Khomeini Research Articles

Long-term survival after hepatic resection for colorectal liver metastases: a single-center study in Iran

BackgroundSurgical resection of colorectal cancer liver metastasis (CRLM) has been associated with improved survival in these patients. The purpose of this study was to investigate the usefulness of liver metastasectomy, also finding independent factors related to survival after liver metastasectomy.MethodsIn a retrospective study, all patients with CRLM who underwent resection of liver metastases between 2012 and 2022 at Imam Khomeini Hospital Complex in Tehran, Iran, were enrolled. All patients were actively followed based on clinicopathologic and operative data.ResultsA total of 248 patients with a median follow-up time of 46 months (Range, 12 to 122) were studied. Eighty-six patients (35.0%) underwent major hepatectomy, whereas 160 (65.0%) underwent minor hepatectomy. The median overall survival was 43 months (Range, 0 to 122 months), with estimated 1-, 3- and 5-year overall survival rates of 91%, 56%, and 42%, respectively. Multivariate analysis demonstrated that a metastasis size > 6 cm, major hepatectomy, rectum as the primary tumor site, and involved margin (< 1 mm) were independent factors associated with decreased overall survival (OS).ConclusionSurgical resection is an effective treatment for patients with CRLM that is associated with relatively favorable survival. A negative margin of 1 mm seems to be sufficient for oncological resection.

Analyzing long-term parking preferences at Imam Khomeini International Airport: a stated preference approach

Analyzing long-term parking preferences at Imam Khomeini International Airport: a stated preference approach

Safety and effectiveness of single- versus double-dose of seasonal influenza vaccine in kidney transplant recipients: a randomized clinical trial

Introduction. Influenza virus poses significant risks to immunocompromised individuals such as those who have received organ transplants and are undergoing immunosuppressive treatment to prevent transplant rejection. Therefore, annual influenza vaccination is recommended for these individuals. This study aimed to comparison of safety and effectiveness of single- versus double-dose of seasonal influenza vaccine in kidney transplant recipients. Materials and methods. This randomized clinical trial involved 50 kidney transplant recipients at Imam Khomeini Hospital. Participants were randomly assigned to two groups: those receiving a single dose (standard dose) and those receiving a double dose of the seasonal flu vaccine. Serum samples were collected before and 4 weeks after vaccination to measure influenza AB-related antibodies. Sixteen patients were excluded from the study. The trial focused on evaluating the vaccine safety and immunogenicity, as well as documenting any local and systemic side effects following vaccination. Results. The results indicated no significant difference in gender, age, and type of immunosuppressive drug used between the single- and double-dose groups (p 0.05). No significant difference in post-vaccination adverse effects, such as injection site pain (p = 0.21) between the two groups. The seroconversion rates (change from IgG 9 IU/µL to IgG 11 IU/µL) for IgG Influenza A were 12.5% (n = 2) in the single-dose group and 26.7% (n = 4) in the double-dose group, and for IgG Influenza B, they were 11.8% (n = 2) and 21.4% (n = 3), respectively. Conclusion. A double dose of the influenza vaccine slightly enhanced the immune response in kidney transplant patients without causing any adverse side effects.

The Rushdie Affair and the Politics of Multicultural Britain

Abstract It is more than thirty years since Ayatollah Khomeini, the supreme leader of Iran, issued a fatwa (religious decree) calling for the execution of the British-Indian novelist Salman Rushdie, whose third novel, The Satanic Verses, was published in 1988. But the ‘Rushdie Affair’ has yet to be subject to a sustained analysis by historians. Journalists and political scientists continue to focus on the fatwa, despite the fact the protests against the novel in Britain – where The Satanic Verses is primarily set – predated Khomeini’s decree by two months. This article fills this lacuna by shifting attention onto the emergence of the campaign against The Satanic Verses in Britain and in Bradford especially, where a copy of Rushdie’s ‘blasphemous’ novel was infamously burnt by Muslim protestors. It shows how an earlier set of campaigns fought in Bradford by Muslim activists paved the way for the city to become a key site of protest against both Rushdie and his novel. The protests that greeted The Satanic Verses were shaped by the contradictory nature of Britain’s emergence as a multicultural society, I argue, and the political complexities thrown up by the hybridized milieu Rushdie had sought to use his fiction to evoke.

