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Imani F, Moghaddam Y, Shariat Moharari R, Etezadi F, Khajavi MR, Hosseini SR. Intrarectal Lidocaine-Diltiazem-Meperidine Gel for Transrectal Ultrasound Guided Prostate Biopsy. Anesth Pain Med 2015; 5:e22568. [PMID: 26161317 PMCID: PMC4493733 DOI: 10.5812/aapm.5(3)2015.22568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 09/01/2014] [Accepted: 10/04/2014] [Indexed: 12/02/2022] Open
Abstract
Background: TRUS-guided needle biopsy of the prostate gland is the current standard method used for diagnosis of prostate cancer. Pain control during this procedure is through the use of i.v. sedation or local anaesthetic (LA), depending on clinician preference. Objectives: The aim of this study was to evaluate the effectiveness of intrarectal lidocaine, lidocaine-diltiazem and lidocaine-meperidine-diltiazem gel for anesthetizing transrectal ultrasound guided prostate biopsy. Patients and Methods: In a randomized double-blind clinical trial, 100 consecutive patients were divided into three groups. The patients received one of the gels before transrectal ultrasound guided prostate needle biopsy: group A, intrarectal and perianal lidocaine, gel 1 g; group B, intrarectal lidocaine gel, 1 g, + perianal diltiazem, 1 g; group C, intrarectal lidocaine gel, 1 g, + meperidine, 25 mg, and perianal diltiazem, 1 g. Visual analog pain scale was used to estimate pain during probe insertion and biopsy. Heart rate and blood pressure during probe insertion and biopsy were recorded too. Results: The mean of visual analog pain scale was 4.5 in group A, 3.5 in group B, and 2.0 in group C during probe insertion (P value = 0.01). The mean of visual analog pain scale was 5.1 in group A, 3.5 group B, and 2.5 in group C during biopsy (P value = 0.001). The groups were comparable for patients' age, weight, serum prostate-specific antigen (PSA), and prostate size (P > 0.05). No side effects of meperidine and lidocaine including drowsiness, dizziness, tinnitus and light-headedness or requiring assistance for activity were noted. Conclusions: Lidocaine-meperidine-diltiazem gel provides significantly better pain control than lidocaine-diltiazem gel and lidocaine gel alone during transrectal ultrasound guided prostate biopsy and probe insertion. This mixture gel is safe, easy to administer and well accepted by patients.
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Affiliation(s)
- Farsad Imani
- Department of Anesthesia, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Yasaman Moghaddam
- Department of Anesthesia, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Shariat Moharari
- Department of Anesthesia, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Etezadi
- Department of Anesthesia, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Khajavi
- Department of Anesthesia, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Reza Hosseini
- Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author: Seyed Reza Hosseini, Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-9122083800, E-mail:
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Moghaddam Y, Lindsay R, Tolhurst J, Millan D, Siddiqui N. A case of sebaceous carcinoma arising in a benign cystic teratoma of the ovary and review of the literature. Scott Med J 2013; 58:e18-22. [DOI: 10.1177/0036933013482665] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To present an extremely rare case of sebaceous carcinoma arising in a mature cystic teratoma of the ovary. Clinical presentation and intervention: A 66-year-old woman presented with abdominal discomfort and a pelvic mass. Abdominal and pelvic ultrasound, as well as CT scan, revealed a 27 cm complex right pelvic mass, which was diagnosed histologically as a sebaceous carcinoma arising in a mature cystic teratoma. The patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy, peritoneal washings, appendicectomy and infracolic omentectomy. Conclusion: This case adds to the rare reports in the literature of sebaceous carcinoma occurring in a mature cystic teratoma. The clinical behaviour and optimal management of this entity are not well established. The patient has been well for 32 months following surgery with no evidence of recurrent disease clinically.
