Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 13 4 2025 11 01 Challenges of Artificial Intelligence in Cancer Diagnosis: An Update on Future and Prospects 1 16 118605 10.30483/rjm.2025.254628.1408 EN Bahare Rashidi Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran Kiarash Zohori Pharmacy graduate, Faculty of Pharmacy, Ayatollah Amoli Branch, Islamic Azad University, Iran Seyyedeh Samin Aminzadeh Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran Seyedeh Fatemeh Abachi School of Medicine, Novosibirsk State University Farnaz Behzad Electrical Department, Faculty of Engineering, Islamic Azad University-South Tehran Branch, Tehran, Iran Alireza Omranzadeh Medical Doctor, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Journal Article 2025 03 02 Background: Artificial intelligence (AI) has become increasingly prominent in the medical field, particularly in the diagnosis of cancer. Objectives: This comprehensive review was conducted to review the challenges of AI in cancer diagnosis. Methods: This comprehensive review was conducted through a systematic search of major scientific databases, including PubMed, Scopus, Web of Science, and IEEE Xplore, utilizing a combination of keywords and Medical Subject Headings (MeSH) terms such as “artificial intelligence,” “machine learning,” “deep learning,” “neural networks,” “cancer diagnosis,” “oncological imaging,” “pathology,” “biomarkers,” and “precision oncology,” covering the period from January 2019 to December 2024 to capture the most relevant and impactful studies in this rapidly evolving field. The inclusion criteria were focused on peer-reviewed original research articles, significant review papers, and high-impact conference proceedings that demonstrated a direct application of AI algorithms in diagnostic procedures, while exclusion criteria encompassed non-English publications, studies with insufficient methodological detail, articles not focused on diagnostic applications, and editorials or opinion pieces without original data, ensuring a robust and evidence-based analysis of the current landscape. Results: The challenges in the widespread utilization of this technology in clinical settings are discussed. Deep learning algorithms, especially convolutional neural networks (CNN), can identify suspicious areas in mammograms, CT scans, and MRI images that doctors may easily overlook. These capabilities improve accuracy and reduce human errors in cancer diagnosis. In addition to image analysis, AI can also analyze patients' molecular and genetic data. Using genomic and proteomic data, this technology can identify gene mutations and specific biological markers of cancer. As a result, early diagnosis and selection of targeted patient treatments are carried out with greater accuracy. However, despite significant progress in this field, several challenges remain, including the accurate interpretation of data, the need for substantial training data, and the ability to generalize algorithms to diverse populations. Conclusion: In conclusion, AI is fundamentally augmenting the field of cancer diagnostics, moving from a theoretical promise to a powerful clinical tool. The evidence demonstrates that AI algorithms, particularly deep learning models, offer significant and measurable benefits.