Does Near Miss Compromise Sexual Function in Reproductive-Aged Women? A Comparative Cross-Sectional Study in Ahvaz, Iran

Background: Maternal near miss (MNM) is defined as any life-threatening event during pregnancy, delivery, or within six weeks after the termination of pregnancy. Objectives: This cross-sectional study aimed to assess sexual function in women with (n = 140) and without MNM (n = 246). Methods: Eligible participants were women with MNM and basic literacy who had given birth at least 8 - 12 weeks prior to the study. Participants were recruited from Imam Khomeini and Taleghani hospitals, while women without MNM were recruited from two public health centers in Ahvaz. Data collection commenced in December 2020 and concluded in March 2021. A demographic questionnaire and the Female Sexual Function Index were used to collect the data. Data were analyzed using independent t-tests, chi-square tests, and multiple linear regression. Results: The predominant mode of delivery among MNM women was cesarean section (70%, P &lt; 0.05). The most common causes of MNM were preeclampsia (41.43%) and placenta accreta (24.29%), followed by hypertension and diabetes (17.86%). Women without MNM reported significantly higher scores in sexual satisfaction (β = 0.355, 95% CI: 0.019, 0.690, P = 0.035), lubrication (β = 0.707, 95% CI: 0.435, 0.980, P &lt; 0.0001), sexual arousal (β = 0.394, 95% CI: 0.116, 0.522, P = 0.007), sexual desire (β = 0.319, 95% CI: 0.116, 0.522, p = 0.002), and total sexual function score (β = 1.768, 95% CI: 0.306, 3.230, P = 0.018). Women who had undergone cesarean section reported lower scores in sexual satisfaction (β = -0.646, 95% CI: -0.983, -0.309, P &lt; 0.0001), orgasm (β = -0.620, 95% CI: -0.965, -0.275, P &lt; 0.0001), sexual arousal (β = -0.473, 95% CI: 0.159, 0.439, P = 0.001), and total sexual function score (β = -3.181, 95% CI: -4.655, -1.707, P &lt; 0.0001). Older women scored significantly lower in all components of sexual function except for pain. Conclusions: The study results indicated that all components of sexual function, except pain, were lower in women with MNM. A significantly higher number of women who had undergone cesarean section experienced MNM and sexual dysfunction. Health policymakers should focus not only on the causes of MNM, particularly cesarean sections, but also on assessing the sexual function of women affected by MNM.

The Accuracy of the S100B Protein Biomarker in the Prognosis of Patients with Acute Spinal Cord Injury

Abstract Introduction The role of some biomarkers such as S100 beta (S100B) has been somewhat known in determining the severity of primary acute spinal cord injury (SCI), and today, it has been the basis of various relevant studies. Therefore, this study estimates the S100B level in serum and cerebrospinal fluid (CSF) in patients with spinal injuries. Methods This was a descriptive-analytic study. In this study, 31 patients with acute SCI referred to Sari Imam Khomeini Hospital, Iran, were recruited. Patients were divided into two groups of complete and incomplete SCI according to the American Spinal Injury Association (ASIA). The S100B concentrations in serum and CSF levels were compared between the two groups. Result There was only significant positive correlation between S100B CSF concentration and complete SCI based on the ASIA criterion, meaning that in cases of complete SCI the S100B CSF concentration was significantly increased correlation coefficient (CC) (cc = 0.529 and p = 0.002). Based on the results of serum S100B protein concentration, 14.70 ng/dL with a sensitivity of 66.7% and specificity of 55% was determined as cutoff for complete SCI. Also, about the CSF S100B protein level variable, concentration of 342.18 ng/dL with 100% sensitivity and 64% specificity was determined as cutoff for complete injury. Conclusion The results of this unique study have shown that S100B were useful markers for predicting the prognosis of patients with acute SCI and cutoff points determined for serum and especially CSF concentrations can differentiate complete and incomplete SCI.

