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Article ; Online: The effect of dexamethasone on the reduction of airway edema and the success of extubation in patients with head and neck surgery admitted to the intensive care unit

Laya Amoozadeh / Mohammad Taghi Beigmohammadi

Tehran University Medical Journal, Vol 80, Iss 2, Pp 128-

2022 Volume 134

Abstract: Background: The decision to extubate the patient is crucial and challenging. The use of corticosteroids to reduce airway edema and extubation failure in intensive care patients is debatable. Methods: In an observational prospective cohort study from ... ...

Abstract	Background: The decision to extubate the patient is crucial and challenging. The use of corticosteroids to reduce airway edema and extubation failure in intensive care patients is debatable. Methods: In an observational prospective cohort study from April 2021 to July 2021, 110 patients undergoing head and neck surgery at Imam Khomeini Hospital's special wards were enrolled. Inclusion criteria: Patients undergoing head and neck surgery. Exclusion criteria: previous corticosteroid use, presence of tracheostomy tube, history of head and neck surgery. The intervention group (n=55) received intravenous dexamethasone 8 mg three times a day for the first 24 hours and 4 mg twice a day for the next 24 hours. The control group did not receive any corticosteroids (n=55). All the patients were weaned with the same protocol, including pressure support ventilation with pressure support 6-8 cm H20 and PEEP <5 cm H2o and FIO2 ≤0.4 for 1-2 hours without respiratory distress, hypoxia, tachycardia, and diaphoresis. Before extubation, the cuff leak test was done for all the patients with the cut-off point of 110 ml. The Chi-square or Fisher's exact test was performed for categorical variables, and a t-test was used to describe the quantitative variables. P-values less than 0.05 were considered statistically significant. Results: The mean age was 52.1±14.1, and there was no difference between the two groups. Demographic characteristics, including sex, body mass index, duration of surgery, kind of intubation, and Acute Physiology and Chronic Health Evaluation (APACHE) II score, were not significantly different. The length of stay in the intensive care unit in the dexamethasone group was significantly longer than the control group (104 vs. 79-hour, P=0.001, CI 95%: 10.995-40.878). The rate of failure in extubation and postoperative stridor was not significantly different between the two groups (P=0.237). Conclusion: Dexamethasone usage seems not to be effective in reducing airway edema, and its routine use is not recommended in ...
Keywords	dexamethasone ; extubation ; intensive care ; laryngeal edema ; Medicine (General) ; R5-920
Language	Persian
Publishing date	2022-05-01T00:00:00Z
Publisher	Tehran University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Cannabidiol Anticonvulsant Effects Against Lithium-Pilocarpine-Induced Status Epilepticus in Male Rats Are Mediated by Neuroinflammation Modulation and Cannabinoids 1 (CB1), But Not CB2 and GABA

Masoumi, Mahla / Manavi, Mohammad Amin / Mohammad Jafari, Razieh / Mirzaei, Alireza / Hedayatyanfard, Keshvad / Beigmohammadi, Mohammad Taghi / Dehpour, Ahmad Reza

Cannabis and cannabinoid research

2023

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2023-11-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2867624-5
ISSN	2378-8763 ; 2578-5125
ISSN (online)	2378-8763
ISSN	2578-5125
DOI	10.1089/can.2023.0067
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Article: Gargle test for successful extubation in critically ill patients underwent head and neck surgeries: A new test.

Beigmohammadi, Mohammad Taghi / Amoozadeh, Laya / Alipour, Abbas

Annals of medicine and surgery (2012)

2022 Volume 82, Page(s) 104759

Abstract: Background: Improvement of predictive tools for recognition of airway edema is crucial for safe extubation and patient safety. This study aimed to evaluate the diagnostic accuracy of the Gargle test (GT) as a new test for assessing airway edema and ... ...

