Ali Mostafaie

Tabriz University of Medical Sciences, Tebriz, East Azarbaijan, Iran

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Publications (6)1.51 Total impact

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    ABSTRACT: Abstract: Introduction: Green light photo selective vaporization of the prostate (PVP) is a minimally invasive method of treatment for clinical benign prostatic hyperplasia with fewer side effects. The aim of this study is to evaluate the safety, effectiveness and cost analysis of PVP compared with transurethral resection of prostate. Methods: A systematic search was done in Cochrane, TRIP database, MEDLINE, NHS EED, NIHR HTA, CRD, Health star database, Pro Quest, Psycoinfo and Google Scholar to find randomized control trials, systematic reviews and HTA reports. The searched keywords were Green light laser (PVP or KTP) and prostate. The cost analysis was done by the perspective of society and providers. Results: Complication rate in 12 included evidences ranged from 0-9.3%. The complication rate of TUR-P (Transurethral Resection of Prostate) was more than PVP. Changing in flow rate reducing residual urine, improving patients’ symptoms and QOL (Quality of life), and operative outcome length of operation varied from no significant to significant differences in favor of TURP. Unit cost in both social and provider view was significantly high in PVP in comparison with TURP. Increasing the number of patients did not change the cost analysis. Conclusion: PVP is a safe method for treatment of clinical BPH, but there is a lack of evidence for the evaluation of effectiveness. Overall, the unit cost for PVP was significantly more than TURP; for this reason this method could not be conducted in very wide indications, because of high cost. Keyword: laser vaporization; ablation techniques; health technology assessment; benign prostatic hyperplasia.
    journal of Lasers in Medical Sciences. 10/2012; 2:153.
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    ABSTRACT: Rationale, aims and objectives  One of the main barriers against the implementation of evidence-based medicine (EBM) is the lack of search skills, an element that affects the finding of the best available evidence. Faculty staff should be capable of using the best evidence in practice and of teaching students to implement EBM elements. They should be familiar with search strategies and evidence databases. The aim of this study is to compare the application of evidence databases by faculties and by residents with no training in this field. Methods  Two hundred fifty-seven faculties and first-year residents of the Tabriz University of Medical Sciences filled out a valid self-administered questionnaire on information-seeking behaviour from August 2008 to June 2010. A chi-square test was used to compare the variables. Results  There were 52.1% of the respondents who were faculty members and 47.9% were residents. Only 8.7% used the Internet for their practice mostly. While Google was the most used resource, TRIP and Cochrane were less used. Significantly, the faculties used these resources more than the residents in both cases. Furthermore, two-thirds of the participants were unfamiliar with medical subject headings (MeSH), and only 14.5% consulted a clinical librarian for help. Conclusion  Significantly, clinicians used evidence databases and online resources minimally for their practice. Additionally, as the faculties used EBM resources more than the residents, this programme should be considered for inclusion in the curricula of medical schools.
    Journal of Evaluation in Clinical Practice 02/2012; · 1.51 Impact Factor
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    ABSTRACT: Abstract: Introduction: To compare the efficacy and cost-effectiveness of Femtosecond laser versus mechanical Microkeratome corneal flap creation in correction of refractive errors. Methods: In this review, a comprehensive search of Medline, SCOPUS, Cochrane, TRIP database, supplemented by HTA and economic databases was performed. We searched for randomized controlled trials (RCTs) of Femtosecond laser which included mechanical Microkeratome in other arm. The quality of the retrieved studies was appraised by two independent reviewers and appropriate articles were finalized. Result: A total of 1142 articles were identified, of which, 1059 were excluded after review of the titles and abstracts and 83 articles remained. Systematic reviews and RCTs were evaluated through CASP international worksheet. Eventually, 61 titles were excluded, leaving 22 articles to be reviewed. Safety: There was no individual evidence to cover all safety components about Femtosecond laser, but in summary, this modality seems a safe method for corneal flap creation. Effectiveness: No statistically significant difference was shown in visual acuity and refractive errors. The important secondary end point of this review was diffuse Lamellar keratitis in 17% of the Femtosecond group versus 5% in mechanical Microkeratome. Inflammation was low-grade and improved during the first 3 months of follow-up period with a low dose medication without corneal scarring. The two groups was comparable in all clinical outcomes including Unorrected Visual Acuity (UCVA), Best Special Corrected Visual Acuity (BSCVA), manifest refraction, wave front aberrometry, Schirmer test, and Tear Break up time (TBUT). Cost Analysis : Results showed that marginal cost incurred due to Femtosecond technology adoption may vary from 27 to 117 € (resulted from sensitivity analysis). It is clear that additional cost may be a small proportion of LASIK procedure total cost. Conclusion: Although Femtosecond flap creation is a modern method with a good quality of corneal flap, but, there is no high-quality evidence to show superiority of Femtosecond laser in clinical outcomes. Although the efficacy and cost of the systems is almost equal, traditional method still remains as the standard approach. Keywords: Lasers; Keratomileusis, Laser In Situ; Laser Therapy; Cost Analysis; Evidence-Based Medicine
    Journal of Lasers in Medical Sciences. 11/2011; 2(1):6-11.
  • Sakineh Hajebrahimi, Ali Mostafaie
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    ABSTRACT: The goal of this article is to help develop, disseminate, and evaluate resources that can be used to practice and teach EBM for urology residents and continuing education of urologists to reduce the gap between research and clinical practice. Urology departments should build capacity for residents to shape the future of quality and safety in healthcare through translating evidence into practice. Cutting edge approaches require knowing how to teach Evidence-based urology, to make Bio-statistics easy to understanding and how to lead improvement at every level. The authors shared their experience about 'what works' in a surgical department to building an Evidence-based environment and high quality of cares.
    Indian Journal of Urology 10/2011; 27(4):490-3.
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    ABSTRACT: The quality of the evidence is a keystone in the understanding of Evidence Based Medicine. Randomized controlled trials (RCTs) rank first among the research designs providing clinical evidence. Knowing about the design of clinical trials is not only the cornerstone of clinical research, but also is a requirement for any clinician who wants to learn about new findings of clinical research in his/her field. Many clinicians have good understanding as well as some misunderstandings about the design of clinical trials. This article is going to provide some crucial comments to be considered in conducting RCTs in order to help in production of better evidence for future of urology research through RCTs.
    Indian Journal of Urology 10/2011; 27(4):494-7.
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    Journal of Lasers in Medical Sciences. 01/2011; 2(1):36-42.