Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 43 840 2025 12 22 A Comparative Study of the Effect of Melatonin and Coenzyme Q10 on Clinical Outcomes Following Coronary Artery Bypass Grafting Surgery A Comparative Study of the Effect of Melatonin and Coenzyme Q10 on Clinical Outcomes Following Coronary Artery Bypass Grafting Surgery 1543 1552 33231 10.48305/jims.v43.i840.1543 FA Mojtaba Mansouri Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-5725-3012 Gholamreza Masoiumi Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-1636-0313 Mohsen Mirmohammadsadeghi Professor, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-6237-6228 Amir Mir Mohammad Sadeghi Professor, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-0785-8881 Amirreza Hemasian Resident of Cardiac Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0003-3488-9402 Journal Article 2024 06 01 <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Background:<span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;"> The present study was conducted with the aim of comparing the effect of melatonin and coenzyme Q10 on the clinical outcomes following coronary artery bypass graft surgery. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Methods: <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">In this clinical trial study, 90 patients who were candidates for coronary bypass grafting were divided into three groups of 30. The first group received 20 mg of melatonin and a placebo orally the night before and two hours before surgery. The second group received 150 mg of coenzyme Q10 and a placebo at the same time points. The third group received an oral placebo both the night before and two hours before surgery. Hemodynamic parameters, inotrope use, hemoglobin levels, serum urea and creatinine levels, and inflammatory factors were evaluated and compared among the three groups. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Findings: <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">The frequency of inotrope consumption was 13(43.3%) in the melatonin group, 18(60%) in the Q10 group, and 23(82.1%) in the control group, and the difference between the three groups was significant (P=0.01). The mean level of CPK-MB in the melatonin group was 279.25±64.76, in the Q10 group 193.37±40.1, and in the control group was 453.21±61.46, and the difference between the three groups was significant(P=0.004). <span style="font-size: 10.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Conclusion:<span style="font-size: 10.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;"> Administration of melatonin and Q10 before coronary artery bypass graft surgery reduces the level of postoperative inflammatory factors. Furthermore, melatonin administration may be preferable to coenzyme Q10 due to its sedative effects and its role in maintaining greater blood pressure stability in patients <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Background:<span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;"> The present study was conducted with the aim of comparing the effect of melatonin and coenzyme Q10 on the clinical outcomes following coronary artery bypass graft surgery. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Methods: <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">In this clinical trial study, 90 patients who were candidates for coronary bypass grafting were divided into three groups of 30. The first group received 20 mg of melatonin and a placebo orally the night before and two hours before surgery. The second group received 150 mg of coenzyme Q10 and a placebo at the same time points. The third group received an oral placebo both the night before and two hours before surgery. Hemodynamic parameters, inotrope use, hemoglobin levels, serum urea and creatinine levels, and inflammatory factors were evaluated and compared among the three groups. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Findings: <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">The frequency of inotrope consumption was 13(43.3%) in the melatonin group, 18(60%) in the Q10 group, and 23(82.1%) in the control group, and the difference between the three groups was significant (P=0.01). The mean level of CPK-MB in the melatonin group was 279.25±64.76, in the Q10 group 193.37±40.1, and in the control group was 453.21±61.46, and the difference between the three groups was significant(P=0.004). <span style="font-size: 10.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Conclusion:<span style="font-size: 10.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;"> Administration of melatonin and Q10 before coronary artery bypass graft surgery reduces the level of postoperative inflammatory factors. Furthermore, melatonin administration may be preferable to coenzyme Q10 due to its sedative effects and its role in maintaining greater blood pressure stability in patients

