
Background: Canceling surgery imposes the high cost of the healthcare provider system and wasted many energy and time from the patient and the care team. Objectives: This study examined the extent and reasons of canceling of surgeries in one of the hospitals affiliated to Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Methods: This was a descriptive-applied study. In order to get the number of operations from April 2018 to March 2020, the hospital used HIS software and then extracted the reasons from the operating room office and the quality improvement office in the hospital. Data were analyzed by SPSS version 21 software. Results: Among 8654 planned surgeries, 0.9% were cancelled. The highest frequency of surgical cancellation is associated with general surgery, and the highest rate of surgical cancellation is associated with the ENT specialty. The highest cancellation rate was 1.82% in August 2018 and 2.87% in February 2019. The lack of preparation of patients and patients did not require surgery was the main and worst reason for discontinuing surgery, respectively. Conclusion: The lack of clinical preparation of the patient was the main reason for the cancellation. Therefore, pre-surgery patient evaluation can help solve this problem, make the operating room more effective, and increase patient satisfaction.
Background: Owing to the crucial role of nutrition with breast milk for both the mother and infant, the implementation of programs that support breastfeeding seems essential. Objectives: This study aims to determine the effect of post-delivery telephone counseling on the rate of exclusive breastfeeding among infants. Methods: This study, as a randomized clinical trial, investigated 170 women who delivered their children in the Sabzevar Shahidan Mobini hospital, Iran in 2017. After acquiring the written informed consent, the researchers randomly assigned the subjects into two groups, including the telephone counseling recipient group (intervention) and the telephone counseling non-recipient group (control). The data collection instruments were questionnaires and checklists. The collected data were analyzed by the SPSS 18 software. Results: The findings of the study showed that 73.8% of the counseling non-recipient group had exclusive breastfeeding, and 26.2% did not have exclusive breastfeeding. In the telephone counseling recipient group, 90.4% exclusively breastfed their infants, while 9.6% did not. Thus, there was a statistically significant difference between the two understudy groups (P<0.05). Conclusion: This research revealed that although mothers were trained how to breastfeed when they were pregnant or were discharged from hospitals, and exclusive breastfeeding was emphasized, implementing the counseling program, even telephonic, and responding mothers’ questions regarding breastfeeding and prevalent problems in this period could be helpful in the first two months after delivery.
Background: Vitamin D deficiency is involved in a broad spectrum of diseases including chronic kidney disease (CKD). Objectives: This study was designed to assess serum vitamin D, renal biomarkers, protein profile, and electrolytes in CKD patients with a clinical trial of vitamin D therapy. Methods: This case-control follow-up interventional study comprised 42 CKD patients and 42 apparently healthy controls. Patients and controls were matched for age and gender. Patients were assigned to receive, a weekly oral dose of vitamin D3 (50000 IU) for 3 successive months. The follow-up therapy was conducted under direct and full physician supervision. Results: Vitamin D was significantly lower in CKD patients compared to controls (29.6±12.4 versus 35.2±9.9 ng/dL, P=0.033). Significant increases were shown in the urea, creatinine, and uric acid in patients compared to controls whereas glomerular filtration rate (GFR), total protein, albumin, and calcium were significantly lower in patients. A significant improvement was noted for vitamin D and calcium where they registered mean values of 43.8±9.1 ng/dL and 9.65±0.70 mg/dL at the end of the therapeutic period compared to 29.6±12.4 ng/dL and 8.61±0.77 mg/dL in patients before vitamin D therapy (P=0.028 and P=0.033, respectively). Conclusion: General amelioration of the metabolic profile of CKD patients in response to vitamin D therapy has been shown. Besides a significant improvement in vitamin D and calcium. Consequently, vitamin D is a useful candidate in clinical settings for the improvement of renal function and controlling of CKD, and more importantly its complications.