Abstract	Background: Improvement of predictive tools for recognition of airway edema is crucial for safe extubation and patient safety. This study aimed to evaluate the diagnostic accuracy of the Gargle test (GT) as a new test for assessing airway edema and predicting successful extubation in patients admitted to the intensive care unit (ICU). Method: In this prospective observational study, patients underwent head and neck surgeries and admitted to ICU included. All the patients were weaned based on the same protocol.Quantitative Cuff Leak Test (CLT) and qualitative CLTwere first applied followed by GT with normal saline 0.9%. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. Results: One hundred and eighteen (male 67, female 51) participated in this study. The agreement between GT and CLT was low (Kappa: quantitative CLT 0.07, qualitative CLT 0.21). The GT compared to CLT had higher sensitivity (33.3% vs 16.6%), specificity (96.3% vs qualitative CLT 92.8%, quantitative CLT 79.4%), PPV (33.3% vs qualitative CLT 11.11%, quantitative CLT 4.0%), NPV (96.3% vs qualitative CLT 95.4%, quantitative CLT 94.6%), and accuracy (92.92% vs qualitative CLT 88.98%, quantitative CLT 76.27%. The cut-off value for GT was estimated 16.5% (sensitivity 74.1% and specificity 60%). Conclusion: The GT is a simple accurate test and can be used as a new test in the ICU for recognition of airway edema and prediction of safe extubation in patients with head and neck surgeries.
Language	English
Publishing date	2022-09-22
Publishing country	England
Document type	Journal Article
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1016/j.amsu.2022.104759
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Article ; Online: Early Versus Late Tracheostomy in Mechanically Ventilated COVID-19 Patients

Samrand Fattah Ghazi / Nima Nazari / Mohammad Taghi Beigmohammadi / Masoud Ramezani / Mohammadreza Salehi / Yeganeh Abedipour

Acta Medica Iranica, Vol 61, Iss

A Comparative Study

2023 Volume 6

Abstract: The decision to perform tracheostomy during the COVID-19 pandemic has been based mainly on practical and empirical standards. Also, the amount of scientific evidence to determine the exact timing of tracheostomy in patients with severe COVID-19 on ... ...

Abstract	The decision to perform tracheostomy during the COVID-19 pandemic has been based mainly on practical and empirical standards. Also, the amount of scientific evidence to determine the exact timing of tracheostomy in patients with severe COVID-19 on mechanical ventilation is not significant. We conducted a retrospective cohort study on mechanically ventilated COVID-19 patients from April 25, 2021 to January 25, 2022 in intensive care units of Imam Khomeini Hospital Complex, Tehran, Iran. The 30-day survival of patients was calculated and compared between patients under tracheostomy and those without tracheostomy. A number of 135 COVID-19 cases (75 patients in the intubated group and 60 patients in the tracheostomy group) were included in this study. The mean age of the population was 53.6±12.4. The overall mortality rate was 101 (74.8%). The 30-day mortality rate was significantly higher in the intubated group (90.6%) than in the tracheostomy group (55%) (P< 0.001). The mortality rate was 60% in the early (≤ 7 days) tracheostomy group and 50% in the late (>7 days) group. This difference was not statistically significant (P> 0.05). Tracheostomy is a preferred method in airway management of severe COVID-19 patients under mechanical ventilation; however, early tracheostomy during the first week of intubation may not be superior to late tracheostomy in decreasing the mortality rate.
Keywords	Coronavirus disease 2019 (COVID-19) ; Late tracheostomy ; Early tracheostomy ; Airway management ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2023-10-01T00:00:00Z
Publisher	Tehran University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Safety and efficacy of pulmonary physiotherapy in hospitalized patients with severe COVID-19 pneumonia (PPTCOVID study): A prospective, randomised, single-blind, controlled trial.

Javaherian, Mohammad / Shadmehr, Azadeh / Keshtkar, Abbasali / Beigmohammadi, Mohammad Taghi / Dabbaghipour, Narges / Syed, Aabis / Attarbashi Moghadam, Behrouz

PloS one

2023 Volume 18, Issue 1, Page(s) e0268428

Abstract: Background: Pulmonary physiotherapy (PPT) is an important treatment in the management of patients with different types of pulmonary disorders. We aimed to evaluate safety and efficacy of PPT in hospitalized patients with severe COVID-19 pneumonia.: ... ...

