Isfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953546020180121IndexIndex1545010.22122/jims.v35i460.11032FAJournalIndex0000-0003-0874-1906Journal Article20181115Click to download the index of this issue.Click to download the index of this issue.https://jims.mui.ac.ir/article_15450_90e2217cd253377081205243ac24b03a.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953546020180121Comparison of the Efficacy of Midazolam and Dexmedetomidine in Quality of Sedation in Mechanically-Ventilated Patients Admitted to Intensive Care UnitComparison of the Efficacy of Midazolam and Dexmedetomidine in Quality of Sedation in Mechanically-Ventilated Patients Admitted to Intensive Care Unit179918051545110.22122/jims.v35i460.8900FAParvizKashefiProfessor, Department of Anesthesiology, School of Medicine AND Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-7254-204XNazaninMahinparvarGeneral Practitioner, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranMaryamKhalifsoltani-KhajooieGeneral Practitioner, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranPejmanMansouriGeneral Practitioner, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranShahinSanaeiGeneral Practitioner, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranJournal Article20171004Background: Caring for patients with respiratory support is one of the important tasks of intensive care units; sedation of patient during ventilation is important. Therefore, this study aimed to compare the effects of midazolam and dexmedetomidine on the sedation quality of patients undergoing mechanical ventilation in intensive care unit.Methods: This study was performed on 100 patients requiring mechanical ventilation in intensive care unit. Patients were randomly assigned into two equal groups of midazolam and dexmedetomidine; signs and complications were recorded in patients. Chi-square and ANOVA tests were used to compare the data.Findings: Dexmedetomidine, like midazolam, had a good sedation effect. The duration of hospitalization in intensive care unit (9.58 vs. 12.36 days, P = 0.011), and the need for ventilation (3.96 vs. 6.74 days, P < 0.001) were significantly lower in dexmedetomidine group, with no serious complications and hemodynamic changes.Conclusion: According to the efficacy of both drugs, depending on the type of patient and its conditions (sensitivity to a particular type of drug), both drugs can be used to sedate patients undergoing mechanical ventilation.Background: Caring for patients with respiratory support is one of the important tasks of intensive care units; sedation of patient during ventilation is important. Therefore, this study aimed to compare the effects of midazolam and dexmedetomidine on the sedation quality of patients undergoing mechanical ventilation in intensive care unit.Methods: This study was performed on 100 patients requiring mechanical ventilation in intensive care unit. Patients were randomly assigned into two equal groups of midazolam and dexmedetomidine; signs and complications were recorded in patients. Chi-square and ANOVA tests were used to compare the data.Findings: Dexmedetomidine, like midazolam, had a good sedation effect. The duration of hospitalization in intensive care unit (9.58 vs. 12.36 days, P = 0.011), and the need for ventilation (3.96 vs. 6.74 days, P < 0.001) were significantly lower in dexmedetomidine group, with no serious complications and hemodynamic changes.Conclusion: According to the efficacy of both drugs, depending on the type of patient and its conditions (sensitivity to a particular type of drug), both drugs can be used to sedate patients undergoing mechanical ventilation.https://jims.mui.ac.ir/article_15451_231f5238a3d80a5d32391b04cd46243a.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953546020180121Designing a Clinical Decision Support System for Managing and Treating Patients with the Chief Complaint of VertigoDesigning a Clinical Decision Support System for Managing and Treating Patients with the Chief Complaint of Vertigo180618111545210.22122/jims.v35i460.9346FANaderTavakoliAssociate Professor, Department of Emergency Medicine, School of Medicine AND Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, IranArghavanVahdatResident, Department of Emergency Medicine, School of Medicine AND Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, IranJournal Article20171216Background: One of the challenging issues for emergency specialists is the etiology of dizziness. Using portable software installing in the mobile cell can help the clinicians to reduce the effects of confounders in emergency treatment of patients.Methods: This study was conducted in 2017 in the Department of Emergency, Rasoul-e Akram hospital, Tehran, Iran. After designing the management protocol for patients with vertigo based on the literature and