Introduction: Neurofibromas, benign peripheral nerve sheath tumors, are the most common among neural lesion. Neurofibromas are rare in head and neck location, although it may involve any part of oral cavity. However, tongue is the most common region. Case Presentation: A 27 year-old man was admitted to Otorhinolaryngology Department due to a swelling in the base of his tongue, since two weeks before. This mass was painless, and without any associated symptoms. He was suffered from a mild eating disorder, too. He had no any positive past medical history, and only a large soft 6×5 cm mass was found at the base of his tongue without bleeding in the oral cavity. Excisional biopsy was performed for him under general anesthesia and the tumor was easily enucleated. The final diagnosis was neurofibroma. After the diagnosis of neurofibroma, the physical reexamination revealed a series of café au lait spots on his skin. Conclusion: the neurofibroma should be considered by otorhinolaryngologist, as a differential diagnosis of tongue mass, and more accurate physical examination are recommended for better management.
Background: The risk of developing diabetes mellitus for an individual with a positive family history of the disease is two- to fourfold higher in an offspring of a diabetic compared with offspring of non-diabetic shown by serum glycated hemoglobin (HbA1c) levels. There is paucity of data on pre-diabetes in our environment. Objectives: This study was designed to determine the baseline HbA1c levels of normoglycemic offspring of type 2 diabetes mellitus (T2DM) patients in Ijebu-ode, Nigeria. Methods: This is a cross-sectional study of offspring of T2DM patients (ODP) and those of offspring of non-diabetic parents (ONDP). Diabetic offspring were exempted from the study. FBS was determined using enzymatic hexokinase method to determine glucose concentrations and exclude diabetes. Serum HbA1c was measured using standard method. Height and weight were measured using standard methods. Body mass index (BMI) was calculated. Results: There were 100 ODP and 100 ONDP aged 16 to 40 years. The most populated aged group was 21 to25 years which is 44% (n=88). 6% (n=12) of the study group were obese. 19% were overweight (n=38). The mean weight of ODP was significantly higher than that of ONDP (P=0.020). Also, the mean HBA1c of ODP was significantly higher than that of ONDP (P<0.001). Conclusion: The serum HbA1c level was significantly higher among ODP than ONDP. The mean weight was significantly higher in ODP than ONDP.
Background: There is scant data on the effectiveness and safety of adjuvant perioperative intravenous (IV) lidocaine in procuring postoperative analgesia and rehabilitation in gynecology surgery in low-resource settings. Objectives: To evaluate the effects of IV lidocaine on postoperative pain and rehabilitation gynecology surgery. Methods: We carried out a randomized single-blinded controlled trial from April to August 2017 (5 months) at the Yaoundé Gynaecology, Obstetrics and Pediatrics Hospital, Cameroon. The study population was made up of ASA 1 and 2, women admitted for elective gynecological surgery under general anesthesia divided into two groups of 17 patients: those to receive IV lidocaine and those to receive normal saline as placebo both intra-and postoperatively as an adjuvant to standard care. The variables studied included the additional doses of fentanyl, postoperative pain, side effects of lidocaine, time to first bowel sounds, the ease with which patients were mobilized and patient satisfaction. Results: Compared to patients in the placebo group, those in the lidocaine group had fewer mean amounts of fentanyl reinjections (P<0.0001), shorter recovery time (P=0.0044), reported lesser pain in the immediate postoperative period (P=0.012) till the 3rd postoperative hour (P<0.001), had more early postoperative bowel sounds (94.1% vs. 11.8%), rehabilitated earlier (P<0.001) and were more satisfied with pain management (P=0.001). The lone observed side effect of IV lidocaine was tolerable bradycardia in six (35.3%) patients. Conclusion: Adjuvant IV lidocaine can be effectively used in gynecological surgery, with the advantage of better postoperative analgesia, quicker rehabilitation and minimal side effects.
