Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 14 2 2026 04 01 Clinical Outcomes of Antibiotic-Impregnated Cement Spacers in the Treatment of Infected Total Hip Arthroplasty: A Pilot Randomized Clinical Trial 1 11 118620 10.30483/rjm.2026.254685.1455 EN Ismaeil Garivani Assistant Professor, Department of Orthopedic Surgery, School of Medicine, North Khorasan University of Medical Sciences Reza Ganji Associated Professor, Department of Orthopedic Surgery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran Mohamad Amin Younessi Heravi Assistant Professor, Department of Medical Physics and Radiology, School of Allied Medical Sciences, North Khorasan University of Medical Sciences, Bojnurd, Iran 0000-0002-7960-3095 Journal Article 2025 11 13 Background: Two-stage revision arthroplasty remains the gold standard for managing periprosthetic joint infection (PJI) following total hip arthroplasty (THA) and involves temporary implantation of an antibiotic-loaded cement spacer. Objective: This pilot randomized clinical trial aimed to compare silicone mold–based articulating spacers with commercially prefabricated spacers regarding infection eradication and functional outcomes in patients with infected THA. Methods: Fourteen patients diagnosed with infected THA were randomly assigned to receive either a prefabricated spacer (control group) or a silicone mold–based spacer (intervention group). Clinical outcomes were assessed using the Hip Osteoarthritis Outcome Score (HOOS) before spacer implantation and six weeks after the first-stage revision. Functional improvement was evaluated using gain score analysis. Statistical analyses were performed using SPSS, with p < 0.05 considered statistically significant. Results: Infection eradication was achieved in all patients in both groups. In both groups, after surgery, there were significant differences in HOOS (p < 0.001) compared with before surgery. Mean HOOS improved significantly after surgery in the control group (from 49.60 ± 9.79 to 71.60 ± 4.72) and in the intervention group (from 48.52 ± 8.64 to 69.67 ± 3.77). Gain score analysis showed no statistically significant difference between groups (p = 0.77). Conclusion: Silicone mold–based spacers demonstrated clinical and infection-control outcomes comparable to those of prefabricated spacers. Given their lower cost and ease of fabrication, silicone mold–based spacers may serve as a practical and cost-effective alternative, particularly in resource-limited settings.

https://journal.razavihospital.ir/article_118620_3cb2f8f7e34d047fe24047216cecd1fe.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 14 2 2026 04 01 Neuroprotective Effects of Morin Against Acrylamide-Induced Cytotoxicity in PC12 Cells 12 23 118618 10.30483/rjm.2026.254683.1453 EN Shabnam Shahsavand Department of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran Simin Joharinia North Khorasan University of Medical Sciences, Bojnurd, Iran Iraj Javadi Department of Toxicology, Shahreza Branch, Islamic Azad University, Shahreza, Iran 0000-0002-9697-2343 Reza Ghasemi Department of Cardiology, School of Medicine, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran 0000-0002-0846-7292 Atefeh Shirinzadeh Feizabadi Department of Anesthesiology, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran Journal Article 2025 10 20 Background: Acrylamide (ACR) is widely used in industry and is also formed in carbohydrate-rich foods during high-temperature cooking processes. The neurotoxicity of ACR in humans and animals is well established, and multiple mechanisms have been proposed to mediate its toxic effects. Among these, oxidative stress and apoptosis pathways have gained considerable attention in recent years. Morin, a bioactive flavonoid found in mulberry, has demonstrated neuroprotective properties, particularly due to its antioxidant and anti-apoptotic activities. Objective: The present study aimed to evaluate ACR-induced neurotoxicity and the potential protective effects of morin in an in vitro model using PC12 cells. Methods: PC12 cells were pretreated with various concentrations of morin (25–400 µM) for 24 hours, followed by exposure to ACR (4.5 mM, IC₅₀ value) for another 24 hours. Cell viability was assessed by MTT assay. Apoptosis was evaluated by flow cytometry using the Sub-G1 peak method, and intracellular reactive oxygen species (ROS) levels were measured using DCF-DA. Results: ACR induced cytotoxicity in a concentration-dependent manner (IC₅₀ = 4.5 mM) and significantly increased both apoptotic cell percentage (to 21.25 ± 1.32%; p < 0.001) and ROS levels (p < 0.001) compared to control. Pretreatment with morin significantly attenuated ACR-induced cytotoxicity in a concentration-dependent manner (p < 0.001), reduced apoptosis (to 5.17 ± 0.86%; p < 0.001), and decreased ROS production (p < 0.001). Morin alone showed no cytotoxicity and reduced basal ROS levels (p < 0.001). Conclusion: Oxidative stress and apoptosis play key roles in ACR-induced neurotoxicity. Morin exerts neuroprotective effects by reducing intracellular ROS production and, consequently, lowering apoptosis levels, thereby significantly mitigating ACR-induced neuronal damage.