Antibody Response before and after the Booster Dose of Inactivated Corona Vaccine in Antibody Deficient Patients

Patients with inborn errors of immunity (IEI) are among the high-risk groups regarding COVID-19. Receiving booster doses (third and fourth) in addition to the standard doses is recommended in these patients. This study investigated the antibody response before and after a booster dose of Sinopharm vaccine in IEI patients.&#x0D; Thirty patients (&gt;12 years) with antibody deficiencies, referred to Imam Khomeini Hospital and Children's Medical Center in Tehran, were enrolled in this prospective cross-sectional study. All patients were fully vaccinated with the BBIBP-CorV vaccine (2 doses of Sinopharm). Initial measurements of anti-receptor-binding domain (anti-RBD) and anti-nucleocapsid (anti-N) IgG antibody responses were conducted by enzyme-linked immunosorbent assay (ELISA). Subsequently, all patients received a booster dose of the vaccine. Four to six weeks after booster injection, the levels of antibodies were re-evaluated.&#x0D; Twenty patients with common variable immunodeficiency (CVID), 7 cases with agammaglobulinemia and 3 patients with hyper IgM syndrome were studied. Anti-RBD IgG and anti-N IgG antibodies increased in all patients after the booster.&#x0D; Our results indicated the need of receiving booster doses of the COVID-19 vaccine in patients with antibody deficiencies, even for enhancing humoral immune response specially in patients with CVID.

Peradilan Agama Islam di Negara Syiah

Ayatollah Imam Khomeini became an important figure in the independence of the Islamic Republic of Iran as a Shia state, using Wilayat al-Faqih as its legal concept with the Imamate principle. The principle of Imamate explains that as long as the Twelfth Imam (Imam Mahdi) is still unseen, the government is led by an Imam whose qualifications are close to the Imam in terms of knowledge and spirituality. Consequently, the way the law is administered and the way the law is adjudicated in the State of Iran is up to the Wali Faqih, and when the Wali Faqih agrees, the rules can be implemented. This paper aims to examine the history, legal system, and judiciary of the Islamic Republic of Iran. The research data is obtained from literature studies (library research) and is descriptive and analytical. The result of the discussion is that Iran has gone through a long history starting from the first Persian empire, namely Akhameniyah, to the occurrence of post-Revolution until now. Iran is a country that adheres to Shi'a Islam and uses the legal concept of Wilayat al-Faqih where high power is in the hands of Wali Faqih. The judicial council is the holder of judicial power, whose head of the judiciary is directly elected by the Wali Faqih. Some of the courts in Iran include the Revolutionary Court, the General Court, and the Supreme Court of Cassation. In Iran, there is also a Clerical Court/SCC that tries clerics or Muslim scholars and this court is very secretive

A placebo-controlled, crossover trial to investigate the efficacy of tiotropium bromide or placebo added to usual care in stable symptomatic post-hematopoietic stem cell transplantation (HSCT) bronchiolitis obliterans syndrome (BOS).

Despite the fundamental progress in hematopoietic stem cell transplant, this treatment is also associated with complications. Graft-versus-host disease is a possible complication of HSCT. Bronchiolitis obliterans syndrome (BOS) is the pulmonary form of this syndrome. Due to the high morbidity and mortality rate of BOS, various studies have been conducted in the field of drug therapy for this syndrome, although no standard treatment has yet been proposed. According to the hypotheses about the similarities between BOS and chronic obstructive pulmonary disease, the idea of using tiotropium bromide as a bronchodilator has been proposed. A randomized, double-blind, placebo-controlled, and crossover clinical trial is being conducted to evaluate the efficacy of tiotropium in patients with BOS. A total of 20 patients with BOS were randomly assigned (1:1) to receive a once-daily inhaled capsule of either tiotropium bromide (KP-Tiova Rotacaps 18 mcg, Cipla, India) or placebo for 1 month. Patients will receive tiotropium bromide or placebo Revolizer added to usual standard care. Measurements will include spirometry and a 6-min walking test. This study was approved by the Research Ethics Committees of Imam Khomeini Hospital Complex, Tehran University of Medical Science. Recruitment started in September 2022, with 20 patients randomized. The treatment follow-up of participants with tiotropium is currently ongoing and is due to finish in April 2024. The authors will disseminate the findings in peer-reviewed publications, conferences, and seminar presentations. Iranian Registry of Clinical Trial (IRCT) IRCT20200415047080N3. Registered on 2022-07-12, 1401/04/21.