Copyright © 2022 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http:// creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Patient safety as a basic principle of quality is dominant in the global health agenda and mentioned as an essential requirement to organize a qualified health care system.1 In hospitals, the Director or chief executive officer (CEO) has the main responsibility for patient safety in the whole hospital, although all clinical leaders are responsible for patient safety within their ward. To clarify responsibilities and support clinical leaders in their work with patient safety, a formal structure is necessary. This formal structure may include a director of patient safety and patient safety officers (PSOs) in each large clinical unit. Moreover, a patient safety committee must be established to reviews all serious events and takes initiatives to improve clinical practice. Unfortunately, the main cause of medical errors in most cases are due to system weakness and therefore the Director and other clinical leaders have responsibility as other clinical staffs when medical errors happen.2 Based on the World Health Organization (WHO) document, PSO is a qualified senior staff member with responsibility and accountability for patient safety. PSO has to develop a schedule of audits, risk management program in order to identify, assess and reduce any adverse events, medication errors and other patient safety subjects. Also, PSO develop reports on different safety and risk activities and disseminate them internally and externally. Furthermore, PSO measures outcome of care to assess performance, with a special focus on patient safety and finally acts on results of audits, measures and feedback by implementing patient safety improvement projects.1 Two major outcomes of world patient safety movement due to Institute of Medicine’s 1999 report on patient safety, To Err Is Human, were (1) new guidelines that focus on requirements for documenting compliance with patient safety data and (2) a new responsibility for health care organizations to establish a “safety culture” based on the “science” of safety.3,4 Thus, PSO is an emerging role to fulfill these responsibilities. PSOs as managers of hospital’s patient safety programs, have a broad portfolio of tasks and responsibilities. These tasks range from reviewing patient charts in order to gather and present data that show compliance with formal regulations to the socially engaged task of planning and implementing programs so as to show improvement on safety targets. Thus, PSOs tasks lead to quality improvement due to data surveillance and reporting. Also, PSO role was defined as establishing connections within and between departments in the hospital. Usually, Most PSOs are nurses and this background help them to connect frontline staff to the hospital’s patient safety goals due to greater credibility with frontline staff and their supportive role between staff.4 Although PSO’s activities could lead to patient safety improvement and the quality consequently health care delivery; however, to achieve this success, there are serious challenges in this field such as high degree of mistrust and fear of reprisal on the frontline.4 To manage and overcome such challenging issues, the Director (CEO), PSOs and other staffs must create and establish a safety culture together to improve medical error reporting system and implement patient safety improvement projects.
The African continent is a known malaria-endemic region. Amid the COVID-19 pandemic, COVID-19/malaria co-infection is of critical importance in Africa due to the similarities in the manifestation of their symptoms. To avert compromising the health status of individuals on the African continent during the COVID-19 pandemic, this commentary sought to examine the link between COVID-19 and malaria, outlining strategies for improving the diagnosis and prevention of COVID-19 and malaria in Africa. A scale-up of malaria-focused care should be considered to ensure adequate reporting of COVID-19 cases in Africa. Likewise, individuals who present for malarial testing should be linked to COVID-19 testing and treatment care in Africa. Also, surveillance activities should be scaled up to ensure accurate COVID-19 case reporting and improved case notification. Regular refresher trainings should be organized for healthcare workers to promote healthcare service delivery.