https://journal.razavihospital.ir/article_118618_fec76061d47d716d375d55cb87790194.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 14 2 2026 04 01 Comparison of Systemic Inflammatory Response Markers Derived from Complete Blood Count between Women with Preeclampsia and Healthy Pregnant Women 24 32 118612 10.30483/rjm.2025.254646.1419 EN Reihane Ashkaninia Innovative Medical Research Center, MMS.C., Islamic Azad ‎University, Mashhad, Iran 0009-0002-0119-4372 Sajad Moosavi Innovative Medical Research Center, MMS.C., Islamic Azad ‎University, Mashhad, Iran 0009-0002-8053-5445 Negar Javdan Innovative Medical Research Center, MMS.C., Islamic Azad ‎University, Mashhad, Iran 0000-0002-5438-5255 Zahra Mohsenian Department of obstetrics and gynecology, MMS.C., Islamic Azad University, Mashhad, Iran Journal Article 2025 05 13 Background: Preeclampsia is a significant pregnancy complication with an underlying inflammatory basis, typically occurring after the 20th week of gestation and associated with increased maternal and fetal risks. Identifying simple and effective markers for its prediction and monitoring can play an important role in early diagnosis and effective management of the condition. Objectives: This study aimed to compare systemic inflammatory response markers derived from complete blood count between women with preeclampsia and normotensive pregnant women. Methods: In this case-control study, 324 pregnant women, including 162 with preeclampsia and 162 healthy pregnant women, were evaluated. The CBC indices were calculated from the first blood sample obtained at hospital admission and compared between the two groups and between the subgroups of non-severe and severe preeclampsia. Statistical analyses were applied to examine correlations by using SPSS version 20. Results: This study demonstrated statistically significant differences in NLR, PLR, and SII indices between women with preeclampsia and healthy pregnant women, whereas the MLR index did not differ significantly. In the comparison between non-severe and severe preeclampsia subgroups, only NLR and MLR showed statistically significant differences. Conclusion: The findings of this study suggest that specific inflammatory indices derived from complete blood count may play an important role in the diagnosis and assessment of preeclampsia severity. These indices are simple, accessible, and cost-effective, and can serve as complementary tools alongside standard clinical and laboratory criteria to support early diagnosis and optimal patient management.

https://journal.razavihospital.ir/article_118612_aa63e6a971d3402d91aa68c904081d35.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 14 2 2026 04 01 Coronary Slow Flow Phenomenon: A Single-Center Analysis of Prevalence and Risk Factors 33 39 118619 10.30483/rjm.2026.254680.1450 EN Nafise Lagzian Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Bahram Shahri Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Morteza Manavifar Department of Cardiology, Mashhad Medical Sciences Branch, Islamic Azad University, Mashhad, Iran Fateme Alikhani Department of Cardiology, Mashhad Medical Sciences Branch, Islamic Azad University, Mashhad, Iran Journal Article 2025 10 16 Background: Coronary slow flow phenomenon (CSFP) is a syndrome characterized by delayed progression of the injected contrast through the epicardial coronary arteries, in the absence of significant stenosis. It is associated with myocardial ischemia, life-threatening arrhythmias, sudden cardiac death, and recurrent acute coronary syndromes. Objective: This study aimed to determine the prevalence of CSFP and its risk factors. Methods: This cross-sectional study was conducted on all patients undergoing diagnostic coronary angiography because of clinical suspicion of cardiovascular disease in Mashhad Ghaem Hospital from March 2019 to March 2020. The individual information checklist was completed, and the diagnosis of the CSFP was made on the basis of corrected TIMI frame count > 27 frames. Results: In the present study, among 1112 patients undergoing coronary angiography, 7.5% had the criteria of CSFP. Statistical tests indicated a significant association between male sex and smoking (p-value < 0.05) with CSFP. The association between hypertension and CSFP was not significant in univariate analysis but became significant after adjustment. Factors such as age, diabetes mellitus, hyperlipidemia, and family history of heart disease had no significant difference between patients with and without CSFP. Conclusion: Coronary slow flow phenomenon is not an uncommon finding during diagnostic coronary angiography. The observed associations with modifiable risk factors, particularly smoking and hypertension, suggest that attention to risk factor modification may be beneficial in patients with CSFP and should be considered in clinical practice.