https://jims.mui.ac.ir/article_33231_6b34b6a9fb1dc5a4fa96ba0c75dd7de2.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 43 840 2025 12 22 The Effect of 12 Weeks of Stretching Exercises on Lower Limb Joints Coordination during Gait under Fatigue in Women with Multiple Sclerosis The Effect of 12 Weeks of Stretching Exercises on Lower Limb Joints Coordination during Gait under Fatigue in Women with Multiple Sclerosis 1553 1561 33230 FA Fatemeh Farahmandi MSc, Department of Exercise Physiology, Faculty of Sport Sciences, Alzahra University, Tehran, Iran 0009-0000-8046-8073 Leila Ghazaleh Assistant Professor, Department of Exercise Physiology, Faculty of Sport Sciences, Alzahra University, Tehran, Iran 0000-0002-5228-2703 Seyed Masoud Nabavi Professor, Head of the Department of Neurology and MS, Faculty of Medicine, Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran 0000-0002-9814-8083 Mohammad Reza Kordi Professor, Department of Sport Physiology, Faculty of Physical Education and Sport Sciences, Tehran University, Tehran, Iran Journal Article 2025 02 02 <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Background:<span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;"> Weak lower limb joint coordination in individuals with multiple sclerosis (MS) impairs gait. Fatigue is a common MS symptom, which negatively affects patients' motor abilities and quality of life. This study investigated the effect of 12 weeks of static stretching exercises on lower limb joint coordination during gait under fatigue in women with MS. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Methods: <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">This quasi-experimental, applied study was conducted on 28 women with relapsing-remitting MS and an Expanded Disability Status Scale score of 0–5 (height: 160.12 ± 4.74 cm, weight: 63.09 ± 9.98 kg, body mass index: 24.56 ± 3.29 kg/m²). Participants were randomly assigned to an experimental (n=13) or control (n=15) group. The 12-week training protocol consisted of at-home static stretching exercises (4 sessions per week). The control group performed no exercise during this period. Dominant leg joint coordination (three pairs) was measured during the stance phase of gait using motion analysis cameras and a force plate at four time points (pre- and post-12 weeks, and pre- and post-fatigue). The fatigue protocol involved on-the-spot jogging until one minute after the patient reached 17 on the Borg scale. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Findings: <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Chronic static stretching exercises had no significant effect on lower limb joint coordination (Hip-Ankle, P = 0.12; Knee-Ankle, P = 0.59; Hip-Knee, P = 0.71). Fatigue had no significant effect on lower limb joint coordination (Hip-Ankle, P = 0.44; Knee-Ankle, P = 0.32; Hip-Knee, P = 0.75). <span style="font-size: 10.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Conclusion:<span style="font-size: 10.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;"> 12 weeks of at home static stretching exercises did not improve lower limb joint coordination in women with MS. Fatigue did not affect lower limb joint coordination in women with MS. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Background:<span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;"> Weak lower limb joint coordination in individuals with multiple sclerosis (MS) impairs gait. Fatigue is a common MS symptom, which negatively affects patients' motor abilities and quality of life. This study investigated the effect of 12 weeks of static stretching exercises on lower limb joint coordination during gait under fatigue in women with MS. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Methods: <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">This quasi-experimental, applied study was conducted on 28 women with relapsing-remitting MS and an Expanded Disability Status Scale score of 0–5 (height: 160.12 ± 4.74 cm, weight: 63.09 ± 9.98 kg, body mass index: 24.56 ± 3.29 kg/m²). Participants were randomly assigned to an experimental (n=13) or control (n=15) group. The 12-week training protocol consisted of at-home static stretching exercises (4 sessions per week). The control group performed no exercise during this period. Dominant leg joint coordination (three pairs) was measured during the stance phase of gait using motion analysis cameras and a force plate at four time points (pre- and post-12 weeks, and pre- and post-fatigue). The fatigue protocol involved on-the-spot jogging until one minute after the patient reached 17 on the Borg scale. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Findings: <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Chronic static stretching exercises had no significant effect on lower limb joint coordination (Hip-Ankle, P = 0.12; Knee-Ankle, P = 0.59; Hip-Knee, P = 0.71). Fatigue had no significant effect on lower limb joint coordination (Hip-Ankle, P = 0.44; Knee-Ankle, P = 0.32; Hip-Knee, P = 0.75). <span style="font-size: 10.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Conclusion:<span style="font-size: 10.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;"> 12 weeks of at home static stretching exercises did not improve lower limb joint coordination in women with MS. Fatigue did not affect lower limb joint coordination in women with MS.