Background: Esophageal cancer is the eighth-most common cancer and the sixth-most common cause of cancer death worldwide. In Iran, its prevalence is high. Surgery is recommended for tumors in early stages. Objectives: This study aims to determine demographic data, therapeutic approaches, postoperative mortality, and survival rate in patients with esophageal cancer who were managed in a referral hospital. Methods: In a cohort study, the patients hospitalized during six-year period were evaluated. Demographic data, tumor characteristics, laboratory data, surgical approaches, and survival time were obtained. Statistical analysis was performed using life tables, proportional hazard Cox regression, and the Kaplan-Meier method by SPSS version 20 software. Survival curves were compared by log-rank analysis. Results: Over six years, 92 patients were admitted of which 54 (58.7%) were male. The average age was 63.08±12.03 years. Ten patients (10.8%) were below 50 years old. Squamous cell carcinoma (SCC) was the most common type (85.8%). Fifty-three patients (57.6%) were selected for the surgery. Postoperative mortality in 30 days occurred in 7 patients (13.2%). The median survival rate was 12.8±2.92 months. The survival rate for one, three and five years were 51.94%, 24.67% and 19.48%, respectively. Two factors that had significant statistical correlation with median survival time were metastasis (P=0.01) and vomiting (P=0.003). Conclusion: Esophageal cancer is a poor prognostic disease and esophagectomy is a morbid operation. To reduce postoperative mortality and increase the survival time, better patient selection and operations by expert surgeons must be considered.
Background: Craniosynostosis is a congenital deformity of the skull that occurs at birth. Objectives: This study aimed to investigate the frequency of different types of craniosynostosis in Isfahan, Iran. Methods: In this retrospective study, the records of all patients referred to the pediatric neurosurgery clinic of Imam Hossein children’s hospital in Isfahan, Iran from 2013 to 2018 were diagnosed with craniosynostosis. Incomplete files were excluded. Demographic information of patients and type of delivery, underlying diseases of their parents, diseases of maternal pregnancy, type of craniosynostosis, syndromic or non-syndromic craniosynostosis were collected. Data were analyzed using SPSS software version 22. Results: The diagnosis of craniosynostosis in 63% of cases (n=121) was a single suture and in 37% of cases (n=72) was a complex suture. There was no significant difference in the frequency distribution of craniosynostosis in males and females (P>0.05). Conclusion: Due to the prevalence of 16 cases per 100,000, we can reduce the complications of this disease by educating doctors and parents.
Background: To test the effectiveness of concept maps used in the education of nursing students in the field of health, we need to use measurement tools. Objectives: The purpose of the study was to develop "Scale for the Effectiveness of Concept Maps in Nursing Education (SECMNE)". Methods: This was a methodological instrument development study. This study was conducted in a university’s health of nursing department in Tokat, Turkey, between September and December 2019. The universe of this study, which used a methodological design, consisted of third and fourth-year nursing students, and the sample size was 174. The item pool was formed with 86 items. The content validity was assessed by 9 experts. The 86-item draft scale that had a 4-point Likert type scoring system. Content validity ratio (CVR), Kaiser-Meyer-Olkin (KMO) test, Bartlett test, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Cronbach’s alpha, and Pearson product-moment correlation analysis techniques were used for the validity and reliability analyses of the scale. Results: The scale consists of 3 subscales (integration of information, integration of the care plan, perception) and 30 items. Scale’s Cronbach alpha is 0.97. Conclusion: The scale developed in this study was concluded to be a valid and reliable measurement tool that can be used to measure the effectiveness of the concept maps in nursing education. The SECMNE can help nursing student identify the lack of knowledge and negative attitudes about concept map in nursing education and prepare nursing care plan.
