and spleen) and the mortality rate in the IsdE+MF59+BCG+Nano-selenium group were significantly reduced compared to the other immunized and control groups.
<strong>Conclusion:</strong> The results demonstrated that the adjuvant MF59, BCG, and synthetic nano-selenium boosters enhance humoral immunity against <em>Staphylococcus aureus</em> infection.<strong>Background:</strong> <em>Staphylococcus aureus</em> causes various hospital-acquired infections and contributes to increased mortality. Vaccination is an effective method to combat these infections. Iron plays an essential role in bacterial pathogenesis. The IsdE protein, an iron (heme) transporter, is a promising vaccine development candidate. This study investigates the effect of BCG performance along with synthetic nano selenium as a booster in formulating a candidate vaccine against <em>Staphylococcus aureus</em> based on IsdE protein and the role of MF59 adjuvant.
<strong>Methods:</strong><strong> </strong>After expressing the IsdE protein using IPTG, a one-millimolar nickel column was used for purification. The vaccine formulation, incorporating the adjuvants MF59, BCG, and synthetic nano-selenium, was prepared and administered subcutaneously in three doses, with two-week intervals, to five groups of Balb/C mice. The levels of total IgG and IgG1 and IgG2a isotypes were measured using ELISA. The mice were challenged with a bacterial dose of 5 × 10⁸ CFU. The bacterial load in internal organs was counted, and animal survival was monitored for 30 days
<strong>Findings:</strong><strong> </strong>Total IgG and the IgG1 and IgG2a isotypes showed a significant increase in all groups receiving the vaccine candidate compared to the control group. The bacterial load in internal organs (liver, kidneys, and spleen) and the mortality rate in the IsdE+MF59+BCG+Nano-selenium group were significantly reduced compared to the other immunized and control groups.
<strong>Conclusion:</strong> The results demonstrated that the adjuvant MF59, BCG, and synthetic nano-selenium boosters enhance humoral immunity against <em>Staphylococcus aureus</em> infection.https://jims.mui.ac.ir/article_33146_2244143888b22cced378fcd1c6ff4695.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954383120251023Examining the Association and Prevalence of Chronic Subdural Hematoma and Its Contributing Factors in Kashan City from 2016 to 2022Examining the Association and Prevalence of Chronic Subdural Hematoma and Its Contributing Factors in Kashan City from 2016 to 2022116411723314510.48305/jims.v43.i831.1164FAEsmaeilFakharianTrauma Research Center, Department of Neurosurgery, Kashan University of Medical Sciences, Kashan, Iran0000-0003-0115-8398KHadijehKalanfarmanfarmaTrauma Research Center, Kashan University of Medical Sciences, Kashan, Iran0000-0002-4663-6616FaezehAsgariTrauma Research Center, Kashan University of Medical Sciences, Kashan, Iran.0000-0002-1613-1246NavidDavariDepartment of Neurosurgery, Kashan University of Medical Sciences, Kashan, IranAydineOmidvarTrauma Research Center, Department of Neurosurgery, Kashan University of Medical Sciences, Kashan, Iran0000-0003-3259-1231HamedYazdanPanahDepartment of Neurosurgery, Kashan University of Medical Sciences, Kashan, Iran0000-0001-9564-4738PayamYazdipourTrauma Research Center, Department of Neurosurgery, Kashan University of Medical Sciences, Kashan, Iran0009-0007-2200-0326SoudabehYarmohammadiTrauma Research Center, Kashan University of Medical Sciences, Kashan, Iran0000-0002-8862-4074Journal Article20240929<strong>Background:</strong> Subdural hematoma (SDH) complications typically result from the rupture of bridging veins traversing the subdural space. The chronic type of subdural hematoma has a more favorable prognosis if managed properly. This study aimed to examine the prevalence of chronic subdural hematoma and its associated factors in Kashan city from 2016 to 2022.<br /><strong>Methods:</strong><strong> </strong>This was a retrospective study conducted on 172 patients with chronic subdural hematoma between 2016 and 2022. Convenience sampling was used, and patient data were extracted from their hospital records using a checklist. Data analysis was performed using descriptive tests (frequency, percentage, mean, and standard deviation) and inferential tests (Chi-square, Fisher's exact test, T-test, and ANOVA).<br /><strong>Findings:</strong><strong> </strong>127 patients (73.8%) were male, and the majority were over 60 years old (72.1%). The average hospitalization period was approximately 8 days, and most patients reported symptoms lasting less than a month (55.8%). No significant association was found between various variables and the type or outcome of subdural hematoma (P > 0.05). The trend in the number of hematoma cases was increasing from 2016 to 2019, decreasing from 2020 to 2021, and rising again in 2022.<br /><strong>Conclusion:</strong> This study highlights the importance of raising public awareness regarding the symptoms of subdural hematoma, particularly among individuals over 60 and those with pre-existing health conditions. Screening programs should be implemented to enable early detection of this condition and to manage associated underlying diseases.<strong>Background:</strong> Subdural hematoma (SDH) complications typically result from the rupture of bridging veins traversing the subdural space. The chronic type of subdural hematoma has a more favorable prognosis if managed properly. This study aimed to examine the prevalence of chronic subdural hematoma and its associated factors in Kashan city from 2016 to 2022.<br /><strong>Methods:</strong><strong> </strong>This was a retrospective study conducted on 172 patients with chronic subdural hematoma between 2016 and 2022. Convenience sampling was used, and patient data were extracted from their hospital records using a checklist. Data analysis was performed using descriptive tests (frequency, percentage, mean, and standard deviation) and inferential tests (Chi-square, Fisher's exact test, T-test, and ANOVA).<br /><strong>Findings:</strong><strong> </strong>127 patients (73.8%) were male, and the majority were over 60 years old (72.1%). The average hospitalization period was approximately 8 days, and most patients reported symptoms lasting less than a month (55.8%). No significant association was found between various variables and the type or outcome of subdural hematoma (P > 0.05). The trend in the number of hematoma cases was increasing from 2016 to 2019, decreasing from 2020 to 2021, and rising again in 2022.<br /><strong>Conclusion:</strong> This study highlights the importance of raising public awareness regarding the symptoms of subdural hematoma, particularly among individuals over 60 and those with pre-existing health conditions. Screening programs should be implemented to enable early detection of this condition and to manage associated underlying diseases.https://jims.mui.ac.ir/article_33145_1c34b2e86eacc79f7b3c7d6902d1388c.pdf