Purpose To study treatment outcome of parathyroid adenomas using ultrasound‐guided radiofrequency ablation. Methods Twenty‐seven patients with a single adenoma of the parathyroid gland were included in the study. Using color Doppler ultrasonography, the lesion and its characteristics were determined, and dextrose was injected to dissect the gland from the surrounding structures. The ablation process was done with 6–12 watts of power. Results No complications were seen in any of the subjects. A significant reduction was seen in serum parathyroid hormone (PTH) and calcium levels after treatment. PTH levels showed a median decrease of 13.8%, and a median decrease of 8.2% was seen in serum calcium levels (p < 0.001). Phosphorus levels did not change significantly after treatment. In 1‐month follow‐up of patients, the lesion size had decreased considerably. In long‐term follow‐up, 11 of 20 patients having subsequent imaging had indistinguishable lesions. Conclusion Our results showed that RFA of parathyroid adenomas caused a significant reduction in biomedical indicators of disease and resulted in a significant reduction or disappearance of the lesion in the majority of the patients while having no considerable complications.
Introduction Fear of childbirth is the main factor, which has decreased the tendency toward selecting natural birth. The immoderate increase in the number of C-sections has increased maternal and neonatal morbidity and mortality. The present study investigates the relationship between awareness, attitude, fear of childbirth, and mode of delivery preference in Primigravid women referring to healthcare centers in Khorramabad, Iran. Method In this descriptive-analytic study, 179 nulliparous pregnant women with the gestational age of> 2,0 weeks who visited selected healthcare centers in Khorramabad for routine pregnancy care in 2020 were selected in two stages and studied. The data were collected via the childbirth attitude questionnaire (CAQ), awareness, attitude, demographic characteristics, current pregnancy characteristics, midwifery history, and history of infertility treatment questionnaires. The data were analyzed via the Chi-squared test. Results The participants had a mean gestational age of 33.73 ± 4.71 weeks. There was a significant different between the level of awareness, and mode of delivery preference (p = 0.005). The majority of the participants (57.5%) had a moderate level of awareness about the mode of delivery. There was a significant different between the level of, attitude, and mode of delivery preference (p = 0.001).) Most of the participants (71.5%) had a negative attitude towards the mode of delivery. There was also a significant different between fear of childbirth and mode of delivery preference (p < 0.001), and most of the participants (71.5%) showed fear of childbirth. Conclusion According to the results of this study, the majority of participants had afraid of childbirth, moderate awareness of mode of delivery, and negative attitudes. So, the healthcare providers should pay special attention to the fear of childbirth and the relevant factors during pregnancy.
Background: Restenosis after coronary angioplasty can have serious complications such as coronary artery bypass graft, myocardial infarction, and death. Objectives: The present study aimed at investigating the factors affecting the recurrence of coronary artery stenosis in patients undergoing angioplasty using the recurrent event data analysis. Methods: A cohort study was performed on patients undergoing coronary angioplasty from March 23, 2009, to January 21, 2011. All patients were followed up from angioplasty to January 21, 2015. First, each of the independent variables was entered into the univariate Cox model with a frailty component. Then, variables with p-values of less than 0.2 were entered into the multivariate analysis. The statistical analysis was done using R software, version 3.6, at the significance level of 0.05. Results: The present study was conducted on 1,000 patients who underwent coronary angioplasty. We found that 441 patients experienced restenosis at least once in the study period. The mean survival time to the first event of restenosis was 44.08 ± 1.06 months. Patients with a history of diabetes, unstable angina, and myocardial infarction had a significantly higher hazard of restenosis compared to other patients (P < 0.05). Conclusions: The results of the recurrent event survival analysis confirmed the significant role of risk factors such as a history of diabetes, unstable angina, and myocardial infarction. Therefore, training to enhance the patients’ awareness and attitude seems necessary to prevent them from exposing whit known risk factors. The periodic follow-up of patients with risk factors and more ongoing care are also necessary.
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Background and Objective: This study was conducted to evaluate epidemiology of risk factors for hepatitis C virus (HCV) transmission, and determine the association of its genotypes with viral load and response to treatment in patients referred to the Infectious Disease Clinic of Khorramabad.Methods: The study included patients infected with hepatitis C referred to the Infectious Disease Clinic of Khorramabad during 2011-14. Those who met the inclusion criteria were referred to counseling centers for risky behaviors. After collecting demographic and epidemiologic data on the modes of transmission, blood samples were collected for more accurate testing. The erum of patients with hepatitis C was evaluated in terms of HCV genotype and viral load using PCR.Results: Among 120 patients studied, 102 (85%) were male and 18 (15%) were female. The most prevalent genotypes were 3a (63.8%), 1a (25%), 1a/1b (5.2%) and 2 (1.7%). Intravenous drug abuse was the main route of transmission of hepatitis C in the study. The genotypes 3a and 1a had a clear correlation with intravenous drug abuse and history of blood transfusion (P<0.05). It was also found that the patients with genotype 3a show a better initial response to treatment with interferon.Conclusion: The study shows that intravenous drug abuse is the main route of transmission, which highlights the need for intervention and education in this group of patients to prevent disease transmission.
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