Isfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954383520251122Comparison of Serum Vitamin D Levels in Clinically Isolated Syndrome PatientsComparison of Serum Vitamin D Levels in Clinically Isolated Syndrome Patients130613113311110.48305/jims.v43.i835.1306FAMostafaHashemianSchool of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-8439-1445AzarNaeimiAssociate Professor, Department of Pathology, School of Medicine, Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-7717-9112VahidShaygannejadProfessor, Department of Neurology, School of Medicine, Neurosciences Research Center Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-6226-0161AzarBaradaranProfessor, Infectious Diseases and Tropical Medicine Research Center, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0001-7058-6367Journal Article20250610<strong>Background:</strong> Vitamin D deficiency is considered a modifiable risk factor in Clinically Isolated Syndrome (CIS), and early interventions to correct vitamin D levels may be an effective strategy in the management of these patients. Considering the role of vitamin D in cases of multiple sclerosis (MS), this study was conducted with the aim of comparing the level of vitamin D in patients with CIS and healthy population.
<strong>Methods:</strong><strong> </strong>In this case-control study, the vitamin D levels of 51 patients with CIS and 150 healthy individuals were measured and compared along with demographic and clinical data. Data were entered into analyzed using chi-square, t-test, and logistic regression tests.
<strong>Findings:</strong><strong> </strong>The mean serum level of vitamin D in the patient and control groups was 37.0 ± 13.8 and 38.8 ± 25.1 ng/dL, respectively, and the difference between the two groups was significant (P = 0.042).
<strong>Conclusion:</strong> It seems that the serum level of vitamin D in patients with CIS is lower than in healthy individuals, suggesting that vitamin D may play a role in the pathogenesis of CIS.<strong>Background:</strong> Vitamin D deficiency is considered a modifiable risk factor in Clinically Isolated Syndrome (CIS), and early interventions to correct vitamin D levels may be an effective strategy in the management of these patients. Considering the role of vitamin D in cases of multiple sclerosis (MS), this study was conducted with the aim of comparing the level of vitamin D in patients with CIS and healthy population.
<strong>Methods:</strong><strong> </strong>In this case-control study, the vitamin D levels of 51 patients with CIS and 150 healthy individuals were measured and compared along with demographic and clinical data. Data were entered into analyzed using chi-square, t-test, and logistic regression tests.
<strong>Findings:</strong><strong> </strong>The mean serum level of vitamin D in the patient and control groups was 37.0 ± 13.8 and 38.8 ± 25.1 ng/dL, respectively, and the difference between the two groups was significant (P = 0.042).
<strong>Conclusion:</strong> It seems that the serum level of vitamin D in patients with CIS is lower than in healthy individuals, suggesting that vitamin D may play a role in the pathogenesis of CIS.https://jims.mui.ac.ir/article_33111_8760d018b44febe1c3bbed05489bf9f2.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954383520251122Association between Nutritional Status and Prognosis of Trauma Patients Hospitalized in the Intensive Care UnitAssociation between Nutritional Status and Prognosis of Trauma Patients Hospitalized in the Intensive Care Unit131213183317410.48305/jims.v43.i835.1312FABabakAlikiaiiProfessor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-3236-1970SaeedAbbasiProfessor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-0930-5698ZeinabZamaniAnesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-1534-3490NaghmehAhmadiAssistante Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0001-9400-7841AmirhoseinPanahiAnesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran0009-0000-0955-7292Journal Article20241006<strong>Background:</strong> Trauma is one of the main causes of ICU hospitalization and mortality. Given that the majority of trauma patients are young and middle-aged, considering possible different nutritional patterns in middle-aged and young people compared to elderly people, this study was conducted with the aim of investigating the effects of malnutrition on the prognosis of these patients.
<strong>Methods:</strong><strong> </strong>This study was conducted on 103 trauma patients aged 40 to 65 years and 65 to 80 years admitted to the ICUs of Al-Zahra Hospital, Isfahan. The MNA-SF questionnaire was used to evaluate the nutritional status and the patients were divided into three groups: normal nutritional status, at risk of malnutrition and malnourished, and the duration of hospitalization, in-ICU mortality, need for mechanical ventilation, and duration of mechanical ventilation were compared between the groups.
<strong>Findings:</strong><strong> </strong>The results indicated that by controlling the effect of age, nutritional status (malnutrition compared to normal nutritional status) had a significant effect on increasing the duration of hospitalization (P = 0.001). In addition, the results showed that by controlling the effect of age, nutritional status did not have a significant effect on the need for mechanical ventilation, the duration of mechanical ventilation, or in-ICU mortality (P = 0.465, P = 0.752, and P = 0.309, respectively).