Abstract	Background: Pulmonary physiotherapy (PPT) is an important treatment in the management of patients with different types of pulmonary disorders. We aimed to evaluate safety and efficacy of PPT in hospitalized patients with severe COVID-19 pneumonia. Methods: In this randomised, single-blind, controlled trial, we enrolled hospitalized, non-intubated patients (18 to 75 years with oxygen saturation (Spo2) in free-air breathing ≤90%) with COVID-19 pneumonia at a referral hospital. Participants were randomly assigned (1:1) to receive PPT (six sessions PPT with breathing exercises and airway clearance techniques) or basic care. The primary outcomes were venous blood O2 (pO2) and CO2 (pCO2) pressures, Spo2, and three-minute walking test (3MWT) that were assessed before and end of sixth session. Secondary outcomes included level of dyspnea, venous blood PH, one-month mortality, three-month mortality and short form-36 (SF-36) after one and three months. The assessor was blinded to the assignment. This trial is registered with ClinicalTrials.gov (NCT04357340). Findings: In April-May 2020, 40 participants were randomly assigned to PPT or basic care groups. While at the end of intervention, pO2 (adjusted mean difference to baseline measure (AMD) 6.43 mmHg [95%CI 2.8, 10.07], P<0.01), Spo2 (AMD 4.43% [95%CI 2.04, 6.83], P = 0.0011), and 3MTW (AMD 91.44 m [95%CI 68.88, 113.99], P<0.01) were higher in PPT group and basic care group, pCO2 was not improved (AMD -2.1 mmHg [95%CI-6.36, 2.21], P = 0.33). Based on the logistic model adjusted to baseline Spo2, the risks of mortality were reduced 81% ([95%CI: 97% reduction to 30% increase], P = .09) and 84% ([95%CI 74% reduction to 5% increase], P = .06) at one-month and three-month, respectively. There were no significant differences in most SF-36 domains scores after one and three months. No serious adverse event was observed during PPT sessions. Conclusion: Early PPT can be considered a safe and relatively effective therapeutic choice for patients with severe COVID-19.
MeSH term(s)	Humans ; COVID-19/therapy ; SARS-CoV-2 ; Prospective Studies ; Single-Blind Method ; Physical Therapy Modalities ; Treatment Outcome
Language	English
Publishing date	2023-01-31
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0268428
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Article ; Online: The effect of Vitamin C and Zn supplementation on the immune system and clinical outcomes in COVID-19 patients.

Firouzi, Safieh / Pahlavani, Naseh / Navashenaq, Jamshid Gholizadeh / Clayton, Zachary Stephen / Beigmohammadi, Mohammad Taghi / Malekahmadi, Mahsa

Clinical nutrition open science

2022 Volume 44, Page(s) 144–154

Abstract: SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus-2) is the most dangerous form of the coronavirus, which causes COVID-19. In patients with severe COVID-19, the immune system becomes markedly overactive. There is evidence that supplementation ... ...

Abstract	SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus-2) is the most dangerous form of the coronavirus, which causes COVID-19. In patients with severe COVID-19, the immune system becomes markedly overactive. There is evidence that supplementation with select micronutrients may play a role in maintaining immune system function in this patient population. Throughout the COVID-19 pandemic, significant emphasis has been placed on the importance of supplementing critical micronutrients such as Vitamin C and Zinc (Zn) due to their immunomodulatory effects. Viral infections, like COVID-19, increase physiological demand for these micronutrients. Therefore, the purpose of this review was to provide comprehensive information regarding the potential effectiveness of Vitamin C and Zn supplementation during viral infection and specifically COVID-19. This review demonstrated a relation between Vitamin C and Zn deficiency and a reduction in the innate immune response, which can ultimately make patients with COVID-19 more vulnerable to viral infection. As such, adequate intake of Vitamin C and Zn, as an adjunctive therapeutic approach with any necessary pharmacological treatment(s), may be necessary to mitigate the adverse physiological effects of COVID-19. To truly clarify the role of Vitamin C and Zn supplementation in the management of COVID-19, we must wait for the results of ongoing randomized controlled trials. The toxicity of Vitamin C and Zn should also be considered to prevent over-supplementation. Over-supplementation of Vitamin C can lead to oxalate toxicity, while increased Zn intake can reduce immune system function. In summary, Vitamin C and Zn supplementation may be useful in mitigating COVID-19 symptomology.
Language	English
Publishing date	2022-06-25
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2667-2685
ISSN (online)	2667-2685
DOI	10.1016/j.nutos.2022.06.006
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Article: Cultural adaptation and psychometric assessment of the Persian version of the lumbar spine instability questionnaire.