standards, the validity of the protocol was approved by the expert panel. A number of 190 patients with vertigo were diagnosed using two methods for treatment and management of the disease. The first group were assessed using designed clinical decision support system, and the second group were assessed using routine method. Treatment duration, maintenance duration, and the differences between the primary and the final diagnosis were compared between the groups.Findings: Differences between the primary and the final diagnosis were significant among both groups (P < 0.050). Mean treatment duration was 3.38 and 4.96 hours in the first and second groups using support system and routine methods, respectively (P < 0.001). Mean hospitalization period was significantly shorter in support system group (9.37 hours) compared to routine method group (11.17 hours) (P < 0.001). The level of physician satisfaction with the support system was average (47.9%).Conclusion: Using clinical decision support system can greatly help physicians to improve the diagnosis, decrease the hospitalization period, and manage the patients with the chief complaint of vertigo much better.Background: One of the challenging issues for emergency specialists is the etiology of dizziness. Using portable software installing in the mobile cell can help the clinicians to reduce the effects of confounders in emergency treatment of patients.Methods: This study was conducted in 2017 in the Department of Emergency, Rasoul-e Akram hospital, Tehran, Iran. After designing the management protocol for patients with vertigo based on the literature and standards, the validity of the protocol was approved by the expert panel. A number of 190 patients with vertigo were diagnosed using two methods for treatment and management of the disease. The first group were assessed using designed clinical decision support system, and the second group were assessed using routine method. Treatment duration, maintenance duration, and the differences between the primary and the final diagnosis were compared between the groups.Findings: Differences between the primary and the final diagnosis were significant among both groups (P < 0.050). Mean treatment duration was 3.38 and 4.96 hours in the first and second groups using support system and routine methods, respectively (P < 0.001). Mean hospitalization period was significantly shorter in support system group (9.37 hours) compared to routine method group (11.17 hours) (P < 0.001). The level of physician satisfaction with the support system was average (47.9%).Conclusion: Using clinical decision support system can greatly help physicians to improve the diagnosis, decrease the hospitalization period, and manage the patients with the chief complaint of vertigo much better.https://jims.mui.ac.ir/article_15452_46c3b2e84687fd51101929492e53fced.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953546020180121Eating Behaviors among Children and Adolescents, Isfahan Province, Iran, 2015Eating Behaviors among Children and Adolescents, Isfahan Province, Iran, 2015181218221545310.22122/jims.v35i460.8915FAAnahitaBabakAssistant Professor, Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-4397-3286ZibaFarajzadeganProfessor, Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-8811-6678Mohomad RezaMassahStudent of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-4397-3286KamalHeidariAssociate Professor, Social Determinant of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-2719-4496RaziehOmidiTeens, Youth, and Schools Health Unit, Deputy of Health AND Isfahan Province Health Center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-1994-2690ArmindokhtShahsanaiAssistant Professor, Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-1384-2464Journal Article20171007Background: Inappropriate nutrition, and obesity in children have become a global problem. Eating behaviors are considered as one of the factors affecting childhood obesity. Breakfast and snack meals are among the important eating behaviors. This study aimed to assess eating behaviors among children and adolescents in Isfahan Province, Iran, in the year 2015.Methods: In this study, 2305 students of elementary and guidance schools were evaluated using questionnaires about their eating behaviors.Findings: 92.3% of students had breakfast meals. 