<strong>Conclusion:</strong> In trauma patients, who are mainly young and middle-aged and active in society, attention to improving nutritional status, especially in malnourished patients, can help improve clinical outcomes and reduce hospitalization duration.<strong>Background:</strong> Trauma is one of the main causes of ICU hospitalization and mortality. Given that the majority of trauma patients are young and middle-aged, considering possible different nutritional patterns in middle-aged and young people compared to elderly people, this study was conducted with the aim of investigating the effects of malnutrition on the prognosis of these patients.
<strong>Methods:</strong><strong> </strong>This study was conducted on 103 trauma patients aged 40 to 65 years and 65 to 80 years admitted to the ICUs of Al-Zahra Hospital, Isfahan. The MNA-SF questionnaire was used to evaluate the nutritional status and the patients were divided into three groups: normal nutritional status, at risk of malnutrition and malnourished, and the duration of hospitalization, in-ICU mortality, need for mechanical ventilation, and duration of mechanical ventilation were compared between the groups.
<strong>Findings:</strong><strong> </strong>The results indicated that by controlling the effect of age, nutritional status (malnutrition compared to normal nutritional status) had a significant effect on increasing the duration of hospitalization (P = 0.001). In addition, the results showed that by controlling the effect of age, nutritional status did not have a significant effect on the need for mechanical ventilation, the duration of mechanical ventilation, or in-ICU mortality (P = 0.465, P = 0.752, and P = 0.309, respectively).
<strong>Conclusion:</strong> In trauma patients, who are mainly young and middle-aged and active in society, attention to improving nutritional status, especially in malnourished patients, can help improve clinical outcomes and reduce hospitalization duration.https://jims.mui.ac.ir/article_33174_819267cd1ea55c4d0a22d903d41ebf2d.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954383520251122The Effects of Two Different Doses of Sublingual Sufentanil on Hemodynamic Changes During Laryngoscopy and Tracheal IntubationThe Effects of Two Different Doses of Sublingual Sufentanil on Hemodynamic Changes During Laryngoscopy and Tracheal Intubation131913273317510.48305/jims.v43.i835.1319FAAzimHonarmandProfessor, Department of Anesthesia, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-2373-9241MohammadrezaSafaviProfessor, Department of Anesthesia, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-8975-7661ShokouhSadeghizadePost Graduate Student, Department of Anesthesia, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0001-7494-992XJournal Article20250119<strong>Background:</strong> Hemodynamic disturbance is one of the most challenging complications during laryngoscopy. This study was conducted with the aim of comparing the effect of two doses of 0.1 and 0.2 μg/kg sufentanil on the hemodynamics of patients during and after laryngoscopy.
<strong>Methods:</strong><strong> </strong>In this clinical trial study, 96 patients who were candidates for surgery under general anesthesia were divided into three groups of 32. Patients in the first and second groups received 0.1 µg/kg and 0.2 µg/kg of sublingual sufentanil (the sufentanil ampoule was administered sublingually into the oral cavity), respectively, three minutes before the induction of anesthesia. In the third group, normal saline was administered sublingually as a placebo three minutes before anesthesia induction. The patients' hemodynamic parameters were evaluated before laryngoscopy and at 1, 3, 5, and 10 minutes after laryngoscopy, and then compared between the three groups.
<strong>Findings:</strong><strong> </strong>Before laryngoscopy, there was no significant difference among the three groups regarding heart rate, blood pressure, or blood oxygen saturation. Changes in systolic, diastolic and mean arterial blood pressure were significantly different between the three groups (P < 0.001) However, the differences in the changes of heart rate (P = 0.059) and blood oxygen saturation percentage (P = 0.237) were not significant among the three groups.
<strong>Conclusion:</strong> The use of 0.2 μg/kg of sublingual sufentanil before laryngoscopy reduce hemodynamic disturbance during and after laryngoscopy, and it seems that the patients who receive this medication dose, have more hemodynamic stability during and after laryngoscopy.<strong>Background:</strong> Hemodynamic disturbance is one of the most challenging complications during laryngoscopy. This study was conducted with the aim of comparing the effect of two doses of 0.1 and 0.2 μg/kg sufentanil on the hemodynamics of patients during and after laryngoscopy.
<strong>Methods:</strong><strong> </strong>In this clinical trial study, 96 patients who were candidates for surgery under general anesthesia were divided into three groups of 32. Patients in the first and second groups received 0.1 µg/kg and 0.2 µg/kg of sublingual sufentanil (the sufentanil ampoule was administered sublingually into the oral cavity), respectively, three minutes before the induction of anesthesia. In the third group, normal saline was administered sublingually as a placebo three minutes before anesthesia induction. The patients' hemodynamic parameters were evaluated before laryngoscopy and at 1, 3, 5, and 10 minutes after laryngoscopy, and then compared between the three groups.