Nakhostin Ansari, Noureddin / Abdollahzade, Zahra / Naghdi, Soofia / Beigmohammadi, Mohammad Taghi / Kashi-Alashti, Mina

BMC sports science, medicine & rehabilitation

2022 Volume 14, Issue 1, Page(s) 90

Abstract: Background: The Lumbar Spine Instability Questionnaire (LSIQ) is a self-reported measure of clinical instability of the lumbar spine. This study aimed to translate and culturally adapt the LSIQ into Persian language (LSIQ-P) and to evaluate its ... ...

Abstract	Background: The Lumbar Spine Instability Questionnaire (LSIQ) is a self-reported measure of clinical instability of the lumbar spine. This study aimed to translate and culturally adapt the LSIQ into Persian language (LSIQ-P) and to evaluate its reliability and validity in a sample of patients with chronic non-specific low back pain (LBP). Methods: In a cross-sectional study, the LSIQ was translated using guidelines. Participants with chronic non-specific LBP, aged ≥ 18 years old, answered an online survey consisting of LSIQ-P, the Persian Functional Rating Index (FRI), and the pain Numeric Rating Scale (NRS). Construct validity, internal consistency reliability, test-retest reliability, standard error of measurement (SEM), smallest detectable change (SDC), discriminant validity, and factor analysis were evaluated. Results: The LSIQ was successfully adapted into Persian. A sample of 100 participants with LBP and 100 healthy subjects completed the survey. Floor and ceiling effects were not observed. Cronbach's alpha = 0.767 and ICC Conclusions: The Persian LSIQ showed satisfactory metric characteristics of reliability and validity. Further studies are required to elucidate the internal structure of the LSIQ-P.
Language	English
Publishing date	2022-05-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2719537-5
ISSN	2052-1847
ISSN	2052-1847
DOI	10.1186/s13102-022-00486-2
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Article ; Online: Safety of megadose meropenem in the empirical treatment of nosocomial sepsis: a pilot randomized clinical trial.

Salehi, Mohammadreza / Rezazade-Moayed, Farah / Khalili, Hossein / Hemati, Homa / Aghdami, Nasser / Dashtkoohi, Mohadese / Dashtkoohi, Mohammad / Beig-Mohammadi, Mohammad-Taghi / Ramezani, Masoud / Hajiabdolbaghi, Mahboobeh / Fattah-Ghazi, Samrand

Future microbiology

2023 Volume 18, Page(s) 335–342

Abstract: Objective: ...

Abstract	Objective:
MeSH term(s)	Humans ; Meropenem/adverse effects ; Anti-Bacterial Agents/adverse effects ; Cross Infection/drug therapy ; Pilot Projects ; Sepsis/drug therapy
Chemical Substances	Meropenem (FV9J3JU8B1) ; Anti-Bacterial Agents
Language	English
Publishing date	2023-05-04
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2254620-0
ISSN	1746-0921 ; 1746-0913
ISSN (online)	1746-0921
ISSN	1746-0913
DOI	10.2217/fmb-2022-0170
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Article ; Online: Safety and efficacy of pulmonary physiotherapy in hospitalized patients with severe COVID-19 pneumonia (PPTCOVID study)

Mohammad Javaherian / Azadeh Shadmehr / Abbasali Keshtkar / Mohammad Taghi Beigmohammadi / Narges Dabbaghipour / Aabis Syed / Behrouz Attarbashi Moghadam

PLoS ONE, Vol 18, Iss 1, p e

A prospective, randomised, single-blind, controlled trial.

2023 Volume 0268428

Abstract: Background Pulmonary physiotherapy (PPT) is an important treatment in the management of patients with different types of pulmonary disorders. We aimed to evaluate safety and efficacy of PPT in hospitalized patients with severe COVID-19 pneumonia. Methods ...