Background: Age is a major determinant of chronic respiratory disease (CRD). This is important because CRD have a main role in shaping morbidity and mortality of individuals and populations. However, less research is done on whether age-related changes in development of CRD differ across diverse racial groups. Objectives: Using a conceptual model that considers race as a proxy of racism rather than genetics and attributing racial differences to sociological rather than biological differences, this study was conducted to explore racial differences in the effects of age on CRD. Based on Marginalization-related Diminished Returns (MDRs) framework, we expect diminished relevance of risk and resources for marginalized people due to racism, segregation, and social stratification. Methods: Using data from baseline population assessment of tobacco and health (PATH) Adults data, we included 23761 adults. The independent variable was age treated as a categorical variable. The primary outcome was presence of any CRD including asthma, bronchitis, emphysema, and chronic obstructive pulmonary disease (COPD). Sex and education were the covariates. Race, as a proxy of racism, was the moderator. To analyze the data, we used logistic regression mode with and without interaction term between age and race. Results: Higher age was associated with higher odds of CRD, while sex, and socioeconomic status (SES) was controlled. In line with the MDRs framework, the positive association between age and CRD was weaker for Black than White adults. Conclusion: Under racism, age loses some of its effect as a major determinant of CRD across racialized groups
Background: The broad scientific community generally associates high socioeconomic status (SES) with better health. However, the protective effects of high educational attainment on health may be weaker for racial and ethnic minorities than non-Latino White individuals. It is important to study whether this difference holds for chronic pain among Black and Latino individuals. Objectives: To compare the association between educational attainment and chronic pain in the US, considering the racial and ethnic background of individuals. Methods: The current study used baseline data from the Population Assessment of Tobacco and Health (PATH-Adults) study. All participants were 18+years old. A total number of 28204 Non-Latino, Latino, White, and Black individuals were enrolled. The outcome was chronic pain treated as a continuous measure. The predictor was educational attainment. Moderators were race and ethnicity. Results: Our linear regressions in the pooled sample showed that higher educational attainment was associated with a lower level of chronic pain; however, this association was weaker for Latinos and Blacks compared to non-Latino and White individuals. Our stratified models also showed that higher educational attainment was more consistently associated with a lower level of chronic pain for non-Latino White individuals than racial and ethnic minorities. Conclusion: The presumed protective effect of educational attainment against chronic pain among individuals varies between different racial and ethnic groups. Future research should test the role of stressful jobs and working conditions in weakening the protective effects of SES against chronic pain for Blacks and Latinos compared to non-Latino White individuals.
Background: The COVID-19 pandemic has caused severe complications, deaths, and damage to societies, and the disease course is unpredictable and ranges from asymptomatic infections to multi-organ failure and death. Objectives: The present study determined the frequency of neurosurgeries canceled owing to the asymptomatic COVID-19 in the patients. Methods: The present study was descriptive-analytical and was conducted on all neurosurgeries in Kashani hospital, Isfahan, Iran in 2021. Moreover, 116 (52.5%) out of 2100 neurosurgeries were canceled, among which 41 cases (35.4%) were related to asymptomatic COVID-19. The necessary data were extracted from the information in the patients’ medical files and were included in the data collection forms. The data were analyzed in SPSS 22 after collection. Results: Among 41 people, whose neurosurgery was canceled, 7 had asymptomatic COVID-19 with few or mild symptoms, and 34 were asymptomatic. The patients of the two groups with asymptomatic and symptomatic COVID-19 were significantly different in age, albumin level, C-reactive protein, and serum creatinine (P<0.05) as the mean age, albumin, and C-reactive protein levels were lower, and serum creatinine was higher in the group of patients with asymptomatic COVID-19. Conclusion: The prevention of asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections played a crucial role in the unhindered transmission of this virus and was the turning point in controlling the pandemic.
Background: The risk of developing diabetes mellitus for an individual with a positive family history of the disease is two-to fourfold higher in an offspring of a diabetic compared with offspring of non-diabetic. Objectives: This study aimed to assess the anthropometric parameters of offspring of type 2 diabetes mellitus (T2DM) patients in Sagamu, Nigeria. Methods: Study subjects were 100 offspring of consecutive T2DM patients’ attending a hospital endocrinology clinic. Diabetic offspring were exempted from the study. FBS was determined employing enzymatic hexokinase method. Height, weight, waist circumference (WC), and hip circumference (HC) were measured utilizing standard methods while body mass index (BMI) and waist-hip ratio (WHR) were calculated. Results: There were 50 males and 50 females study subjects, aged 16 to 65 years. The most populated aged group was 16 to 25 years of which 48.6% (n=36) were males and 51.4% (n=38) were females. Totally, 18 subjects were either obese or overweight. Significantly, male subjects had a greater mean weight compared to females (P=0.021) while females had greater mean BMI (P=0.037). Mean WHR was significantly higher among male subjects (P=0.018). Conclusion: Common Anthropometric parameters are normal, female subjects tend to have higher BMI while males have higher weight and WHR.