https://journal.razavihospital.ir/article_118619_03b5f76384df11479a886380ad85180c.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 14 2 2026 04 01 A Comparative Analysis of Short-term Clinical Outcomes Between Laparoscopic and Open Surgical Approaches in the Sigmoid Colon Cancer 40 45 118617 10.30483/rjm.2026.254655.1428 EN Sahar Nemani Neman Innovative Medical Research Center, MMS.C., Islamic Azad University, Mashhad, Iran 0009-0000-0343-147X Tooraj Zandbaf Department of General Surgery, MMS.C., Islamic Azad University, Mashhad, Iran 0000-0002-4882-5058 Hanie Gholami Students Research Committee, MMS.C., Islamic Azad University, Mashhad, Iran 0009-0006-3821-8445 Mohammad Javad Ghamari Department of General Surgery, MMS.C., Islamic Azad University, Mashhad, Iran 0000-0002-0351-6219 Journal Article 2025 09 20 Background: Sigmoid cancer is prevalent and responsible for over 10% of cancer-related deaths. The primary treatment is surgical resection of the colon and affected lymph nodes, done via open or laparoscopic surgery. Objective: This study aimed to investigate short-term clinical outcomes between laparoscopic and open surgical approaches for sigmoid colon cancer. Methods: This cross-sectional study involved 90 patients with sigmoid cancer, comprising 44 patients in the open surgery group and 46 in the laparoscopic group. Demographic information, surgery duration, length of hospital stay, duration of NPO after surgery, postoperative infections, anastomotic leaks, and pathological results of excised lymph nodes were collected. IBM SPSS version 20 was utilized for the analysis. Results: Our study included 90 patients (37 women, 53 men) with an average age of 59.93±8.60 years. The open surgery group consisted of 44 patients, while the laparoscopic surgery group comprised 46 patients. The results indicated that laparoscopic surgery was more effective at resecting more lymph nodes, resulting in shorter hospital stays and shorter fasting (NPO) times than open surgery. (P-value<0.005). Conclusion: Laparoscopic surgery is a safe, reliable, and secure option for patients with sigmoid cancer, as this technique not only minimizes the length of hospitalization but also results in improved outcomes and expedited patient recovery.

https://journal.razavihospital.ir/article_118617_a7e95fc38085fb3e8f1c1b2b17dee29d.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 14 2 2026 04 01 The Relationship between Resilience and Mental Health in Pregnant Women: A Cross-Sectional Study in Eastern Iran 46 53 118616 10.30483/rjm.2025.254631.1424 EN Hamideh Yazdimoghaddam Iranian Research Center on Healthy Aging, Operating Room Department, Faculty of Paramedics, Sabzevar University of Medical Sciences, Sabzevar, Iran Mahbubeh Abdollahi PhD in Biostatistic, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran Elahe Jesmani Master of Midwifery, School of Nursing and Midwifery, Mashhad university of medical sciences, Mashhad, Fatemeh Zahra Karimi Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran Journal Article 2025 08 22 Background: Pregnancy represents a particularly vulnerable phase in a woman's life. Evaluating resilience during this period is essential for understanding how expectant mothers adapt to potentially high-risk situations. Objective: Examining the association between resilience and mental health among pregnant women. Methods: In this cross-sectional analysis, 205 pregnant women visiting healthcare centers participated. Participants completed a demographic questionnaire, the Connor-Davidson Resilience Scale (CD-RISC), and the Mental Health Inventory, both of which are previously validated instruments. Data were analyzed using SPSS software (version 21) with descriptive statistics, independent t-tests, and Pearson's correlation coefficient, adopting a significance level of p < 0.05. Results: The average scores (mean ± SD) were 92.75 ± 16.36 for resilience, 55.74 ± 8.51 for psychological well-being, and 34.68 ± 9.59 for psychological distress. Analysis revealed a significant positive correlation between resilience and psychological well-being (r = 0.55, p < 0.001) and a significant negative correlation between resilience and psychological distress (r = -0.29, p < 0.001). Conclusion: Resilience acts as a protective psychological factor, significantly contributing to the mental health of pregnant women. Implementing educational programs to build resilience skills is therefore recommended for this population.