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Affiliation(s)
- Y Moghaddam
- Specialist Trainee, Department of Pathology, Glasgow Royal Infirmary, UK
| | - R Lindsay
- Specialist Trainee in Histopathology, Department of Gynaecological Oncology, Princess Royal Maternity Hospital, Glasgow Royal Infirmary, UK
| | - J Tolhurst
- Consultant Histopathologist, Department of Pathology, Glasgow Royal Infirmary, UK
| | - D Millan
- Consultant Histopathologist, Department of Pathology, Glasgow Royal Infirmary, UK
| | - N Siddiqui
- Consultant Gynaecological Oncologist, Department of Gynaecological Oncology, Princess Royal Maternity Hospital, Glasgow Royal Infirmary, UK
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Amini H, Moghaddam Y, Nejatisafa AA, Esmaeili S, Kaviani H, Shoar S, Shabani A, Samimi-Ardestani M, Akhlaghi AAK, Noroozi A, Mafi M. Senior medical students' attitudes toward psychiatry as a career choice before and after an undergraduate psychiatry internship in Iran. Acad Psychiatry 2013; 37:196-201. [PMID: 23632933 DOI: 10.1176/appi.ap.10120171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES The study aimed to assess 1) the attitudes of medical students in the sixth and seventh years (known as interns in Iran) toward psychiatry as a career choice, and 2) the degree of attractiveness of psychiatry as a career choice, with regard to various defined aspects, before and after an undergraduate psychiatry internship (similar to the medical school psychiatry rotation in the United States, but mandatory in Iran) in three major medical schools in Tehran, the capital of Iran. METHOD Sixth- and seventh-year medical students (locally called interns, N=347) at Tehran, Shahid Beheshti, and Iran Universities of Medical Sciences were consecutively invited to complete anonymous self-report questionnaires designed to assess their perceptions of careers in psychiatry before and after internship in psychiatry wards. Also, students evaluated psychiatry in terms of the factors that reflected the degree of attractiveness of this specialty. RESULTS Positive responses toward choosing psychiatry as a career were seen in 18.8% before and 20.0% after psychiatry rotation. No significant differences were observed in the positive responses before and after psychiatry internship. The students' opinions changed to a more attractive degree in terms of only 3 out of the 13 defined aspects. There was also no significant difference in the total score on attractiveness of psychiatry before and after the psychiatry internship. CONCLUSIONS The study indicated that undergraduate psychiatry internship might not induce more students to consider psychiatry as a possible career. The present pattern of psychiatry education in Iran seems not to positively affect most aspects of medical students' attitudes toward psychiatry.
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Affiliation(s)
- Homayoun Amini
- Dept. of Psychiatry, Tehran University of Medical Sciences, Roozbeh Hospital, Tehran, Iran.
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Amini H, Nejatisafa AA, Shoar S, Kaviani H, Samimi-Ardestani M, Shabani A, Esmaeili S, Moghaddam Y. Iranian medical students' perception of psychiatry: before and after a psychiatry clerkship. Iran J Psychiatry 2013; 8:37-43. [PMID: 23682250 PMCID: PMC3655228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE We aimed to compare the medical students' attitude towards psychiatry before and after psychiatry clerkship, and to examine the association of choosing psychiatry as a future career with some personal characteristics. METHOD In a self-controlled, quasi-experimental study, all of the medical students entering the psychiatry clerkship in three major medical schools of Iran located in Tehran (Tehran, Shahid Beheshti, and Iran University of Medical Sciences) were asked to participate anonymously in the study on the first and the last 3-days of their psychiatry clerkship. From 346 invited 4th-5th year medical students, 225 (65%) completed anonymous self-report questionnaires before and after a 4-week psychiatry clerkship. RESULTS Positive response to choose psychiatry as a career was seen in 13.3% and 18.3% before and after psychiatry rotation, respectively. However, the difference was not statistically significant; about one-quarter of the students were turned on to psychiatry and 25% were discouraged during the clerkship. Individual pair wise comparisons revealed significant improvements only in two out of 13 measured aspects of psychiatry. Seventeen out of 38 (47.7%) students who identified psychiatry as the career of choice or strong possibility reported that one of their family members or close friends' mental illness had an impact on their choice. Those students who considered psychiatry as the strong possibility claimed that they are more interested in humanities (OR = 2.96; 95% CI: 1.17, 7.49), and playing a musical instrument (OR = 2.53; 95% CI: 1.15, 5.57). CONCLUSION It may be concluded that exposure to psychiatry clerkship could influence medical students' opinion about psychiatry positively, or negatively. Personal characteristics and individual interests of students may play an important role in choosing psychiatry as their future career.