Background: Sleep disorders of breathing encompass a spectrum of disorders ranging from primary snoring to obstructive sleep apnea syndrome (OSAS), which leads to septoplasty in the most patients. Objectives: The aim of this study was to evaluate the effects of nasal septoplasty surgery on the severity of OSAS. Methods: The current quasi-experimental self-controlled study was conducted on adult patients with deviated nasal septum and were candidate for nasal septoplasty. Before surgery and two months after surgery, patients underwent respiratory polygraph. The parameters assessed included the airflow and oximetry indices. The severity of sleep apnea will be assessed based on the Apnea-Hypopnea Index (AHI). Also, the severity of snoring was scored from zero to 10 based on the visual analog scale (VAS). The severity of daytime sleepiness was also determined using the Epworth Sleepiness Scale (ESS). Data were analyzed by using SPSS software. Results: There was a significant reduction in the mean score of ESS after the surgery (P<0.001), daytime fatigue (P=0.002), and daytime sleepiness (P<0.001). Also, breathing quality during sleep showed that the severity of apnea (P<0.001), snoring (P<0.001), as well as ESS (P<0001) were significantly improved. There were no significant changes in the means of oxygen saturation (P=0.14) and rapid eye movement (REM) sleep (P=0.06) after non-REM stage 1-2 (P=0.09), but following non-REM stage 3-4 significantly improved (P=0.03). Conclusion: The correction of nasal obstruction improved the general health of OSAS patients. These results further reflected that the corrective surgery could improve the patients’ emotional state and social performance, effectively upgrading their quality of life.
Introduction: The main symptoms of new coronavirus in patients are fever or chills, tiredness, and dry cough. In this case, we reported a woman who got involved in COVID-19 pneumonia with gastrointestinal instead of lower respiratory symptoms. Case Presentation: A 67 years old woman was referred to an outpatient clinic in Tehran with fever, chills, sneezing, tiredness, severe nausea, anorexia, and diarrhea. She did not have a cough, dyspnea, or chest pain and her lung sound was normal. According to the blood O2 saturation decreasing, C-reactive protein increasing, and the lung imaging findings, she was admitted with COVID-19 pneumonia diagnosis in the infectious care department of a hospital. The 2019-nCoV real-time polymerase chain reaction (PCR) intranasal assay was negative. She was treated with intranasal oxygen therapy, anti-inflammatory drugs, and prednisone. After one week she was discharged in generally good condition and quarantined for two weeks later. After 25 days the COVID-19 IgM and IgG antibodies were in positive ranges. Conclusion: Severe fatigue, mainly in elders caused the inability to cough, and light inspiration force especially in the lower lung lobes could explain the normal lung sounds in the physical examination. Also, we hypothesized that reverse circulation of the virus may occur from the gastro intestine to the respiratory system. The gut-lung microbial imbalance may affect the severity in patients with extrapulmonary symptoms, especially in old ages. Furthermore, damage to the vagus nerve along the path in the proximity to lungs infected with COVID-19 can cause nausea without gastrointestinal involvement.