<strong>Findings:</strong><strong> </strong>Before laryngoscopy, there was no significant difference among the three groups regarding heart rate, blood pressure, or blood oxygen saturation. Changes in systolic, diastolic and mean arterial blood pressure were significantly different between the three groups (P < 0.001) However, the differences in the changes of heart rate (P = 0.059) and blood oxygen saturation percentage (P = 0.237) were not significant among the three groups.
<strong>Conclusion:</strong> The use of 0.2 μg/kg of sublingual sufentanil before laryngoscopy reduce hemodynamic disturbance during and after laryngoscopy, and it seems that the patients who receive this medication dose, have more hemodynamic stability during and after laryngoscopy.https://jims.mui.ac.ir/article_33175_279ea52163e81b3a0505949bfa5f181f.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954383520251122Comparison of Antibiotic Use and Bacterial Infections among Patients Hospitalized to the Intensive Care Unit During the First and Fifth Wave of COVID-19 Pandemic in a University Hospital in IranComparison of Antibiotic Use and Bacterial Infections among Patients Hospitalized to the Intensive Care Unit During the First and Fifth Wave of COVID-19 Pandemic in a University Hospital in Iran132813363317910.48305/jims.v43.i835.1328FAMohammadShirzadiDepartment of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0001-9606-8146MojtabaAkbariIsfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-5777-9612FatemehSafariAmin Hospital, Isfahan University of Medical Sciences, Isfahan, IranArmitaAkbariDepartment of Biotechnology, Faculty of Biological Sciences, Falavarjan Branch, Islamic Azad University, Isfahan, Iran0009-0009-7524-699XMaliheAlenaseriAmin Hospital, Isfahan University of Medical Sciences, Isfahan, IranMansourSiavashIsfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-0590-6410HamidSolgiDepartment of Bacteriology and Virology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-8521-1063Journal Article20250124<strong>Background:</strong> The overuse of antibiotics during the COVID-19 pandemic has increased the risk of antimicrobial resistance, posing a serious challenge to healthcare systems. This study aimed to compare patterns of antibiotic consumption and microbial resistance among ICU-admitted COVID-19 patients during two different waves of the pandemic.
<strong>Methods:</strong><strong> </strong>This descriptive cross-sectional study was conducted on COVID-19 patients admitted to the ICU during the first (2020) and fifth (2021) waves of the pandemic. Indicators such as mortality rate, number of microbial cultures, frequency of Gram-positive and Gram-negative bacteria, antibiotic consumption, and antibiotic resistance patterns in Gram-negative bacteria were evaluated.
<strong>Findings:</strong><strong> </strong>During the first wave, 439 patients and during the fifth wave, 506 patients were admitted to the ICU. Positive bacterial infections were reported in 12.3% and 15.8% of patients, respectively, while mortality rates were 35% and 40.9%. <em>Klebsiella pneumoniae</em> was the most common organism in both waves, and the lowest resistance was observed to colistin. In the first wave, meropenem (3,316 vials) and vancomycin (1,937 vials) had the highest usage, whereas in the fifth wave, levofloxacin (1,745 vials) and meropenem (1,735 vials) were the most prescribed antibiotics.
<strong>Conclusion:</strong> In the fifth wave, the implementation of infection control programs and antimicrobial stewardship led to a reduction in antibiotic consumption and decreased drug resistance among Gram-negative bacteria. These findings highlight the importance of continuing such interventions in the management of ICU patients.<strong>Background:</strong> The overuse of antibiotics during the COVID-19 pandemic has increased the risk of antimicrobial resistance, posing a serious challenge to healthcare systems. This study aimed to compare patterns of antibiotic consumption and microbial resistance among ICU-admitted COVID-19 patients during two different waves of the pandemic.
<strong>Methods:</strong><strong> </strong>This descriptive cross-sectional study was conducted on COVID-19 patients admitted to the ICU during the first (2020) and fifth (2021) waves of the pandemic. Indicators such as mortality rate, number of microbial cultures, frequency of Gram-positive and Gram-negative bacteria, antibiotic consumption, and antibiotic resistance patterns in Gram-negative bacteria were evaluated.
<strong>Findings:</strong><strong> </strong>During the first wave, 439 patients and during the fifth wave, 506 patients were admitted to the ICU. Positive bacterial infections were reported in 12.3% and 15.8% of patients, respectively, while mortality rates were 35% and 40.9%. <em>Klebsiella pneumoniae</em> was the most common organism in both waves, and the lowest resistance was observed to colistin. In the first wave, meropenem (3,316 vials) and vancomycin (1,937 vials) had the highest usage, whereas in the fifth wave, levofloxacin (1,745 vials) and meropenem (1,735 vials) were the most prescribed antibiotics.