Abstract	Background Pulmonary physiotherapy (PPT) is an important treatment in the management of patients with different types of pulmonary disorders. We aimed to evaluate safety and efficacy of PPT in hospitalized patients with severe COVID-19 pneumonia. Methods In this randomised, single-blind, controlled trial, we enrolled hospitalized, non-intubated patients (18 to 75 years with oxygen saturation (Spo2) in free-air breathing ≤90%) with COVID-19 pneumonia at a referral hospital. Participants were randomly assigned (1:1) to receive PPT (six sessions PPT with breathing exercises and airway clearance techniques) or basic care. The primary outcomes were venous blood O2 (pO2) and CO2 (pCO2) pressures, Spo2, and three-minute walking test (3MWT) that were assessed before and end of sixth session. Secondary outcomes included level of dyspnea, venous blood PH, one-month mortality, three-month mortality and short form-36 (SF-36) after one and three months. The assessor was blinded to the assignment. This trial is registered with ClinicalTrials.gov (NCT04357340). Findings In April-May 2020, 40 participants were randomly assigned to PPT or basic care groups. While at the end of intervention, pO2 (adjusted mean difference to baseline measure (AMD) 6.43 mmHg [95%CI 2.8, 10.07], P<0.01), Spo2 (AMD 4.43% [95%CI 2.04, 6.83], P = 0.0011), and 3MTW (AMD 91.44 m [95%CI 68.88, 113.99], P<0.01) were higher in PPT group and basic care group, pCO2 was not improved (AMD -2.1 mmHg [95%CI-6.36, 2.21], P = 0.33). Based on the logistic model adjusted to baseline Spo2, the risks of mortality were reduced 81% ([95%CI: 97% reduction to 30% increase], P = .09) and 84% ([95%CI 74% reduction to 5% increase], P = .06) at one-month and three-month, respectively. There were no significant differences in most SF-36 domains scores after one and three months. No serious adverse event was observed during PPT sessions. Conclusion Early PPT can be considered a safe and relatively effective therapeutic choice for patients with severe COVID-19.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Safety and efficacy of pulmonary physiotherapy in hospitalized patients with severe COVID-19 pneumonia (PPTCOVID study)

Mohammad Javaherian / Azadeh Shadmehr / Abbasali Keshtkar / Mohammad Taghi Beigmohammadi / Narges Dabbaghipour / Aabis Syed / Behrouz Attarbashi Moghadam

PLoS ONE, Vol 18, Iss

A prospective, randomised, single-blind, controlled trial

2023 Volume 1

Abstract	Background Pulmonary physiotherapy (PPT) is an important treatment in the management of patients with different types of pulmonary disorders. We aimed to evaluate safety and efficacy of PPT in hospitalized patients with severe COVID-19 pneumonia. Methods In this randomised, single-blind, controlled trial, we enrolled hospitalized, non-intubated patients (18 to 75 years with oxygen saturation (Spo2) in free-air breathing ≤90%) with COVID-19 pneumonia at a referral hospital. Participants were randomly assigned (1:1) to receive PPT (six sessions PPT with breathing exercises and airway clearance techniques) or basic care. The primary outcomes were venous blood O2 (pO2) and CO2 (pCO2) pressures, Spo2, and three-minute walking test (3MWT) that were assessed before and end of sixth session. Secondary outcomes included level of dyspnea, venous blood PH, one-month mortality, three-month mortality and short form-36 (SF-36) after one and three months. The assessor was blinded to the assignment. This trial is registered with ClinicalTrials.gov (NCT04357340). Findings In April-May 2020, 40 participants were randomly assigned to PPT or basic care groups. While at the end of intervention, pO2 (adjusted mean difference to baseline measure (AMD) 6.43 mmHg [95%CI 2.8, 10.07], P<0.01), Spo2 (AMD 4.43% [95%CI 2.04, 6.83], P = 0.0011), and 3MTW (AMD 91.44 m [95%CI 68.88, 113.99], P<0.01) were higher in PPT group and basic care group, pCO2 was not improved (AMD -2.1 mmHg [95%CI-6.36, 2.21], P = 0.33). Based on the logistic model adjusted to baseline Spo2, the risks of mortality were reduced 81% ([95%CI: 97% reduction to 30% increase], P = .09) and 84% ([95%CI 74% reduction to 5% increase], P = .06) at one-month and three-month, respectively. There were no significant differences in most SF-36 domains scores after one and three months. No serious adverse event was observed during PPT sessions. Conclusion Early PPT can be considered a safe and relatively effective therapeutic choice for patients with severe COVID-19.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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