Background: Ankylosing spondylitis (AS) is a chronic, progressive, and disabling disease among rheumatological diseases. Objectives: Current study aimed to investigate the Time lag between the onset of symptoms and final diagnosis of AS, and also identify the factors that contribute to that delay in Sulaymaniyah province. Methods: In this cross-sectional study, 104 (AS) patients who satisfied the modified New York 1984 criteria were enlisted. The time lag was defined as the diagnosis delay (DD) between the appearance of the first symptoms and the correct diagnosis of AS. Spearman correlation analysis was used to detect correlations between variables. Results: The higher percentage of variables with DD≥6 years were urban 32 (74.4%), housewife 15(34.9%), had no family history 42 (97.7%), with high diploma 33 (76.7%), and positive HLAB27 31 (72.1%), the first specialist consulted orthopedics 21(48.8%) then GP 6 (14.9). Moreover, the higher percentage of variables with DD<6 years were diagnosis years between 2000 to 2020, rural 55 (90.2), 39 (63.9%) respectively, higher education 47 (77%), employee and worker 22 (36.1%), positive family history 44 (72.1%), positive human leukocyte antigen (HLAB27-61) (100%), inflammatory back pain 47 (77%), rheumatologist 29 (47.5%). The average year’s DD is 6.48. A statistically significant positive correlation was detected between the DD and age, age at diagnosis but, a negative correlation was found between the DD time and, age at symptom onset. Conclusion: The Time lag between the onset of symptoms of AS and the final diagnosis in Sulaymaniyah was 6.48 years. (HLA-B27), age, age at diagnosis, education level, occupation, 1st specialist, 1st symptom at onset of disease and family history are the factors that affect delayed diagnosis in Sulaymaniyah patients with AS.
Background: The risk of fractured vertebral increases in patients with rheumatoid arthritis as they are more likely to suffer from osteopenia, and osteoporosis. Objectives: This study aimed to investigating the rate and risk factors of vertebral fractures in patients with rheumatoid arthritis. Methods: We recruited 201 patients aged between 30 and 70 who attended the rheumatology department at Shahid Hemn Teaching Hospital in Sulaymaniyah, between January and September 2022. Medical records were reviewed for disease and treatment characteristics while also clinically evaluated by a rheumatologist. Spinal radiographs were assessed by two experienced radiologists blinded to patients’ clinical diagnosis and status. Compression fractures were classified by using the Genant semiquantitative method, and the type of fracture was classified as wedged fracture, biconcave fracture, or crushed fracture. Results: Of the 201 included participants, 151 were female, and 50 were male. The BMI of women was higher than men by nearly four points (P<0.001). Most women were also illiterate (68/151, 45.0%) and unemployed (139/151, 92.1%). Hypertension (28.4%) and diabetes mellitus (14.4%) were the most reported comorbidities. Women were more likely to have higher DAS28 scores while men had more vertebral fractures (P=0.003). The probability of fractures increased with age, male sex, and illiteracy compared to primary school, osteopenia, and osteoporosis through simple and multiple logistic regression models. Conclusion: With at least one fracture affects females and males at a rate of 27.8% and 52.0%, respectively. Also reported that age, male sex, illiteracy, osteopenia, and osteoporosis significantly increase the risk of fractures.
Background: The field of neurology encompasses a wide range of disease types, and recognizing the most common manifestations of these diseases, particularly in subgroups, is critical for improving appropriate diagnostic and therapeutic measures. Objectives: The purpose of this study was to determine the frequency of common manifestations of neurological diseases in patients referred to a military hospital’s internal neurology clinic. Methods: This was a cross-sectional descriptive study of patients referred to the internal neurology clinic of a reference military hospital, Tehran, Iran in 2020. The sampling was done at random using a checklist. Finally data was analyzed by using SPSS software. Results: Women made up the majority of patients in 336 samples 182 (54.2 %) versus 154 (45.8 %). The patients’ average age was 49.5±16.5 years, with 28.3 % (n=95) being elderly. The three most common complaints raised by patients were headache, movement disorder, and sensory disorder, accounting for 29.5%, 27.7%, and 27.7% of complaints, respectively. Seventeen patients (5.1%) also mentioned other issues, with anger, anxiety, depression, and nausea being the most common complaints. Conclusion: Headache, movement disorder, and sensory disorder are the most common neurological disorders referred to a military hospital. Because of the high prevalence of these issues, it is necessary to establish specialized clinics and conduct additional research to determine the most common types of sensory and movement disorders, as well as the most effective methods of prevention and treatment in medical centers.