Publications by authors named "Fazeleh Majidi"

5 Publications

  • Page 1 of 1

Nasogastric tube insertion in intubated patients with the guide of wire rope: A prospective randomised controlled study.

Int J Clin Pract 2021 Jun 12:e14508. Epub 2021 Jun 12.

Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Nasogastric tube (NGT) insertion is sometimes required in intubated patients. NGTs are prone to kink and coil during blind insertion. We hypothesised that wire rope guide-assisted NGT insertion with chin lift can significantly improve the first-attempt success rate over the conventional technique during its insertion in intubated patients.

Objective: Mean time to successful insertion of NGT, the failure rate of NGT insertion in the first attempt, the failure rate of NGT insertion in the second attempt and overall failure rate were assessed along with the incidence of any complications.

Method: This prospective clinical trial conducted 100 adult patients presenting for abdominal surgery under general anaesthesia. These patients were randomised to an experimental technique of Wire rope guide with chin lift (wire group) or a control technique of head flexion (control group) for insertion of the NGT.

Results: The first-attempt success rate was 98% in wire group compared with 74% in the control group (P = .001). Thus, the first-attempt failure rate was 2% in wire group compared with 26% in the control group (P = .001). The median time required to insert the NGT was significantly shorter in wire group (35.3 ± 4.8 vs 61.5 ± 6.2 seconds, P = .001). The incidences of kinking/coiling, bleeding, and moderate injuries were significantly lower in wire group.

Conclusion: The use of rope wire guide for correct positioning of the NGT in intubated patients is less time-consuming with the high first-attempt success rate and lower incidence of procedure-related injuries compared to the conventional method.
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June 2021

Prophylactic administration of diphenhydramine/paracetamol reduced emergence agitation and postoperative pain following maxillofacial surgeries: a randomized controlled trial.

Eur Arch Otorhinolaryngol 2021 May 27. Epub 2021 May 27.

Department of Oral and Maxillofacial Surgery, Dental School, Tehran University of Medical Sciences, Tehran, Iran.

Background: Emergence agitation after maxillofacial surgeries is an anxious and problematic complication for the surgeon and anesthesiologist that may lead to self-extubation, haemorrhage, and surgical destruction. In this study, we investigated the effects of preemptive administration of diphenhydramine on emergence agitation and quality of recovery after maxillofacial surgery in adult patients.

Methods: Eighty-five patients undergoing maxillofacial surgery were randomized into two groups. The diphenhydramine group (Group D, n = 40) received diphenhydramine premedication 0.5 mg/kg before anesthesia induction, while the control group (Group C, n = 40) received volume-matched normal saline as a placebo. Before incision, all patients receive 0.1 mg/kg morphine sulfate slowly intravenously within 5 min. Continuous infusion of remifentanil 0.2 μg/kg/h and inhalation of isoflurane was maintained during the anesthesia period. Paracetamol 1 g was infused 15 min before extubation. We evaluated the incidence of agitation during the extubation period after general anesthesia, hemodynamic parameters, and recovery characteristics during the postoperative period.

Results: During extubation time, the incidence of emergence agitation was lower in Group D than in Group C (16% vs. 49%, P = 0.041). The time from isoflurane discontinuation to extubation (7.7 min in Group D vs. 6.8 min in Group C, P = 0.082) was not different. Grade of cough during emergence, the severity of pain, analgesic requirements, and hemodynamic changes were lower in group D compared with Group C.

Conclusions: Preemptive administration of diphenhydramine provided smooth emergence from anesthesia. It also improved the quality of recovery after maxillofacial surgery.

Trial Registration Number: This study was registered at (registration number IRCT20130304012695N3).
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May 2021

Survivin and Her2 Expressions in Different Grades of Urothelial Neoplasms of Urinary Bladder.

Iran J Pathol 2021 21;16(2):154-161. Epub 2020 Dec 21.

Research and Development Center Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background & Objective: Urothelial neoplasm (UN) of bladder is a potentially lethal malignancy, particularly in locally advanced or metastatic cases. Development of molecular markers such as HER2 and Survivin may provide useful information on diagnosis and prognosis in UN of bladder.

Methods: We studied the immunohistochemical (IHC) expression of HER2 and Survivin in 84 radical/partial cystectomy and transurethral resection (TUR) specimens with different histologic grades and stages. All samples were obtained from Pathology Department of Sina Hospital in Tehran, Iran from 2014 to 2018.