Influential factors for final neurorehabilitation outcome scores in patients with spinal cord injury: A longitudinal cohort study

Study designLongitudinal prospective cohort study. ObjectivesTo assess the coefficient of efficacy and the influence of various demographic and neurological factors on changes in Spinal Cord Independence Measure III (SCIM-III) scores over time in traumatic spinal cord injury (TSCI) patients. SettingPatient recruitment and evaluations were conducted at the Brain and Spinal Injury Research Center in Imam Khomeini Hospital Complex, Tehran, Iran. MethodsThe study was performed over an 8-year period in our outpatient rehabilitation setting. Changes in SCIM-III scores were assessed in 559 TSCI patients (of 1460 enrolled patients) who fit the inclusion criteria. All included patients participated in our outpatient rehabilitation program, which consisted of a multidisciplinary education program combined with occupational therapy, physical therapy, and home nursing as a rehabilitation package for a 6-month period. Patients then received follow-up assessments every 6 months. ResultsPredictors of the SCIM-III score as a rehabilitation outcome tool, and of its change over time, included age (younger patients had better outcomes, p = 0.067), marital status (married patients had better outcomes, p = 0.031), education level (patients with university education had better outcomes, p = 0.003), occupation status (employed patients had better outcomes, p = 0.009), and neurological level of injury (patients with injuries at lower levels had better outcomes, p < 0.001). However, sex and injury severity as per the American Spinal Injury Association Impairment Scale (AIS) had no significant effects on functional outcomes (i.e., SCIM-III score changes over time). ConclusionAge, marital status, education level, employment, and neurological level all affected the final SCIM-III scores of SCI patients. By contrast, sex and AIS grade were not significant predictors of SCIM-III outcomes. Further studies that include additional factors may be useful for future SCIM-III models.

Sourcing aliphatic and polycyclic aromatic hydrocarbons (PAHs) in Jinga shrimp (Metapenaeus affinis) muscle tissues and surface sediments (study case: Northwest Persian Gulf).

This study addresses the sources of aliphatic hydrocarbons (AHs) and polycyclic aromatic hydrocarbons (PAHs) in the surface sediments of the northwestern Persian Gulf and the muscle tissues of Jinga shrimp (Metapenaeus affinis), a commercially important aquatic species. In November 2018, 28 Jinga shrimp samples were systematically collected from four key fishing areas in Behrgan and Khormusi: Imam Khomeini Port (S1), Mahshahr Port (S2), Sejafi (S3), and Behrgan Wharf (S4). Additionally, sediment samples were collected from these locations, and AHs and PAHs concentrations were analyzed using gas chromatography-mass spectrometry (GC-MS). The average aliphatic concentration in Jinga shrimp was 4800.32 (μg g-1 DW), exceeding the sediment samples' 2496.69 (μg g-1 DW) estimate. Hydrocarbon component analysis revealed EPA priority list (PAH-16) and measured PAHs (PAH-29) concentrations in Jinga shrimp ranging from 1095.8 to 2698.3 (ng g-1 DW) and in sediments from 653.6 to 1019.5 (ng g-1 DW). Elevated AHs and PAHs in Jinga shrimp, compared to sediments, suggest a petrogenic source, notably at station S4 near Behrgansar and Nowruz oil fields. Low molecular weight (LMW) compounds dominated in both shrimp and sediment PAHs. Aliphatic composition profiles in shrimps closely mirrored sediment profiles, illustrating an even-to-odd carbon dominance gradient. Diagnostic ratio examinations of hydrocarbons indicated pervasive petroleum derivatives in the environment. This study establishes a direct correlation between hydrocarbon concentrations in shrimp and sediment samples and the corresponding aliphatic groups, PAH-16, and PAH-29. The findings underscore the potential of Jinga shrimp as a reliable indicator of hydrocarbon pollution in the northwestern Persian Gulf.

The Armenian Community and Changing Iranian Perceptions of Minority

Until a decade ago, it was unusual for officials in the Islamic Republic to use the word aqaliat (minority) to refer to ethno-linguistic minorities or Muslim sect minorities. Efforts to cast Sunni Muslims as a minority, or Azeri speakers, were treated with hostility, as the state, following a specific proclamation on ethnicity and sectarianism by Ayatollah Khomeini, viewed these concepts as divisive to the ummah and ultimately a threat to national security. Aqaliat was instead reserved for non-Muslims, specifically those recognized as minorities in the constitution: Assyrian, Chaldean and Armenian Christians, and Zoroastrian and Jewish Iranians. It is therefore worthwhile to examine how one such minority community, Iranian Armenians, has reacted to these changes.