https://journal.razavihospital.ir/article_118605_5af0c1dffbb8f486ee4f3a43aa503368.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 13 4 2025 11 01 A Study of Toxification Types in Intubated Poisoned Patients in the ICUs of Taft Shahid Beheshti and Yazd Shahvali Hospitals (2015–2019) 17 25 118600 10.30483/rijm.2025.254503.1308 EN Ghongheh OmidShafiee Department of Medical Sciences, Yazd Branch, Islamic Azad University, Yazd, Iran Hamid Owliaey Department of Forensic Medicine & Clinical Toxicology, Yazd Branch, Islamic Azad University, Yazd, Iran Sareh Rafatmoghadam Department of Internal medicine, Fasa University of Medical Sciences, Fasa, Iran Shadi Talebi Department of Medical Sciences, Yazd Branch, Islamic Azad University, Yazd, Iran Hamidreza Ghasemirad Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Marjan Shariatpanahi Department of Pharmacology and Toxicology, School of Pharmacy, Iran University of Medical Sciences, Tehran, Iran Forouzan Farez Department of Medical Sciences, Yazd Branch, Islamic Azad University, Yazd, Iran Faezeh Niknam Department of Internal medicine, Faculty of medicine, Shahid Sadougi University of Medical Sciences and Health Service, Yazd, Iran Mehrnoush Giahi Yazdi General Practitioner, Social security organization of Yazd, Iran Journal Article 2024 03 08 Background: Although poisoning is one of the most common reasons for visits to emergency departments, the types of toxification among intubated poisoned patients in ICUs have not been well documented. Objectives: This study aimed to identify the toxification types among intubated poisoned patients in an intensive care unit (ICU). Methods: This retrospective cross-sectional study was conducted on poisoned patients with chemical compounds, hospitalized in ICU, and underwent endotracheal intubation. Toxicological and clinical factors, as well as outcomes, were collected and analyzed. Analysis was performed using the Chi-square test and Fisher's exact test. The p-value < 0.05 was considered significant. Results: In this study, 307 patients with the diagnosis of poisoning were evaluated. The most common toxic agents were methadone (46.8%), opium (5.9%), organophosphorus compounds (5.9%), methanol (4.2%), and other chemical substances (2.4%). A single compound poisoned most patients (70%). Furthermore, 167 patients (54.4%) experienced accidental poisoning or drug abuse, while the remaining cases (45.6%) were due to suicidal intentions. Significant differences were observed between these two groups (suicidal and accidental poisoning groups) regarding age, gender, types of toxification, and grouping and duration of ICU hospitalization (P < 0.05). Significant differences were found in patient outcomes based on toxification types, toxification type grouping, or ICU hospitalization duration (P < 0.05). Conclusion: Our results indicate that opioids, especially methadone, were the most frequent cause of poisoning in our study. Pesticide poisoning occurred significantly more often in patients with suicidal intent. Additionally, patient outcomes were significantly influenced by age, gender, type, grouping of toxic agents, and duration of ICU hospitalization.

https://journal.razavihospital.ir/article_118600_41699aa38a241281d9a37eab1dbaa551.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 13 4 2025 11 01 Association between vitamin D receptor BsmI (rs1544410) gene polymorphism and serum vitamin D, serum calcium, and osteoporosis risk in women over 40 years 26 35 118601 10.30483/rijm.2025.254610.1393 EN Ava Dadfar Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran Payman Sasannezhad Department of Orthopedics, Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran Zohreh Nobakht Assistant Professor of Rheumatology, Department of Internal medicine, Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran Journal Article 2025 01 27 Objectives: We investigated the relationships between the vitamin D receptor BsmI (rs1544410) gene polymorphism, serum vitamin D and calcium levels, and the risk of osteoporosis in women aged 40 years and older. Methods: This case-control investigation enrolled participants (30 cases and 30 controls) classified into normal and osteoporotic groups using a dual-energy X-ray absorptiometry (DEXA) scan. Vitamin D and calcium levels were obtained from peripheral blood samples. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was performed to detect the BsmI polymorphism. Differences between groups were analyzed using an analysis of variance (ANOVA) test. Results: 60 individuals (30 cases and 30 age-matched controls) were enrolled. The lumbar and femoral T-scores, as well as calcium levels, were significantly lower in the cases compared to the controls (P < 0.005). Among postmenopausal women, the lumbar T-scores significantly differed between cases with VDR polymorphisms (P = 0.003) and controls (P = 0.001). Among premenopausal women, there was only a significant difference in VDR polymorphisms in the control group (P = 0.006). Calcium and vitamin D levels were significantly different between the VDR polymorphisms in cases and control groups, but only among postmenopausal women (P < 0.005 for all comparisons). No significant differences were observed between the VDR polymorphism in terms of femoral T-scores, neither in the cases nor the controls (P for all > 0.005). Conclusion: This study found no differences in VDR polymorphism between individuals with and without osteoporosis. Additionally, the lumbar T-scores, calcium, and vitamin D levels were significantly different between the VDR polymorphisms in the case and control groups among postmenopausal women.