https://jims.mui.ac.ir/article_33230_db8b1247beaa42158ebfe5c489ca36db.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 43 840 2025 12 22 A Comparative Study of the Sedative Effects of and Analgesic Effects of Two Combinations of Ketodex to Fenofol in Patients Undergoing Endoscopic Retrograde Cholangiopancreatography (ERCP): A Randomized Triple-Blind Clinical Trial A Comparative Study of the Sedative Effects of and Analgesic Effects of Two Combinations of Ketodex to Fenofol in Patients Undergoing Endoscopic Retrograde Cholangiopancreatography (ERCP): A Randomized Triple-Blind Clinical Trial 1562 1570 33237 10.48305/jims.v43.i840.1562 FA Mohammadreza Safavi Professor, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-8975-7661 Azim Honarmand Professor, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-2373-9241 Sorour Sadat Asayesh Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0009-0001-4153-5808 Journal Article 2025 02 28 <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Background:<span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;"> Sedatives such as dexmedetomidine, propofol, Ketamine benzodiazepines and opioids can be used during ERCP. The objective of this study is to compare the Sedative and analgesic effects of two drug Combinations of dexmedetomidine-ketamine with propofol- fentanyl in patients undergoing ERCP. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Methods: <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">This study was a randomized triple_blind clinical trial which was performed from September 2023 to November 2023 on 110 patients who were Candidates for ERCP.The patients were divided into two groups. In this study the variables of pain, quality of Sedation, satisfaction of the gastroenterologist, diastolic and systolic blood pressure respiration rate and arterial blood oxygen saturation were studied. The recorded data was entered into The SPSS Version 26 software The independent t-test and repeated measures test were used to Compare the data in the different time spans and the different groups. A P <0.05 was considered as the significance threshold. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Findings: <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">A total of 110 patients were assigned to two groups using the simple allocation method. It was observed that a smaller percentage of patients in the Fenofol group required added doses of opioids. (8% %compared to 100%.). The mean level of gastroenterologist satisfaction (8.8% compared to 4.8%) and patient satisfaction, (9.3 compared to 7.8) was higher in the Fenofol group compared to the ketodex group. In assessing the effects, it was observed that by comparing the groups in terms of pain and the quality of sedation, there was a significant difference between the two groups (P<0.001), but there was not a significant difference regarding the complications between the two groups. <span style="font-size: 10.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Conclusion:<span style="font-size: 10.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;"> Using fenofol had superior (better) outcomes (efficacy) Compared to Ketodex in patients undergoing ERCP. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Background:<span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;"> Sedatives such as dexmedetomidine, propofol, Ketamine benzodiazepines and opioids can be used during ERCP. The objective of this study is to compare the Sedative and analgesic effects of two drug Combinations of dexmedetomidine-ketamine with propofol- fentanyl in patients undergoing ERCP. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Methods: <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">This study was a randomized triple_blind clinical trial which was performed from September 2023 to November 2023 on 110 patients who were Candidates for ERCP.The patients were divided into two groups. In this study the variables of pain, quality of Sedation, satisfaction of the gastroenterologist, diastolic and systolic blood pressure respiration rate and arterial blood oxygen saturation were studied. The recorded data was entered into The SPSS Version 26 software The independent t-test and repeated measures test were used to Compare the data in the different time spans and the different groups. A P <0.05 was considered as the significance threshold. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Findings: <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">A total of 110 patients were assigned to two groups using the simple allocation method. It was observed that a smaller percentage of patients in the Fenofol group required added doses of opioids. (8% %compared to 100%.). The mean level of gastroenterologist satisfaction (8.8% compared to 4.8%) and patient satisfaction, (9.3 compared to 7.8) was higher in the Fenofol group compared to the ketodex group. In assessing the effects, it was observed that by comparing the groups in terms of pain and the quality of sedation, there was a significant difference between the two groups (P<0.001), but there was not a significant difference regarding the complications between the two groups. <span style="font-size: 10.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Conclusion:<span style="font-size: 10.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;"> Using fenofol had superior (better) outcomes (efficacy) Compared to Ketodex in patients undergoing ERCP.