<strong>Conclusion:</strong> In the fifth wave, the implementation of infection control programs and antimicrobial stewardship led to a reduction in antibiotic consumption and decreased drug resistance among Gram-negative bacteria. These findings highlight the importance of continuing such interventions in the management of ICU patients.https://jims.mui.ac.ir/article_33179_1709c8963c0c22c3c8d938ebc8366de0.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75954383520251122Comprehensive Review of Genetic and Epigenetic Dimensions of Endometriosis, New Treatment StrategiesComprehensive Review of Genetic and Epigenetic Dimensions of Endometriosis, New Treatment Strategies133713533317610.48305/jims.v43.i835.1337FASeyed MortezaJavadi RadAssistant Professor, Department of Cell and Molecular Biology and Microbiology, School of Biological Science and Technology, University of Isfahan, Isfahan, Iran0000-0002-2891-2293YaldaRiahiStudent, Department of Cell and Molecular Biology and Microbiology, School of Biological Science and Technology, University of Isfahan, Isfahan, Iran0009-0005-9341-8549FaribaBehnamfarProfessor, Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-4218-5982Journal Article20250415<strong>Background:</strong> Endometriosis is a benign condition with an unidentified genetic cause, and conventional therapeutic methods are ineffective.
<strong>Methods:</strong><strong> </strong>Articles pertaining to the genetic and epigenetic dimensions of endometriosis were extracted. Theories concerning the etiology of endometriosis were examined. Therapeutic prospects were evaluated considering both genetic and epigenetic factors of endometriosis.
<strong>Findings:</strong><strong> </strong>Retrograde menstruation, coelomic metaplasia, embryonic rest, metastatic endometriosis, and endometrial stem cell recruitment are regarded as etiological factors of endometriosis. Genome-wide investigations have found variables linked to an elevated incidence of endometriosis. Epigenetic modifications, such as diminished COX2 promoter methylation, can influence the quantity and functionality of neutrophils by elevating estrogen synthesis, hence contributing to the onset of endometriosis. Two critical factors in the onset and advancement of endometriosis are the evasion of endometriotic lesions from the immune response and elevated concentrations of inflammatory cytokines. Novel therapeutic alternatives for endometriosis encompass aromatase inhibitors, and their combination with gestagens, oral contraceptives, or gonadotropin-releasing hormone agonists not only demonstrates efficacy but also alleviates pain, diminishes the size of ectopic lesions, and enhances patients' quality of life. Histone deacetylase inhibitors limit the growth of endometriotic stromal cells while exhibiting little negative effects on normal stromal cells.
<strong>Conclusion:</strong> Genetics and epigenetics significantly influence the development of endometriosis, and therapeutic approaches utilizing epigenome-modulating agents present promising new options, demonstrating superior efficacy compared to conventional treatments.<strong>Background:</strong> Endometriosis is a benign condition with an unidentified genetic cause, and conventional therapeutic methods are ineffective.
<strong>Methods:</strong><strong> </strong>Articles pertaining to the genetic and epigenetic dimensions of endometriosis were extracted. Theories concerning the etiology of endometriosis were examined. Therapeutic prospects were evaluated considering both genetic and epigenetic factors of endometriosis.
<strong>Findings:</strong><strong> </strong>Retrograde menstruation, coelomic metaplasia, embryonic rest, metastatic endometriosis, and endometrial stem cell recruitment are regarded as etiological factors of endometriosis. Genome-wide investigations have found variables linked to an elevated incidence of endometriosis. Epigenetic modifications, such as diminished COX2 promoter methylation, can influence the quantity and functionality of neutrophils by elevating estrogen synthesis, hence contributing to the onset of endometriosis. Two critical factors in the onset and advancement of endometriosis are the evasion of endometriotic lesions from the immune response and elevated concentrations of inflammatory cytokines. Novel therapeutic alternatives for endometriosis encompass aromatase inhibitors, and their combination with gestagens, oral contraceptives, or gonadotropin-releasing hormone agonists not only demonstrates efficacy but also alleviates pain, diminishes the size of ectopic lesions, and enhances patients' quality of life. Histone deacetylase inhibitors limit the growth of endometriotic stromal cells while exhibiting little negative effects on normal stromal cells.
<strong>Conclusion:</strong> Genetics and epigenetics significantly influence the development of endometriosis, and therapeutic approaches utilizing epigenome-modulating agents present promising new options, demonstrating superior efficacy compared to conventional treatments.https://jims.mui.ac.ir/article_33176_84d443585ec2caf0bf31681f10085df7.pdf