https://journal.razavihospital.ir/article_118601_40ddabb3f82d93eaad56559610f8815f.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 13 4 2025 11 01 Assessment of Oral Health-Related Quality of Life Using the Oral Impacts on Daily Performance (OIDP) Index 36 45 118603 10.30483/rijm.2025.254626.1407 EN Sara Esfandi Department of Dentistry, Razavi Hospital, Imam Reza International University, Mashhad, Iran Mohammad Harati Department of Dentistry, Razavi Hospital, Imam Reza International University, Mashhad, Iran Journal Article 2025 01 10 Background: The Oral Impact on Daily Performance (OIDP) index is a key indicator that evaluates how individuals' oral health conditions affect their ability to perform daily activities. Objectives: This study aimed to evaluate oral health-related quality of life (OHRQoL) via the OIDP index among patients visiting the dental clinic at Razavi Hospital. Methods: This cross-sectional study was conducted on 100 systemically healthy adults attending the dental clinic at Razavi Hospital. Demographic data, oral hygiene behaviors, and dental visit history were collected through a questionnaire. OHRQoL was assessed using the validated Persian version of the OIDP index. Clinical oral health status was evaluated by measuring the decayed, missing, and filled teeth (DMFT) index and Bleeding on Probing (BOP). Data were analyzed using Fisher's Exact Test, Pearson correlation, and independent t-test. P-values lower than 0.05 were considered statistically significant. Results: Of the 100 participants (68% female, mean age 52.25 ± 15.00 years), 75% reported at least one daily activity affected by oral health in the past six months. Eating food (51%), smiling (17%), and social interaction (16%) were the activities most impacted. Toothache (59%) was the leading cause of functional limitations. The mean OIDP score was 6.52 ± 6.10. OIDP scores were significantly correlated with age (r = 0.243, P = 0.015) and DMFT (r = 0.421, P < 0.001), but not with brushing frequency or dental visit frequency. No significant difference in OIDP scores was found between individuals with BOP-positive and BOP-negative results. Conclusion: The impact of oral and dental health on patients' quality of life was considerable, with dental pain being the most common contributing factor. Higher impact levels were significantly associated with increasing age and higher DMFT scores.

https://journal.razavihospital.ir/article_118603_11523b583c31d9f02e7b3d357fd0201a.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 13 4 2025 11 01 Pediatric Arrhythmia Management in Congenital Heart Disease (CHD): A 20-Year Epidemiologic Study and Therapeutic Insights at Imam-Reza Hospital (2001-2020) 46 55 118604 10.30483/rijm.2025.254625.1406 EN Hassan Mottaghi Moghaddam Shahri Pediatric and Congenital Cardiology Division, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Shayan Salehi Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Sadegh Yaghoobkhani Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mohammad Abbasi Tashnizi Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Mohammad Tayyebi Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Nazanin Sadat Moaven Zadeh Pediatric and Congenital Cardiology Division, Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran Mahmood Hosseinzadeh Maleki Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran 0000-0003-3254-5112 Feisal Rahimpour Pediatric and Congenital Cardiology Division, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mohsen Yaghubi Department of Extra-Corporeal Circulation (ECC), Razavi Hospital, Imam Reza International University, Mashhad, Iran 0000-0001-8061-3779 Journal Article 2025 06 07 Background: Arrhythmia in children with congenital heart disease (CHD) can be due to abnormal anatomy, genetic mutations, hemodynamic abnormalities, primary myocardial disease, hypoxic tissue damage, or postoperative complications. Objectives: This study aimed to investigate the epidemiological findings of children with various arrhythmias and their treatment outcomes. Methods: The study was cross-sectional. The data were derived from 762 patients with arrhythmias, including tachyarrhythmias, bradyarrhythmias, and premature beats. The patient's demographic and clinical information, as well as their electrocardiogram (ECG), Holter monitor, echocardiography, and electrophysiology results, were collected and analyzed using SPSS software. Results: The study found that 44.6% of the patients were female and 55.4% were male. The mean age of patients with tachyarrhythmias was 5.9 years, while those with bradyarrhythmias were 10 years old, and those with premature beats were 6.5 years old. The most common symptoms were palpitations, murmur, and slow pulse. The most common arrhythmias were supraventricular tachycardia (SVT) and premature atrial contractions (PACs). Conclusion: The study revealed that cardiac abnormalities, including septal defects and valve abnormalities, were prevalent in patients with arrhythmias. Cardiomyopathy was associated with a higher risk of mortality. The study's findings emphasize the importance of paying attention to the presence of accompanying anomalies, palpitations, abnormal heart sounds, or bradycardia during the examination, as these are associated with an increased risk of mortality.