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Affiliation(s)
- Homayoun Amini
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran,Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali-Akbar Nejatisafa
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran,Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Shoar
- Development Association of Clinical Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Hosein Kaviani
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran,Departments of Psychology, University of Bedfordshire, Luton, UK
| | - Mehdi Samimi-Ardestani
- Departments of Psychiatry, Imam Hosein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Shabani
- Departments of Psychiatry, Mental Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Esmaeili
- Development Association of Clinical Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Yasaman Moghaddam
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Parsa S, Aghazadeh A, Nejatisafa AA, Amini H, Mohammadi MR, Mostafazadeh B, Moghaddam Y. Freshmen versus interns' specialty interests. Arch Iran Med 2011; 13:509-15. [PMID: 21039007 DOI: 010136/aim.0011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study was to determine career preferences of medical students at the time of entering medical school compared with interns who were graduating; and to determine what factors influence the choice of a special discipline as a career. METHODS A cross-sectional, questionnaire-based survey study involving freshmen and interns at Tehran University of Medical Sciences was conducted in 2006 - 2007. Respondents anonymously completed a specialties questionnaire developed by Feifel et al. The questionnaire was translated into Persian (Farsi) and several items were modified based on the circumstances. RESULTS The response rate was 91 (73%) among freshmen and 137 (77%) among interns. Forty-six freshman students (50%) and 71 interns (51.8%) indicated that they had not developed a strong decision about any particular field of medicine and needed more time. The preferred specialties among freshmen were surgery and internal medicine; whereas graduating students were more interested in "other specialties". There was no significant difference between pediatrics, gynecology, psychiatry, and general practice among the two groups. There was a significant difference in rating when it came to "anticipated income", "prestige" and "helping patients" of which interns were less interested compared to freshmen in these three areas. CONCLUSION Approximately one-half of the medical students were unclear about their future goals. The experience of medical school may play a role in diminishing students' interest in surgery and internal medicine as prospective careers.
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Affiliation(s)
- Shima Parsa
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, South Kargar Avenue, Tehran, Iran
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Williams N, Moghaddam Y, Falzon M, Fulford L, Keshtgar M. Risk prediction of additional nodal metastases after positive sentinel lymph node biopsy in early breast cancer: an independent comparison of three mathematical models. Eur J Surg Oncol 2010. [DOI: 10.1016/j.ejso.2010.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Moghaddam Y, Falzon M, Fulford L, Williams NR, Keshtgar MR. Comparison of three mathematical models for predicting the risk of additional axillary nodal metastases after positive sentinel lymph node biopsy in early breast cancer. Br J Surg 2010; 97:1646-52. [DOI: 10.1002/bjs.7181] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Abstract
Background
Women with breast cancer and a positive axillary sentinel lymph node (SLN) are recommended to undergo complete axillary lymph node dissection; however, further nodal disease is not always present. Mathematical models have been constructed to determine the risk of metastatic disease; three of these were evaluated independently.
Methods
Data from 108 women with breast cancer who had a positive SLN biopsy and completion axillary lymph node dissection were used. Measurements of additional parameters over those usually determined (such as size of SLN metastasis) were assessed under the supervision of two pathologists. These data were used to determine the predicted risk of non-SLN metastases using three mathematical models (from Memorial Sloan-Kettering Cancer Center (MSKCC), Cambridge University and Stanford University) and a comparison made with the observed findings. Analyses were made using the area under the receiver operating characteristic (ROC) curve (AUC).
Results
Some 53 (49·1 per cent) of 108 patients had a positive non-sentinel axillary lymph node metastasis. The AUC values were 0·63, 0·72 and 0·67 for the MSKCC, Cambridge and Stanford nomograms respectively.
Conclusion
This independent comparison found no significant difference between the models, although the Cambridge model had the advantage of requiring fewer measurements with a more accurate predictive performance.
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Affiliation(s)
- Y Moghaddam
- Department of Histopathology, University College Hospital, London, UK
| | - M Falzon
- Department of Histopathology, University College Hospital, London, UK
| | - L Fulford
- Department of Histopathology, University College Hospital, London, UK
| | - N R Williams
- Department of Surgery, University College London Medical School, London, UK
| | - M R Keshtgar
- Department of Surgery, University College London Medical School, London, UK
- Department of Surgery, Royal Free Hospital, London, UK
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Moghaddam Y, Falzon M, Fulford L, Williams NR, Keshtgar MR. Independent comparison of three mathematical models for predicting the risk of additional nodal metastases after positive sentinel lymph node biopsy in early breast cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Mulheran P, Browne C, Moghaddam Y. Adatoms and interstitials in the rutile TiO2(110) surface: structure and dynamics. Molecular Simulation 2009. [DOI: 10.1080/08927020802607375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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