https://jims.mui.ac.ir/article_33237_cb0b5f1330d14a551aac833db0baf14c.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 43 840 2025 12 22 1571 1576 33233 10.48305/jims.v43.i840.1571 FA Maryam Derakhshan Assistant Professor, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0003-0939-1848 Marzieh Derakhshan Assistant Professor of Reproductive Biology, Department of Anatomical Sciences, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0003-4879-7357 Shahnaz Eskandari Assistant Professor, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-6591-8742 Amirhossein Taab Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-8439-1445 Journal Article 2025 04 30 Background: Breast cancer is the most common cancer diagnosed in the world. Despite numerous advances, its recurrence is still a big challenge; Based on this, the study was conducted with the aim of evaluating the pathology of breast masses in patients of Al-Zahra Teaching Hospital, Isfahan. Methods: In this cross-sectional study, information related to age, sex and pathology of breast masses of 522 patients who referred to Alzahra Hospital in Isfahan for examination of breast lesions between 2014 and 2019 were collected and analyzed. All these patients had undergone breast biopsy. Data were analyzed by Student's t test and described by presenting frequency, percentage, mean and standard deviation. Findings: A total of 522 patients with mean age 40.42 years were included in the study, 480 (92%) were women. Invasive ductal carcinoma (74%) and in situ ductal carcinoma (14%) were the most frequent. Other pathologies were respectively 284 (87.9%) cases of benign tumoral lesions with the predominance of two fibrocystic lesions (129 people) and fibroadenoma (121 people), were inflammatory types 28 (8.7%) cases and gynecomastia 11 (3.4%) cases. Conclusion: According to the findings of this study, the prevalence of breast cancer in people under 40 years old is high in Iran; Therefore, it is recommended to investigate the risk factors in Iranian women and spread public education. Background: Breast cancer is the most common cancer diagnosed in the world. Despite numerous advances, its recurrence is still a big challenge; Based on this, the study was conducted with the aim of evaluating the pathology of breast masses in patients of Al-Zahra Teaching Hospital, Isfahan. Methods: In this cross-sectional study, information related to age, sex and pathology of breast masses of 522 patients who referred to Alzahra Hospital in Isfahan for examination of breast lesions between 2014 and 2019 were collected and analyzed. All these patients had undergone breast biopsy. Data were analyzed by Student's t test and described by presenting frequency, percentage, mean and standard deviation. Findings: A total of 522 patients with mean age 40.42 years were included in the study, 480 (92%) were women. Invasive ductal carcinoma (74%) and in situ ductal carcinoma (14%) were the most frequent. Other pathologies were respectively 284 (87.9%) cases of benign tumoral lesions with the predominance of two fibrocystic lesions (129 people) and fibroadenoma (121 people), were inflammatory types 28 (8.7%) cases and gynecomastia 11 (3.4%) cases. Conclusion: According to the findings of this study, the prevalence of breast cancer in people under 40 years old is high in Iran; Therefore, it is recommended to investigate the risk factors in Iranian women and spread public education.

https://jims.mui.ac.ir/article_33233_10d3aeb6639675594477989a6098627d.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 43 840 2025 12 22 Identification of Bacterial Agents and Antibiotic Resistance Patterns in Pediatric Blood Infections at Hakim Children's Hospital, Tehran Identification of Bacterial Agents and Antibiotic Resistance Patterns in Pediatric Blood Infections at Hakim Children's Hospital, Tehran 1577 1585 33228 10.48305/jims.v43.i840.1577 FA Neda Yousefi Nojookambari PhD. in Medical Bacteriology, Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0001-6321-598X Zohreh Ghalavand Associate Professor, Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-1998-2716 Nasrin Dashti Associate Professor, Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran 0000-0002-3377-0090 Bahram Nikmanesh Associate Professor, Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran 0000-0001-7035-6633 Journal Article 2025 08 02 <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Background: Bloodstream infections (BSIs) are life-threatening hospital-acquired infections with high mortality in children, especially neonates. Antimicrobial resistance (AMR) has emerged as a global challenge, complicating the management of these infections. This study aimed to investigate the prevalence and antibiotic resistance patterns of bacteria isolated from blood cultures in pediatric patients. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Methods: A cross-sectional study was conducted at Hakim Hospital, Tehran, on 11,208 blood cultures from children aged 1 day to 15 years. Bacterial isolates were identified using standard blood culture methods and biochemical tests. Antibiotic susceptibility was determined using the Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Findings: Among 478 positive cultures (4.3%), 54% were Gram-negative bacilli (Pseudomonas, Klebsiella, and Stenotrophomonas maltophilia), 34.5% were Gram-positive cocci (predominantly Staphylococcus and Enterococcus species), and 12.3% were Candida species. Gram-negative isolates showed high resistance to third-generation cephalosporins (97–100%) and ampicillin-sulbactam (98.3%). Co-trimoxazole and levofloxacin were the most effective antibiotics. Gram-positive isolates demonstrated high resistance to penicillin (100%) and erythromycin (85%), but linezolid remained highly effective (97.3% susceptibility). <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Conclusion: The high prevalence of antimicrobial resistance in pediatric bloodstream infections underscores the necessity of evidence-based antibiotic prescribing based on susceptibility testing results and the implementation of enhanced infection control programs. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Background: Bloodstream infections (BSIs) are life-threatening hospital-acquired infections with high mortality in children, especially neonates. Antimicrobial resistance (AMR) has emerged as a global challenge, complicating the management of these infections. This study aimed to investigate the prevalence and antibiotic resistance patterns of bacteria isolated from blood cultures in pediatric patients. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Methods: A cross-sectional study was conducted at Hakim Hospital, Tehran, on 11,208 blood cultures from children aged 1 day to 15 years. Bacterial isolates were identified using standard blood culture methods and biochemical tests. Antibiotic susceptibility was determined using the Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Findings: Among 478 positive cultures (4.3%), 54% were Gram-negative bacilli (Pseudomonas, Klebsiella, and Stenotrophomonas maltophilia), 34.5% were Gram-positive cocci (predominantly Staphylococcus and Enterococcus species), and 12.3% were Candida species. Gram-negative isolates showed high resistance to third-generation cephalosporins (97–100%) and ampicillin-sulbactam (98.3%). Co-trimoxazole and levofloxacin were the most effective antibiotics. Gram-positive isolates demonstrated high resistance to penicillin (100%) and erythromycin (85%), but linezolid remained highly effective (97.3% susceptibility). <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Conclusion: The high prevalence of antimicrobial resistance in pediatric bloodstream infections underscores the necessity of evidence-based antibiotic prescribing based on susceptibility testing results and the implementation of enhanced infection control programs.

https://jims.mui.ac.ir/article_33228_877f8395efda54ec44a890080c4e4fc0.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 43 840 2025 12 22 Association between Latent Tuberculosis Infection and Clinical Severity of COVID-19 Association between Latent Tuberculosis Infection and Clinical Severity of COVID-19 1586 1592 33216 10.48305/jims.v43.i840.1586 FA Morteza Pourahmad Professor, Department of Infectious Diseases and Tropical Medicine, School of Medicine, Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0003-1946-2953 Mahnaz Momenzadeh Assistant Professor, Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-7136-3069 Somayeh Haghighipour Assistant Professor, Department of Infectious Diseases and Tropical Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0003-4618-1655 Nima Arezoomandi Assistant Professor, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0003-3247-4828 Mahshid Maleki School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Manijeh Shams Health unit, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-7028-2734 Firozeh Abbasi Health unit, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-8996-7706 Maryam Nasirian Professor, Department of Epidemiology and Biostatistics, School of Health, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-8365-3845 Journal Article 2025 10 25 Background: Considering the hypothesis of cross-immunity between Mycobacterium tuberculosis and SARS-CoV-2, this study aimed to determine the association between a positive tuberculosis skin test (PPD) as a marker for latent tuberculosis infection (LTBI) and COVID-19 disease severity. Methods: This cross-sectional analytical study was conducted on 90 patients with confirmed COVID-19 who had been referred to Al-Zahra Hospital in Isfahan. Patients were divided into three groups: mild, moderate, and severe disease (30 patients in each group) according to standard guidelines. A tuberculin skin test (PPD) was performed for all participants, and a positive result was defined as an induration size ≥10 mm. Data were analyzed using SPSS version 24 and the chi-square test. Findings: Among the 90 patients studied, 19 (21.1%) had a positive PPD test. Data analysis showed a statistically significant association between a positive PPD test result and the severity of COVID-19 disease (p < 0.001). 94.7% (18 out of 19) of patients with positive PPD were in the mild disease group. In contrast, none of the patients with severe COVID-19 (out of 30) had a positive PPD test. Furthermore, the presence of a BCG vaccine scar was not statistically significantly associated with the severity of COVID-19 disease (P = 0.9). Conclusion: The results of the study suggest that latent tuberculosis infection (based on a positive PPD skin test) may be associated with the occurrence of milder forms of COVID-19. This may indicate a potential protective role of cellular immunity induced by Mycobacterium tuberculosis against the severity of SARS-CoV-2 infection. Background: Considering the hypothesis of cross-immunity between Mycobacterium tuberculosis and SARS-CoV-2, this study aimed to determine the association between a positive tuberculosis skin test (PPD) as a marker for latent tuberculosis infection (LTBI) and COVID-19 disease severity. Methods: This cross-sectional analytical study was conducted on 90 patients with confirmed COVID-19 who had been referred to Al-Zahra Hospital in Isfahan. Patients were divided into three groups: mild, moderate, and severe disease (30 patients in each group) according to standard guidelines. A tuberculin skin test (PPD) was performed for all participants, and a positive result was defined as an induration size ≥10 mm. Data were analyzed using SPSS version 24 and the chi-square test. Findings: Among the 90 patients studied, 19 (21.1%) had a positive PPD test. Data analysis showed a statistically significant association between a positive PPD test result and the severity of COVID-19 disease (p < 0.001). 94.7% (18 out of 19) of patients with positive PPD were in the mild disease group. In contrast, none of the patients with severe COVID-19 (out of 30) had a positive PPD test. Furthermore, the presence of a BCG vaccine scar was not statistically significantly associated with the severity of COVID-19 disease (P = 0.9). Conclusion: The results of the study suggest that latent tuberculosis infection (based on a positive PPD skin test) may be associated with the occurrence of milder forms of COVID-19. This may indicate a potential protective role of cellular immunity induced by Mycobacterium tuberculosis against the severity of SARS-CoV-2 infection.