91.8% of the students consume snack meals in addition to breakfast meal. Different routes of snack meals preparation consisted of home supplied (78.5%), school store (12.1%), near-school shops (7%), and huckster (about 1%). Students’ mothers were the major responsible for providing snacks.Conclusion: Our findings indicate inappropriate quality of eating behaviors among children and adolescents in Isfahan Province, especially for snack meals, despite acceptable knowledge among families. Families play a key role in selecting these behaviors, showing the necessity to pay more attention to the role of the family in this field.Background: Inappropriate nutrition, and obesity in children have become a global problem. Eating behaviors are considered as one of the factors affecting childhood obesity. Breakfast and snack meals are among the important eating behaviors. This study aimed to assess eating behaviors among children and adolescents in Isfahan Province, Iran, in the year 2015.Methods: In this study, 2305 students of elementary and guidance schools were evaluated using questionnaires about their eating behaviors.Findings: 92.3% of students had breakfast meals. 91.8% of the students consume snack meals in addition to breakfast meal. Different routes of snack meals preparation consisted of home supplied (78.5%), school store (12.1%), near-school shops (7%), and huckster (about 1%). Students’ mothers were the major responsible for providing snacks.Conclusion: Our findings indicate inappropriate quality of eating behaviors among children and adolescents in Isfahan Province, especially for snack meals, despite acceptable knowledge among families. Families play a key role in selecting these behaviors, showing the necessity to pay more attention to the role of the family in this field.https://jims.mui.ac.ir/article_15453_273928cb4859a0db86ba8aefd34c1755.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953546020180121Prevalence of Musculoskeletal Disorders among the Specialty Residents in Different Years and Fields in School of Medicine, Isfahan University of Medical Sciences, Iran, 2016Prevalence of Musculoskeletal Disorders among the Specialty Residents in Different Years and Fields in School of Medicine, Isfahan University of Medical Sciences, Iran, 2016182318291545410.22122/jims.v35i460.9341FAAlirezaSafaeianAssistant Professor, Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranBehrangKhaliliStudent of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranNegahTavakolifardAssistant Professor, Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-9866-6681Seyed AlirezaMortazaviAssistant Professor, Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranJournal Article20171215Background: High prevalence of musculoskeletal disorders is one of the serious problems of today's society, especially in the working class, and has a high prevalence in healthcare community staff, according to some studies. The purpose of this study was to evaluate the prevalence of musculoskeletal disorders in specialty residents of different fields and years in School of Medicine, Isfahan University of Medical Sciences, Iran, in 2016.Methods: In this cross-sectional study, 400 residents from all specialty fields in Isfahan University of Medical Sciences were randomly selected. Musculoskeletal disorders of the auxiliaries were assessed using self-administered standard Nordic questionnaire. Data were analyzed using SPSS software.Findings: There was a significant difference in presence of pain during the last week between the specialty residents of different fields (P < 0.001). The presence of pain during the last week was more prevalent among the specialty residents of urology (90.0%), internal medicine (87.2%), neurology (86.2%), ophthalmology (81.3%), orthopedic surgery (80.0%), pathology (72.2%), and anesthesiology (71.4%) than the other fields. There was no significant difference between the specialty residents of different years according to the pain location (P > 0.050).Conclusion: The prevalence of musculoskeletal disorders among the specialty residents in different years is similar; but in some fields that have more shift works and physical activity, pain may be more prevalent than the other fields.Background: High prevalence of musculoskeletal disorders is one of the serious problems of today's society, especially in the working class, and has a high prevalence in healthcare community staff, according to some studies. The purpose of this study was to evaluate the prevalence of musculoskeletal disorders in specialty residents of different fields and years in School of Medicine, Isfahan University of Medical Sciences, Iran, in 2016.Methods: In this cross-sectional study, 400 residents from all specialty fields in Isfahan University of Medical Sciences were randomly selected. Musculoskeletal disorders of the auxiliaries were assessed using self-administered standard Nordic questionnaire. Data were analyzed using SPSS software.Findings: There was a significant difference in presence of pain during the last week between the specialty residents of different fields (P < 0.001). The presence of pain during the last week was more prevalent among the specialty residents of urology (90.0%), internal medicine (87.2%), neurology (86.2%), ophthalmology (81.3%), orthopedic surgery (80.0%), pathology (72.2%), and anesthesiology (71.4%) than the other fields. There was no significant difference between the specialty residents of different years according to the pain location (P > 0.050).Conclusion: The prevalence of musculoskeletal disorders among the specialty residents in different years is similar; but in some fields that have more shift works and physical activity, pain may be more prevalent than the other fields.https://jims.mui.ac.ir/article_15454_05da33eab200f4c5b5ba3ed05beb2ec5.