Effect of empagliflozin on left ventricular volumes in type 2 diabetes or prediabetes heart failure patients with reduced ejection fraction

Objective: Sodium-glucose cotransporter 2 (SGLT2) inhibitors, such as empagliflozin are antidiabetic drugs that have recently been reported to have cardio-protective action; however, their effect on cardiac structure and function in heart failure with reduced ejection fraction (HFrEF) has not yet been determined. This study evaluates the efficacy of empagliflozin on left ventricular (LV) volumes in type 2 diabetes or prediabetes patients with HFrEF. Methods: This randomised, double-blind, trial study was conducted on 104 patients with type 2 diabetes or prediabetes with HFrEF referred to Imam Khomeini and Golestan hospitals in Ahvaz, Iran. The patients were randomised to receive empagliflozin (10 mg once daily) in addition to standard treatments of HFrEF or receive only standard treatments (control group) for six months. During the six months of follow-up, changes in LV volumes, LVEF, hospitalisation for heart failure (HF) were evaluated. Results: Empagliflozin reduced LVEDVI and LVESVI by 10.0 and 8.0 mL/m2 (p < 0.0001). Furthermore, a significant increase in LVEF was observed in the empagliflozin group (p < 0.0001) without any significant change in the control group (p = 0.389). The hospitalisation rate was lower in the empagliflozin group than the control group (3.8% vs. 23.1%; p = 0.008). Conclusions: Empagliflozin is effective in reducing LV volumes and hospitalisation rate in patients with type 2 diabetes and prediabetes and HFrEF. Therefore, treatment with empagliflozin for six months was associated with a significant reduction in adverse cardiovascular outcomes in these patients.

Missed nursing care and its relationship with nurses’ moral sensitivity: a descriptive-analytical study

BackgroundMissed care rates are an indicator of healthcare quality. Missed nursing care can reduce patient safety and lead to adverse events. Moral sensitivity enables nurses to interpret and respond to clients’ needs according to ethical principles. Despite the importance of moral sensitivity and its role in the quality of care, the relationship between nurses' moral sensitivity and missed nursing care has not been extensively studied. This raises the question of whether there is an association between nurses' moral sensitivity and missed care. This study was conducted to investigate the relationship between nurses’ moral sensitivity and missed nursing care in the medical and surgical departments of Imam Khomeini Hospital in Urmia, Iran.MethodsA cross-sectional study was conducted in 2022, on 202 nurses working in the medical and surgical departments of Imam Khomeini Medical Education Center, Urmia, Iran. Stratified random sampling was used to select the participants. A questionnaire on demographic characteristics, Kalisch's missed care questionnaire, and Lutzen's moral sensitivity questionnaire were used to collect data. Data were analyzed using the Pearson correlation test and linear regression analysis.ResultsMost participants (52.97%) showed moderate moral sensitivity. Nurses’ mean moral sensitivity and total missed care scores were 149.07 ± 21.60 and 59.45 ± 4.87, respectively. Pearson correlation test showed no significant correlation between moral sensitivity scores and the total missed care scores (r = 0.041, p = 0.152). However, in the regression analysis, moral sensitivity (β = 0.213, p < 0.001), age (β = 0.131, p < 0.001), working in rotating shifts (β = 0.183, p < 0.001), monthly income (β = 0.079, p = 0.004), work experience (β = 0.030, p = 0.010), and monthly work hours (β = 0.247, p = 0.010) influenced missed care. Approximately, 0.98% of the variance in the missed care was explained by these variables.ConclusionOur nurses reported moderate levels of moral sensitivity and a concerning level of missed care. Missed care can have detrimental effects on patient safety. Therefore, nursing managers must address this issue promptly.

Accuracy of Chest Xray in Hospitalized COVID-19 Patients

Introduction: At the end of the year 2019 a novel virus named SARS-CoV-2 caused Coronavirus Disease 19 (COVID-19), manifesting as lung infection which can result in severe pneumonia. The gold standard for diagnosis of the virus is the detection of viral RNA through reverse transcriptase PCR (RT-PCR). Materials and Methods: This study is a retrospective analysis of diagnostic yield of chest imaging modalities in the diagnosis of COVID-19 in patients admitted to the Imam Khomeini hospital, Tehran, Iran during march 2020 until July 2020. Results: 204 hospitalized patients with a mean age of 58.5 years, diagnosed with COVID-19 were enrolled in this study, who had their disease confirmed by PCR. About 20% of patients had normal O2 Saturation (above 93%) and 80% had low O2 Saturation. Also 70% of patients were hospitalized to the ICU. Among investigated patients, 87.6% had abnormal findings in their CXR. Also, 97.1% of patients had abnormal CT-Scan. In this study, the sensitivity of the CXR in the diagnosis of COVID-19 was 87.5% (CI 95%, 83 to 91) and the sensitivity of the chest CT-Scan was 97.1% (CI 95%, 94.8 to 99). Discussion: Utilizing CXR as a first-line imaging modality is recommended in many countries and clinical settings and chest CT-Scan is mainly reserved for other additional roles. This study reveals a CXR sensitivity of 87.5% which is in accordance with the recent literature (69-90%).

