per Internal Diseases and Pediatrics 2024-07 1 1 1 8 article Asieh Mansour 1 Atefeh Amrollahi Bioki 2 Sayed Mahmoud Sajjadi-Jazi m_sajadi@sina.tums.ac.ir 3 Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute Background and aims: There is emerging evidence that tea has beneficial effects and bioactive compounds, and an increasing number of studies have been conducted regarding tea consumption and health outcomes. However, most of these studies are on green tea and coffee, and few studies have been conducted on black tea. Therefore, the aim of this study is to investigate the relationship between black tea consumption and the severity of steatosis and liver fibrosis in patients with type 2 diabetes (T2DM) and non-alcoholic fatty liver disease (NAFLD). Methods: In this cross-sectional study, which was conducted on patients with T2DM and NAFLD, the effect of tea intake on liver steatosis and fibrosis was investigated by transient elastography (TE). Tea consumption was estimated by a validated food frequency questionnaire. Patients were classified according to the severity of steatosis and liver fibrosis: steatosis above 66% and F ≥2 were considered as severe steatosis and moderate to severe fibrosis, respectively. Univariate and multivariate regression models were used to analyze the data considering potential confounding factors. Results: 108 patients with T2DM and NAFLD participated in this study. The mean ± standard deviation (SD) of the patients for age, body mass index (BMI), fasting blood sugar and glycosylated hemoglobin (HbA1c) were 44.69 ± 5.56 years, 30.71 ± 3.82 kg/m2, 152.46 ± 51.94 mg/dL, and 8.33±3.95%, respectively. In this cross-sectional study, high black tea consumption was associated with a lower proportion of clinically significant liver steatosis (>S3) after adjusting for age, sex, BMI, smoking, physical activity, HbA1c, total cholesterol, triglyceride and high-density lipoprotein (HDL) (P=0.009). Compared to less than 3 cups, consumption of 3 to 5 cups or more than 5 cups of black tea per day was associated with a 73% (odds ratio [OR] 0.27, 95% confidence interval [CI]: 0.09–0.89) and 81% (OR 0.19, 95% CI: 0.05–0.76) reduction in the odds of liver steatosis, respectively. No association was demonstrated between tea consumption and the severity of liver fibrosis (P>0.05). Conclusion: Thus, for T2DM patients with NAFLD, higher intake of black tea is associated with less severe hepatic steatosis.   http://idap.ir/article-1-21-en.pdf non-alcoholic fatty liver disease type 2 diabetes liver steatosis fibrosis black tea eng Internal Diseases and Pediatrics 2024-07 1 1 9 16 article Minoo Mohraz 1 Hassan Jalili 2 Maryam Shafaati 3 Payam Tabarsi 4 Mohammadreza Salehi mr-salehi@sina.tums.ac.ir 5 Department of Infectious Diseases, Faculty of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences Department of Biological Sciences, Faculty of Science and Technology, University of Tehran Research center for antibiotic stewardship & antimicrobial resistance, Tehran University of Medical Sciences Department of Infectious Diseases, Faculty of Medicine, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences Research center for antibiotic stewardship & antimicrobial resistance, Tehran University of Medical Sciences The Covid-19 pandemic had a devastating impact on public health and the social and economic indexes of people around the world. One of the most important approaches to control the Covid-19 pandemic was vaccination. several vaccines using different technologies and platforms were produced and subjected to numerous preclinical and clinical trials. The University of Oxford and the British-Swedish pharmaceutical company "AstraZeneca" were able to develop and introduce a Covid-19 vaccine based on the chimpanzee adenoviral vector previously known as ChAdOx1nCoV-19 and now called AZD1222. This vaccine is commonly known as AstraZeneca vaccine. The aim of this study is to investigate the side effects reported for this vaccine in the literature. In this review, the literature was searched for articles from January 1, 2020 to July 1, 2024, and all types of articles were studied. Relevant keywords were then searched and articles that focused on vaccine side effects or reported side effects of the AstraZeneca vaccine were included. The results revealed: First, the rate and type of side effects mentioned in the studies after general vaccination were more than the cases reported and predicted in the preliminary clinical trials of the vaccine. Second, common serious side effects reported from the AstraZeneca vaccine were neurological diseases, including cerebral venous sinus thrombosis, hemorrhagic stroke, Guillain-Barre syndrome, and transverse myelitis. Last, the most serious complication of this vaccine has been thrombotic thrombocytopenia, which has resulted in the death of patients in some cases, and its rate is 0.73 out of every 100,000 people receiving the first dose of the vaccine. Although this vaccine was removed from the general vaccination program in some countries, including the United Kingdom, in a relatively short period after