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953546020180121Survey and Classification of Functional Characteristics in Neural Network Technique for the Diagnosis of Ischemic Heart Disease: A Systematic ReviewSurvey and Classification of Functional Characteristics in Neural Network Technique for the Diagnosis of Ischemic Heart Disease: A Systematic Review183018391545510.22122/jims.v35i460.8576FAShirinAyaniPhD in Medical Informatics, Department of Computer Sciences, Faran (Mehr Danesh) Non-governmental Institute of Virtual Higher Education, Tehran, IranKhadijehMoulaeiMSc Student, Department of Medical Informatics, School of Health Managment and Information Siences, Iran University of Medical Sciences, Tehran, IranMaryamJahanbakhshInstructor, Department of Management and Health Information Technology, School of Management and Medical Information, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-0876-5422RezaMoulaeiStudent of Medicine, School of Medicine, Jundishapur University of Medical Sciences, Ahvaz, IranJournal Article20170801Background: Nowadays, the prevalence of ischemic heart diseases (IHDs) leads to destructive effects such as patient death. Late diagnosis of such diseases as well as their invasive diagnostic approaches made researchers provide a decision support system based on neural network techniques, while using minimum data set for timely diagnosis. In this regard, selecting minimum useful features is significant for designing neural network structure and it paves the way to attain maximum accuracy in obtaining the results.Methods: In this systematic review, valid databases using sensitive keywords were initially searched out to find articles related to "diagnosing the ischemic heart disease using artificial neural networks" and afterwards, scientific methods were used to analyze and classify the content.Findings: Researchers applied various extractable features from demographic data, medical history, signs and symptoms, and paraclinical examinations, to design the neural network structure. Among them, the features obtained from electrocardiographic test, embedded in paraclinical examinations, had led to a remarkable increase of efficiency in neural network.Conclusion: Utilizing such diagnostic decision support systems in practical environments depends on their high confidence coefficient and physicians’ acceptability. Therefore, it can be useful to improve maturity in the design of the neural network structure depending on the choice of the minimum optimal features, and to create required infrastructures to input patients’ real, accurate, and flowing data in these systems.Background: Nowadays, the prevalence of ischemic heart diseases (IHDs) leads to destructive effects such as patient death. Late diagnosis of such diseases as well as their invasive diagnostic approaches made researchers provide a decision support system based on neural network techniques, while using minimum data set for timely diagnosis. In this regard, selecting minimum useful features is significant for designing neural network structure and it paves the way to attain maximum accuracy in obtaining the results.Methods: In this systematic review, valid databases using sensitive keywords were initially searched out to find articles related to "diagnosing the ischemic heart disease using artificial neural networks" and afterwards, scientific methods were used to analyze and classify the content.Findings: Researchers applied various extractable features from demographic data, medical history, signs and symptoms, and paraclinical examinations, to design the neural network structure. Among them, the features obtained from electrocardiographic test, embedded in paraclinical examinations, had led to a remarkable increase of efficiency in neural network.Conclusion: Utilizing such diagnostic decision support systems in practical environments depends on their high confidence coefficient and physicians’ acceptability. Therefore, it can be useful to improve maturity in the design of the neural network structure depending on the choice of the minimum optimal features, and to create required infrastructures to input patients’ real, accurate, and flowing data in these systems.https://jims.mui.ac.ir/article_15455_22210129bf34852d73ea41affbbd9bba.pdf