Critical Content Analysis of Narrative Version of Islamic Medicine

Background and Objective: The nature of Narrative version of Islamic medicine (NIM) is based on Quran and hadith, exclusive attention to Islamic narrative references and rejection of the strategies of other medical schools. This study was conducted to criticize NIM. Methods: In this qualitative study of content analysis, after collecting the opinions of 6 prominent scholars of NIM, the criticisms of these opinions were presented and categorized by three doctors specialized in Persian medicine, a cleric in the field of Islamic jurisprudence and a methodologist by holding expert panel meetings. Findings: Criticisms were raised based on three points of view. The intra-religious area including the routine of Ahl al-Bayt (The holy family of the Prophet Muhammad) in illness and the role of physicians, the place of reason and experience in Islamic sciences, differences in geographical areas, not mentioning the full history of patients and newly occurring diseases was brought up. From a medical point of view, the important points include lack of a research method to check the effectiveness of a medical narrative, lack of diagnostic aspects and an approach to screening. From the viewpoint of religious and social consequences, religious trauma resulting from lack of response to treatment attributed to Ahl al-Bayt, approach to other manifestations of Western civilization, ethical issue of producing, prescribing and selling drugs by a group and loss of life and money due to waste of time in cases with definitive or relative treatment was raised in other medical schools. Conclusion: Based on the results of this research, the introduction of this theory to society without sufficient investigations in the seminaries and universities of medical sciences may cause physical, mental and religious trauma at the individual and social level

Association between left ventricular hypertrophy with retinopathy and renal dysfunction in patients with essential hypertension

Introduction: It has been suggested that hypertension (HTN) is associated with certain target organ damage (TOD) and related clinical conditions. On the other hand, left ventricular hypertrophy (LVH) has been considered as an independent risk factor of cardiovascular events and death. The aim of this study was to examine the relationship between HTN-induced LVH and TOD (retinopathy and renal failure). Methods: We assessed 102 hypertensive subjects (43 males and 59 females) with a mean age of 60.2 +/- 8.8 (range 35-81) years. LVH was defined as a left ventricular mass index (LVMI) of more than 51 and 47 g/(m to the power of 2.7), in men and women, respectively. The degree of retinopathy on ophthalmological examination was defined according to the Keith-Wagener classification. Serum creatinine, blood urea nitrogen and urine protein concentrations were also measured. Results: Hypertensive retinopathy was found in 94 (92.2 percent) cases (Grades I 55.9 percent; II 28.5 percent; III 3.9 percent; IV: 3.9 percent). The mean systolic and diastolic blood pressures and serum creatinine concentration showed significant correlation with the severity of LVH. There was no significant relationship between LVH severity and retinopathy or proteinuria. Conclusion: The tight control of systolic and diastolic blood pressures in the first step of essential hypertension can assist to postpone LVH. Furthermore, routine measurement of serum creatinine can predict the risk of cardiovascular complications in the hypertensive patient

Information needs in operating room teams: what is right, what is wrong, and what is needed?

BACKGROUND: Safe surgical care requires effective information transfer between members of the operating room (OR) team. The present study aims to assess directly, systematically, and comprehensively, information needs of all OR team-members. METHODS: Thirty-three OR team-members (16 surgeons/anesthesiologists, 17 nurses) took part in a mixed-method interview. Participants indicated what information they need, their problems accessing it, and potential interventions to improve information transfer. They also rated the importance of different sources of information and the quality (accuracy, availability, timeliness, completeness, and clarity) of the information that they typically receive. Theme extraction and statistical analyses (descriptive and inferential) were used to analyze the data. RESULTS: The patient emerged as the top source of information. Surgeons and anesthesiologists relied more on information from fellow clinicians, as well as information originating from diagnostic and imaging labs. They were also more critical about the quality of the information than nursing personnel. Anesthesiologists emerged as the most reliable source of information, whereas information coming from surgeons was deemed lacking in quality (even by surgeons themselves). Finally, the more time participants had spent working in ORs, the more negative views they had about the information that they receive-an unexpected finding. Communication skills training, standardized communication protocols, and information technology (IT) systems to function as a central information repository were the top three proposed interventions. CONCLUSIONS: This study comprehensively maps information sources, problems, and solutions expressed by OR end-users. Recent developments in skills training modules and patient safety interventions for the OR (Surgical Safety Checklist) are discussed as potential interventions that will ameliorate communication in ORs, with a view to enhance patient safety and surgical care

Diurnal corrected qt interval and qt dispersion variation in non-alcoholic cirrhotic patients and healthy control: A case-control study, Iran

Background: Cirrhosis could lead to a long corrected QT (QTc) interval in a subgroup of patients, but there are spare data on its diurnal variation. Objectives: The present study aimed to determine the diurnal variation of QTc interval and its relationship to heart rate and blood pressure variation during 24-hour Holter-monitoring in non-alcoholic cirrhosis in comparison with the healthy controls. Methods: The study population comprised 15 patients with non-alcoholic cirrhosis and 15 healthy subjects, undergoing 24-hour electrocardiogram (ECG), heart rate, and blood pressure monitoring. The mean QT interval, mean QTc, maximum and minimum QT, QT dispersion (QTdisp), heart rate, and mean arterial blood pressure were measured for each person for 24 hours. Liver stiffness measurement (LSM) was performed by FibroScan® 502 machine (EchoSense, Paris, France, 5 MHz). The results were demonstrated as percentages and mean ± SD. P value � 0.05 was considered significant. Results: Mean QTc was significantly higher in cirrhosis (438 ms) than healthy controls (401.7 ms) (P = 0.03). The mean heart rate was significantly different in cirrhotic patients (79.6 ± 2.9/bpm) compared to healthy controls (72.47 ± 2.0/bpm) (P = 0.05). Conclusions: In this study, QTc was prolonged and increased with the severity of cirrhosis, and its diurnal variation in cirrhosis was different from healthy subjects. © 2020, Author(s)

Blood pressure nomograms by age and weight for Iranian children and adolescents

Background: Normal standard references of blood pressure (BP) for children and adolescents have been suggested to be constructed based on anthropometric indices. Accordingly, we aimed to develop first BP reference percentiles by weight and age for Iranian children aged 3-18 years old. Materials and Methods: A total of 16,246 children and adolescents aged 3-18 years were included from 3 cross-sectional studies conducted in Tehran- Iran. Data on demographic characteristics, anthropometric indices and BP values of these subjects were gathered. Quantile regression model was used to assess the need for weight adjustment in different percentiles of systolic and diastolic BPs with age, gender, and the corresponding weight percentiles. Then, Age- and sex-specific BP nomograms were developed according to weight. Results: All the regression coefficients for weight percentiles were statistically significant in quantile regression of BPs, which confirms the positive effect of adjustment for weight (P < 0.05). The BP percentiles by age and weight are presented for each gender. All the BP percentiles rose steadily in all the weight percentiles with minor discrepancies between the two genders. Based on the weight-adjusted BP curves, lean subjects are estimated to have a higher prevalence of hypertension while this figure is lower among the overweight and obese children. Conclusion: This study presents the first Iranian BP references by age and weight for 3 to 18 year old children and adolescents. BMI-adjusted BP curves were found to be a better tool for assessing the prevalence of hypertension in children and adolescents, on the basis of which a more reliable classification standard for hypertension could be obtained