https://journal.razavihospital.ir/article_118616_286face921923c2b81566a8e6a96f265.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 14 2 2026 04 01 Comparison of Complex Regional Pain Syndrome Prevalence Between WALANT and Regional Anesthesia in Distal Radius Fracture Surgery 54 63 118621 10.30483/rjm.2026.254684.1454 EN Saber Barazandeh Rad Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Babak Toloue Ghamari Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mehrdad Sadighi Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Amir Sabaghzadeh Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Farsad Biglari Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Meisam Jafari Kafiabadi Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0003-4869-0998 Mohammad Akhbari Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Adel Ebrahimpour Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Journal Article 2025 12 21 Background: Distal radius fractures are among the most common skeletal injuries that require surgical intervention. This study compares the Wide-Awake Local Anesthesia No Tourniquet (WALANT) technique with regional anesthesia with respect to surgical outcomes and the incidence of complex regional pain syndrome (CRPS). Objective: This study aimed to compare the Wide-Awake Local Anaesthesia No Tourniquet (WALANT) technique with regional anaesthesia in patients undergoing distal radius fracture surgery. Specifically, it evaluated differences in surgical outcomes, including intraoperative blood loss, duration of surgery, postoperative pain, and changes in haemoglobin, and assessed the incidence of complex regional pain syndrome (CRPS) between the two groups. The findings were intended to inform clinical decision-making regarding anaesthesia selection for this common orthopaedic procedure. Methods: In this Non-Randomized Clinical Trial, 59 patients with distal radius fractures were divided into two groups: 30 received WALANT, and 29 received regional anesthesia. Outcomes assessed included intraoperative blood loss, hemoglobin drop, postoperative pain (VAS score), surgery duration, and CRPS incidence. Results: Blood loss was higher in the WALANT group (147 mL, SD = 29) compared to the regional anesthesia group (121 mL, SD = 39; p = 0.005). Hemoglobin drop was similar between groups (1.3 g/dL, SD = 2.2 vs. 1.0 g/dL, SD = 0.2; p = 0.574). Postoperative pain scores showed no significant difference (1.60, SD = 1.16 vs. 1.07, SD = 0.80; p = 0.081). Surgery duration was significantly shorter in the WALANT group (138 min, SD = 33 vs. 157 min, SD = 24; p = 0.022). CRPS incidence was lower in the WALANT group (30%) than in the regional anesthesia group (37.9%), but the difference was not statistically significant (p = 0.52). Conclusion: Both WALANT and regional anesthesia are safe and effective for distal radius fracture surgery. WALANT offers a shorter surgical time and eliminates the need for a tourniquet, despite higher blood loss. It may be a viable and efficient alternative.

https://journal.razavihospital.ir/article_118621_f1e1218c9205cc27662a7977533796aa.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 14 2 2026 04 01 A Rare Case of Spontaneous Hepatic Rupture Secondary to a Solitary Necrotic Nodule of the Liver in a Pregnant Woman; Never Put off the Action Until Tomorrow 64 68 118614 10.30483/rjm.2025.118614 EN Soosan Nazari Department of Obstetrics and Gynecology, Razavi Hospital, Imam Reza International University, Mashhad, Iran Azam Sabri Bonhangi Department of Anesthesiology, Razavi Hospital, Imam Reza International University, Iran Ghazaleh Khademian Department of Anesthesiology, Razavi Hospital, Imam Reza International University, Iran 0009-0007-2887-3136 Benyamin Fazli Department of Anesthesiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran 0000-0002-6952-9020 Shirin Sadri Department of Obstetrics and Gynecology, Maternity Division, Gloucester Royal Hospital, Gloucester, United Kingdom Journal Article 2025 08 17 Background: Spontaneous hepatic rupture (SHR) in pregnancy is a rare and life-threatening event that causes a high burden of maternal and perinatal mortality. Herein, we describe a pregnant woman with a perplexing manifestation that results in maternal mortality followed by SHR. Case Presentation: A 37-year-old woman at 38 weeks of gestational age, complaining of continuous and worsening epigastric pain with intermittent vomiting, was admitted to the emergency department. Regarding the abdominal pain's unexplained nature, some paraclinical findings, such as deceleration in fetal heart rate and breech presentation, led to the emergent cesarean section being scheduled. After the baby's birth, a massive hemorrhage originating from the Glisson capsule, hepatic right lobe, and the partial section of the left hepatic lobe were seen. Unfortunately, the surgical intervention can not manage the patient at the end of the surgery. Conclusion: The multidisciplinary approach and aggressive intervention of SHR patients may heighten the chance of survival, especially in pregnant women.

https://journal.razavihospital.ir/article_118614_863f45eeaf3175eb9073fee8399db865.pdf