launched, it was used in many countries until 2024. Perhaps it was appropriate that the international health organizations replaced this vaccine and other vaccines with similar platforms with the Covid-19 vaccines with other platforms in 2021, considering the complications reported. http://idap.ir/article-1-22-en.pdf Covid-19 AstraZeneca vaccine side effects adenovirus vaccine vector eng Internal Diseases and Pediatrics 2024-07 1 1 17 23 article Neda Hatami 1 Ali Ghandali 2 Seyed Mohammad Tavangar 3 Amir Pejman Hashemi Taheri 4 Farshad Sharifi 5 Vahid Haghpanah 6 Mohammad Reza Mohajeri-Tehrani mrmohajeri@tums.ac.ir 7 Sayed Mahmoud Sajjadi-Jazi m_sajadi@tums.ac.ir 8 Institute of Endocrinology and Metabolism, Iran University of Medical Science School of medicine, Tehran University of Medical Sciences Department of Pathology, Dr. Shariati Hospital, Tehran University of Medical Sciences Department of Radiology, Tehran University of Medical Sciences Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences Background and aims: Thyroid nodules are widely encountered in the population and the approximate prevalence is 19–35% by using ultrasonography. Elastography can assess the stiffness of the thyroid nodules and in case of malignancy; the stiffness is expected to be higher due to changes in the nodule structure. Shear wave elastography (SWE) is a novel operator independent elastography technique, which has shown promising results for distinguishing benign from malignant thyroid nodules. The aim of this study was to evaluate the association between conventional ultrasound and SWE parameters with thyroid nodule malignancy. Methods: This retrospective study was performed in an endocrinology clinic during 2019-2020. Conventional ultrasonography and SWE findings of thyroid nodules were evaluated and compared with the results of fine needle aspiration (FNA). Then, the diagnostic performance of SWE, alone or in combination with conventional ultrasonography, was assessed in the detection of malignant thyroid nodules. Results: This study was conducted on 201 thyroid nodules (28 nodules in men and 173 nodules in women). The sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-) and accuracy of SWE (using a threshold of 65 kilopascal [kPa] for the maximum stiffness) in the prediction of malignant thyroid nodules were 50%, 98.56%, 34.75, 0.51 and 96.55%, respectively. After considering conventional ultrasonography in addition to SWE, the sensitivity, specificity, LR+, LR- and accuracy of ultrasound for the detection of malignant lesions were changed to 71.43%, 93.24%, 10.57, 0.31 and 92.26%, respectively. Conclusion: SWE could be useful in the assessment of thyroid nodules; it can be used beside the conventional ultrasonography to discriminate malignant lesions from the benign ones.   http://idap.ir/article-1-23-en.pdf thyroid nodule fine needle aspiration shear wave elastography ultrasonography malignancy eng Internal Diseases and Pediatrics 2024-07 1 1 24 28 article Faezeh Moghimpour Bijani fzbijani@gmail.com 1 Farid Kosari 2 Mehrnam Amuyi 3 department of internal medicine, school of medicine, Tehran University of Medical Sciences Department of Pathology, school of medicine, Tehran University of Medical Sciences Department of Radiology, School of Medicine, Tehran University of Medical Sciences Peripheral primitive neuro-ectodermal tumors (PNET) are classified as Ewing sarcoma family of tumors (ESFT) and are most common in young adults and children. PNETs originated from chest wall are previously named Askins’ tumors. Histopathologic exam reveals round blue cells with high N/C ratio and high mitotic rate. Immunohistochemistry demonstrates CD99, NKX2.2 and S100 on tumor cells surface. Chromosomal translocation t (11; 22) (q24; q12) is usually considered for definite diagnosis. Herein, a forty-five-year-old patient with thoracic peripheral PNET is reported with extended local invasion. Moreover, the patient developed non-islet cell tumor hypoglycemia (NICTH), which was successfully controlled by corticosteroids administration.   http://idap.ir/article-1-24-en.pdf PNET tumor Hypoglycemia Mesenchymal tumor Chest wall-originated tumor eng Internal Diseases and Pediatrics 2024-07 1 1 29 38 article Majid Sorouri msorourip@sina.tums.ac.ir 1 Siavosh Nasseri-Moghaddam 2 Liver and Pancreaticobiliary Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences In this article, we conduct a critical appraisal of the clinical guideline titled “American Gastroenterological Association-American College of Gastroenterology Clinical Practice Guideline: Pharmacological Management of Chronic Idiopathic Constipation.” Our analysis is approached from the perspective of a clinician rather than that of a guideline author or researcher. We employed the AGREE-II (Appraisal of Guidelines for Research and Evaluation II) checklist as a framework for our evaluation. The guideline systematically reviews ten pharmacological treatments compared to placebo in adults aged 18 years and older with idiopathic chronic constipation. Importantly, the recommendations do not encompass patients with opioid-induced constipation, those with constipation resulting from other medical conditions, or individuals with irritable bowel syndrome with constipation, as well as pregnant women.  