Results: From the total number of 84 UN samples, 10 cases (11.9%) showed papillary neoplasm of low malignant potential, 30 cases (35.7%) presented with low-grade papillary urothelial neoplasm, and 44 cases (52.4%) diagnosed as high-grade papillary urothelial neoplasm. HER2 and Survivin expressions were seen in 44 (52.4%) (=0.610) and 9 (10.7%) patients (=0.046), respectively. Survivin expression showed a mild increase in high grade UN.

Conclusion: Our findings suggest that the IHC expression of Survivin and HER2 are not well associated with histological grades of urothelial neoplasms of bladder. This may be partly due to relatively small sample size and other factors such as patient characteristics or antibody specifications.
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December 2020

Sleep disorders as a possible predisposing attack factor in neuromyelitis optica spectrum disorder (NMOSD): A case-control study.

Clin Neurol Neurosurg 2021 May 20;204:106606. Epub 2021 Mar 20.

Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Sleep disturbances are common in neuromyelitis optica spectrum disorder (NMOSD) and have a great impact on patients' quality of life. According to a report, there is a 64% prevalence of poor sleep quality in NMOSD patients. Therefore, this study was done to evaluate the effect of sleep disturbances on NMOSD acute exacerbations.

Materials And Methods: This case-control study was conducted at Sina Hospital in 2019. A total of 60 patients with NMOSD diagnosis were enrolled in the study (30 patients were in the remission phase while 30 patients were hospitalized due to acute attacks). Sleep disorders were evaluated in both groups. Sleep quality was assessed during the last month using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Data were analyzed by SPSS software version 21.

Results: Among 60 patients who were evaluated in both the control and attack groups, 86.7% were female. The duration of the disease was 68.23 ± 42.89 months in the control group and 69.83 ± 6.90 in the attack group. The mean age of patients was 34.15 years old. Sleep quality was unfavorable in 30% and 56% of patients in control and attack groups, respectively. There were significant differences between the two groups in sleep latency, habitual sleep efficiency, sleep duration, and sleep disturbance.

Conclusion: The present study revealed that there was a significant difference in sleep quality between controls and attack patients and could show a direct relationship between sleep disorders and NMOSD attacks.
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May 2021

Risk indicators associated with in-hospital mortality and severity in patients with diabetes mellitus and confirmed or clinically suspected COVID-19.

J Diabetes Metab Disord 2021 Jan 7:1-11. Epub 2021 Jan 7.

Department of Endocrinology Medicine, Sina Hospital, Tehran University of Medical Sciences, Hasan Abad Sq, Tehran, Iran.

Purpose: This study aims to investigate risk indicators of in-hospital mortality and severity of coronavirus disease-2019 (COVID-19) in patients with diabetes mellitus (DM).

Methods: In this retrospective study, we studied patients with COVID-19 referred to Sina Hospital, Tehran, Iran, from February 20 to May 14, 2020. Patients with either a positive real-time reverse-transcriptase polymerase-chain-reaction test of swab specimens or high clinical suspicion according to the World Health Organization interim guidance were included. We accurately divided all patients into two groups based on diabetes affection and followed-up patients with DM based on incurring death, severe COVID-19, and in-hospital complications.

Results: We enrolled 574 patients with COVID-19 in the final analysis, of whom 176 (30.7%) patients had DM. In this study, 104 (18.1%) patients deceased, and 380 (66.2%) patients incurred severe COVID-19. We found that COVID-19 patients with DM had a significantly higher mortality rate ( value<0.001), severe disease ( value<0.001), and in-hospital complications (all values<0.05). Besides that, in patients with DM, admission temperature (odds ratio (OR): 1.69, P value: 0.024), oxygen saturation (OR: 0.92, P value: 0.004), and urea (OR: 1.01, P value: 0.048) were independent risk indicators of in-hospital mortality. In addition, subgroup analysis of diabetic patients based on admission glucose level showed significant differences between these groups regarding acute cardiac injury ( value: 0.044) and acute liver injury (P value: 0.002).

Conclusions: Patients with DM admitted with lower oxygen saturation, elevated temperature, and higher urea are more susceptible to progress to more severe COVID-19 and poor prognosis. This indicates a necessity for more precise care during hospitalization for these patients.

Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-020-00701-2.
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January 2021