https://jims.mui.ac.ir/article_33216_b52bd057e37fc8688dddf113c39501e2.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 43 840 2025 12 22 Capsule Colonoscopy for Screening of Gastrointestinal Diseases: A Case Series Study Capsule Colonoscopy for Screening of Gastrointestinal Diseases: A Case Series Study 1593 1598 33212 10.48305/jims.v43.i838.1593 FA Elham Tabesh Associate Professor, Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-8533-7945 Iman Izadi Assistant Professor, Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-6797-4094 Marziyeh Dehghani Internist, Khorshid Hospital, Isfahan, Iran 0000-0002-7246-3456 Peyman Adibi Professor, Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-6411-5235 Journal Article 2025 06 01 <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Background:<span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;"> Capsule colonoscopy is used for examination of whole gastrointestinal tract for diagnosis, follow up and even screening of gastrointestinal disease. In this study we aimed to use capsule colonoscopy for screening of gastrointestinal tract for evaluation of iron deficiency anemia, follow up of colon polyp and surveillance of inflammatory bowel disease. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Methods: <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Four patients were included in this study, two of whom were examined to investigate the cause of iron deficiency anemia, and one patient with a history of colon polyps and another with a history of inflammatory bowel disease were subjected to capsule colonoscopy and then colonoscopy. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Findings: <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">In one of the patients who was under examination due to anemia, the exact location of the bleeding was determined, but in the other patient, the capsule passed through the stomach with a long delay and the images could not be judged. In a patient with a history of colon polyps, more polyps were observed in the colonoscopy capsule compared to colonoscopy, and in a patient with a history of ulcerative colitis, capsule colonoscopy had acceptable findings compared to colonoscopy. <span style="font-size: 10.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Conclusion:<span style="font-size: 10.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;"> The use of capsule colonoscopy is more acceptable and safe method compared to other endoscopic methods, it seems that its use in diseases of the small intestine, polyposis syndromes, and inflammatory bowel disease and as a screening of asymptomatic individuals can be effective. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Background:<span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;"> Capsule colonoscopy is used for examination of whole gastrointestinal tract for diagnosis, follow up and even screening of gastrointestinal disease. In this study we aimed to use capsule colonoscopy for screening of gastrointestinal tract for evaluation of iron deficiency anemia, follow up of colon polyp and surveillance of inflammatory bowel disease. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Methods: <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Four patients were included in this study, two of whom were examined to investigate the cause of iron deficiency anemia, and one patient with a history of colon polyps and another with a history of inflammatory bowel disease were subjected to capsule colonoscopy and then colonoscopy. <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Findings: <span style="font-size: 10.0pt; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; letter-spacing: -.1pt; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">In one of the patients who was under examination due to anemia, the exact location of the bleeding was determined, but in the other patient, the capsule passed through the stomach with a long delay and the images could not be judged. In a patient with a history of colon polyps, more polyps were observed in the colonoscopy capsule compared to colonoscopy, and in a patient with a history of ulcerative colitis, capsule colonoscopy had acceptable findings compared to colonoscopy. <span style="font-size: 10.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; color: #6600cc; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;">Conclusion:<span style="font-size: 10.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'B Mitra'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-style: italic;"> The use of capsule colonoscopy is more acceptable and safe method compared to other endoscopic methods, it seems that its use in diseases of the small intestine, polyposis syndromes, and inflammatory bowel disease and as a screening of asymptomatic individuals can be effective.

https://jims.mui.ac.ir/article_33212_8b6089269d17381873ec2207506aa62a.pdf