Assessment of Ganglion Impar Block Effect on Treatment Results of Coccydynia: A Cross-Sectional Study

Background: The ganglion impar block is a minimally invasive technique used for alleviating pain associated with coccydynia. Objectives: This research evaluates the effectiveness of the ganglion impar block in treating patients with coccydynia who have not benefited from conservative treatments. Methods: This cross-sectional analysis reviewed the clinical records of coccydynia patients who received ganglion impar block injections at Urmia Imam Khomeini Hospital, Urmia, Iran, between 2020 and 2022. Data regarding age, gender, body mass index (BMI), onset of pain, and levels of patient satisfaction post-treatment were gathered from the medical records. Results: The study comprised 26 patients, with 4 (15.4%) being male and 22 (84.6%) female. The average age and BMI were 39.15 ± 14.24 years and 28.91 ± 2.14 kg/m2, respectively, which did not show significant variation (P = 0.19). The average Visual Analogue Scale (VAS) score before the ganglion impar block was 6.23 ± 2.35, which reduced to 4.47 ± 2.41 immediately after the procedure. At the 1-month follow-up, the average VAS score had further decreased to 3.47 ± 0.79. The decrease in VAS scores, both immediately after the procedure and at the 1-month follow-up, was statistically significant. The success rate of the block (defined as a reduction in pain of at least 20% from the baseline) was significantly high immediately and one-month post-procedure (P &lt; 0.001). Out of the 26 patients treated with the impar block, satisfaction rates were 42.3% excellent, 27% good, 19.2% fair, and 11.5% poor. Conclusions: The study endorses the trans-sacro-coccygeal “needle inside needle” method for providing relief to patients suffering from coccydynia. The findings revealed significant patient satisfaction, with the majority describing their experience as excellent.

Investigation of Laboratory Indicators, Clinical Symptoms, and COVID-19 Vaccination History in Children Referred to Imam Khomeini Hospital in Jiroft City, South Iran

Background: The commencement of COVID-19 vaccination has had an impact on hospitalizations and deaths of patients. This study aims to investigate the effect of COVID-19 vaccination on children›s hospitalizations and deaths. Methods: This cross-sectional study examined 893 children infected with COVID-19 referred to Imam Khomeini hospital in Jiroft City in the south of Iran in 2022. Data collected and analyzed included demographic variables including age, sex, place of residence, underlying disease, vaccination status, injection dose of vaccine, history of contact with a patient with COVID-19, and clinical and laboratory characteristics such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), white blood cell (WBC), creatinine (CR) and days of hospitalization. The data were analyzed using SPSS-v20 software. Results: The average age±SD of the patients is 4.6±3.9 years. There were 302 (33.81%) children in the age group of 9 to 12 years and 133 (14.89%) of children were in the age group under one year. The most common clinical symptoms in children with COVID-19 were fever (67.41%), diarrhea (38.63%), and cough (30.57%). ESR and CRP were 27.72±20.8, and 25.51±32.8 respectively amongst the participants. Out of 893 children, 480 (53.75%) were vaccinated and 413 (46.24%) had not received the vaccine. Out of 480 vaccinated children, 460 (95.83%) were outpatient, and only 20 (4.16%) were hospitalized, and out of 413 non-vaccinated children, 241 (58.35%) were outpatient, and 172 (41.64%) were hospitalized. Conclusion: The results showed that vaccination led to a 95.83% reduction in hospitalization and a 100% reduction in long-term hospitalization. The COVID-19 vaccination is very effective in preventing the harmful effects of COVID-19 in future trends and pandemics.

Postnatal growth failure of very low-birth-weight infants in Southwest Iran: A descriptive analytical study.