The guideline emphasizes patient-oriented outcomes. While the recommendations are articulated with clarity, they are primarily based on evidence of limited quality, despite the use of sound methodological approaches. No significant conflicts of interest appear to compromise the integrity of the recommendations. The guideline lacked explicit treatment steps or instructions for applying its recommendations, focusing solely on the efficacy of the ten reviewed drugs. Although Readers may infer those over-the-counter options such as fiber, magnesium oxide, and senna (and possibly lactulose) may serve as initial therapeutic measures. Furthermore, polyethylene glycol and bisacodyl or picosulfate (for short-term or rescue therapy) are identified as effective and low-cost treatment options. In contrast, linaclotide, plecanatide, and prucalopride are recognized as effective but associated with higher costs. Overall, the guideline serves as a framework for managing chronic idiopathic constipation, emphasizing patient-oriented outcomes and evidence-based recommendations. However, the absence of explicit treatment steps and the limited empirical evidence supporting most treatments will restrict its practical application and effectiveness. http://idap.ir/article-1-25-en.pdf Constipation guideline fiber magnesium oxide senna lactulose polyethylene glycol bisacodyl picosulfate lubiprostone linaclotide plecanatide prucalopride appraise AGREE eng Internal Diseases and Pediatrics 2024-07 1 1 38 39 article Amir Kasaeian amir_kasaeian@yahoo.com 1 Majid Sorouri 2 Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences Liver and Pancreaticobiliary Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences The history of the p-value is deeply tangled with the development of statistical methods in the early twentieth century, and its initial conceptual development emerged from the need to measure the strength of evidence against the null hypothesis. Today, p-values are a widely used statistical tool in medical research, employed to assess the significance of study findings. However, there are often misunderstandings regarding their correct interpretation and limitations, which can lead to incomplete conclusions and poor decision-making in this field. On the other hand, p-values also have significant limitations. Therefore, while p-values are useful tools in medical research, they must be interpreted with caution and in the relevant context. Clinical researchers should be aware of the limitations of p-values in order to accurately assess the medical literature. With the proper use of p-values, we can enhance the quality and impact of medical research. http://idap.ir/article-1-26-en.pdf P-value History Statistical Inference Statistical Significance eng Internal Diseases and Pediatrics 2024-07 1 1 40 47 article Hanieh Zaer-Rezaii 1 Masoud Sofalei 2 Samira Soleimanpour 3 Mohammad Kiasalar mkiasalar@nasrme.ac.ir 4 Faculty of Psychology, Islamic Azad University, Alborz, Iran Faculty of Cinema Department, Faculty of Cinema and Theater, University of Arts medical library and information Sciences, Medical Education Studies and Development Center, Iran University of Medical Sciences Medical Ethics, National Agency for Strategic Research in Medical Science Education, Ministry of Health and Medical Education Background and aims: The increasing presence and activity of health professionals in social media has violated the privacy and rights of patients - especially children who are more vulnerable - more than ever. This study aims to provide a favorable context for developing ethical and local guidelines by reviewing ethical considerations and international guidelines regarding the preparation and publishing of news, photos and films of children. Methods: Searching appropriate keywords in reliable databases, 24 research articles and 7 chapters from 4 books were selected and studied for this narrative review. Results: This research showed that the ethical guidelines for producing and publishing news, photos and films of children can be compiled based on 8 ethical codes including 2 categories and 4 subcategories: Harm minimization (consideration of health anxiety/avoidance of stereotyping, discrimination and social stigma/considering the vulnerable/caution in sensitive subjects) and respecting children's rights (respecting privacy/obtaining informed consent/maintaining confidentiality/observing social norms). Conclusion: This study tried to clarify the subject through a narrative review, and by proposing 8 codes of ethics, it aimed to facilitate the work of subsequent researchers in compiling a local ethical guideline. Discourse creation in the public sphere is suggested to inform the public audience. Inclusion of the ethical codes in teaching resources is also recommended to involve the target audience. http://idap.ir/article-1-27-en.pdf ethical guidelines codes of ethics media photo film news children