https://journal.razavihospital.ir/article_118604_d6ff953d320b2e752fb06fbd074c17ac.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 13 4 2025 11 01 A retrospective study on clinical and Para clinical findings of Quetiapine toxicity cases admitted in Clinical Toxicology Center, Imam Reza Hospital for five years 56 66 118596 10.30483/rijm.2025.254590.1380 EN Mohammad Shakibafar Mashhad University of Medical Sciences, Mashhad, Iran Bita Dadpour Medical Toxicology Research Center, Faculty of Medicine, Mashhad University of medical sciences, Mashhad, Iran Zahra Ataee Department of Internal Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Journal Article 2025 01 25 Background: Quetiapine is a dibenzothiazepine-derived antipsychotic drug that has been evaluated for the management of patients with psychotic disorders. Quetiapine is associated with an increased risk of death in dementia-related psychosis in elderly patients. There is a risk of increased suicidal thoughts and behavior associated with drug treatment in patients with major depressive disorder. Objectives: Our study aims to investigate the patients with quetiapine poisoning within 5 years. Methods: The files of patients who were poisoned by antipsychotic drugs during the study period were collected at the poisoning department of Imam Reza Hospital. Those who reported poisoning with Quetiapine were included in the study and analyzed. The checklist was prepared in advance, and information was entered into it. Based on the normality or not of the data distribution, parametric and non-parametric tests were used, and SPSS was used to analyze the data. Results: The number of 31 cases was related to patients who registered poisoning with Quetiapine; 15 were male (48.38%), and 16 were female (51.61%). The average age of the patients was 45.25±35.51, and the average total dose consumed was 745.85±242.65. Also (64.51%) were discharged from the hospital with full or partial recovery, and no deaths were reported. Also, the average dose consumed had a significant relationship with QTC, WBC, level of consciousness, heart rate, and outcome (P<0.05), while no significant relationship was observed with other variables. Conclusion: According to the present study, Quetiapine has many side effects, the most being cardiovascular complications, which show the need for special clinical care related to the heart and blood vessels.

https://journal.razavihospital.ir/article_118596_2a4cb7f84dea5ebd753a04717b80c04a.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 13 4 2025 11 01 Malignant Carotid Body Tumor: A Case Report and Comprehensive Literature Review 67 77 118599 10.30483/rijm.2025.254621.1402 EN Hassan Ravari Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran 0000-0002-9224-0639 Reza Sahebi Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran 0000-0001-8702-0992 Reza Asadi MD, Ph.D of Epidemiology, Zamen Salamati Research Company, Mashhad, Iran 0000-0002-5016-2994 Journal Article 2024 08 07 Background: Malignant carotid body tumors (CBTs) are rare neoplasms arising from the chemoreceptor cells at the carotid bifurcation. They are often misdiagnosed and can lead to serious complications if not treated timely. Case presentation: A 44-year-old female presented with a mass in the neck, persisting for six months, without any accompanying symptoms, such as pain or difficulty swallowing. Physical examination revealed a firm 3 x 4 cm mass on the right side of her neck, near the mandible. Doppler ultrasound identified a semi-vascular mass (2.5 x 3.5 cm) at the right carotid bifurcation, further confirmed by contrast-enhanced computed tomography (CECT), indicating vascularity and causing the widening of the carotid arteries. The mass received blood supply from small arterioles stemming from the external carotid artery. Surgical exploration also demonstrated a firm, fibrous mass classified as a grade-2 tumor according to the Shamblin classification. The tumor was successfully excised after cauterizing small arterial branches from the internal and external carotid arteries. Conclusion: The evaluation of this case revealed the significance of early diagnosis and surgical intervention in managing malignant CBTs, as they can lead to serious complications. A multidisciplinary approach that includes imaging and surgical expertise is crucial for successful outcomes.

https://journal.razavihospital.ir/article_118599_49757c5c1794ebdc0d55bf09839fda7d.pdf