Preterm infants are more prone to poor growth and neurodevelopment. The first few weeks of life play an important role in the growth and neurodevelopment of very-low-birth-weight (VLBW) infants. The Vermont Oxford Network, evaluating the postnatal growth of preterm newborns, considers growth failure as body weight <10th percentile for postmenstrual age. This study aims to assess the frequency of postnatal growth failure in VLBW infants in Southwest Iran. This descriptive analytical study was performed on VLBW infants in the neonatal intensive care unit (NICU) of Imam Khomeini Hospital (Ahvaz, Iran) from September 2019 to August 2020. Growth failure was confirmed when a newborn's weight at discharge was smaller than the 10th percentile corrected age (≤-1.28 Z-score), based on the Fenton growth chart as a standard. This study was performed on 353 infants. Intrauterine growth retardation was detected in 29% of female and 10.6% of male newborns, who were born at a gestational age of 32 and 31 weeks or higher respectively. Upon hospital discharge, postnatal growth failure was detected in all newborn girls, except for those born at 32 weeks of gestation, and all newborn boys, except for those born at a gestational age of 33-34 weeks. Postnatal growth retardation in VLBW infants born in our NICU was much higher than that of other centers. Overcrowding, short length of hospitalization, low nurse-to-patient ratio, and untrained nurses were among the reasons for poor postnatal growth in our center.

Managing Hepatotoxicity Caused by Anti-tuberculosis Drugs: A Comparative Study of Approaches.

Tuberculosis (TB) is one of the oldest and most well-known diseases that has been associated with humans for many years and remains a global health challenge today. Timely diagnosis and proper treatment are crucial for controlling and preventing the spread of the disease. While anti-TB drugs offer many benefits, inadequate monitoring can lead to a range of side effects, including hepatotoxicity, which is a major concern and can cause treatment discontinuation. The aim of this study was to determine the approach to the hepatotoxicity of anti-TB drugs and to investigate potential relationships between demographic factors, underlying medical conditions, and successful retreatment outcomes for hepatotoxicity induced by anti-TB drugs. For this study, we reviewed the medical records of patients who experienced hepatotoxicity due to anti-TB treatment and were admitted to the infectious ward of Imam Khomeini Hospital between April 2015 and February 2019. The data were collected using a questionnaire. The findings indicated that the female gender, weight loss at the beginning of hospitalization, hepatitis C virus, hepatitis B virus (HBV), heart disease, and high levels of aspartate aminotransferase (AST) and alanine transaminase (ALT) at the beginning of hepatotoxicity are risk factors for failure to the retreatment of hepatotoxicity. There were two different approaches to the anti-TB retreatment regimen. The first approach involved gradually starting the drugs in full dose, while the second approach encompassed starting the drugs in the minimum dose and then increasing to the maximum dose. The results demonstrated no significant difference between the two approaches to managing hepatotoxicity induced by anti-TB drugs. Drug-induced hepatotoxicity is a common occurrence that often results in treatment discontinuation. Understanding the prevalence of this complication and identifying appropriate methods of rechallenge treatment is crucial to reducing complications and mortality rates.

Schwannoma of the Upper Extremity: A Clinical Series

Background: Schwannoma, the most common primary neural tumor of the upper extremity, arises from Schwann cells of the nerve sheet. The tumor is usually painless and slow-growing. Symptomatic masses could be treated through intra- or extra-capsular excision. Herein, we aim to evaluate the long-term results of surgical treatment of 12 cases of upper extremity Schwannoma.&#x0D; Methods: Twelve cases of confirmed Schwannoma who were treated in Imam Khomeini University Hospital, Tehran, Iran, from 2011 to 2022, were included in our case series. All operations were done using loupe magnification or under a microscope. Age, sex, location of the mass, size of the tumor, affected nerve, histological diagnosis, and clinical follow-up, including the neurological status of the patients, were documented.&#x0D; Results: Twelve patients with a mean age of 44 years were included. Seven (58.3%) were men and five (41.66%) were women. The mean follow-up period was 45 months (range: 6-135). The hand was the most common location of involvement and the digital nerve was the most frequent origin of Schwannoma. Postoperative evaluation showed no tumor recurrence and pain resolved in all twelve patients (100%). Sensory dysfunction resolved completely in 5 out of 8 patients who reported sensory impairment preoperatively (62.5%) and no motor function improvement was seen in the patient with motor deficit.&#x0D; Conclusion: Adequate operative techniques can lead to complete tumor removal without neurological loss or recurrence. Neural function improvement in most cases is achieved. New neurologic impairment after excision of Schwannoma is rare.