Amir Pirooz’s research while affiliated with Guilan University of Medical Sciences and other places

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Publications (7)


The study flowchart.
Comparison of clinical findings at baseline, 2, 4, 8, and 12 weeks of follow-up in the PEG and ZS groups using the general linear model. (a) Number of defecation; The upper curve, representing the ZS group, shows an increase in the frequency of defecation with a much faster course. (b) Fecal encopresis; The lower curve representing the ZS group shows a decrease in the frequency of fecal encopresis over time, but the upper curve shows an increasing trend despite a good decrease in the first 4 weeks. (c) VAS pain score; The lower curve that represents the ZS group indicates a significant decrease over time. (d) Fecal consistency; The difference between the two groups is not statistically significant.
Comparison of the medication adherence based on the 4-item Morisky scale at 2, 4, 8, and 12 weeks of follow-up in the PEG and ZS groups.
Comparison of Ziziphus jujube Mill. Syrup versus polyethylene glycol in children with functional constipation: a randomized clinical trial
  • Article
  • Full-text available

January 2025

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2 Reads

Fatemeh Keihanian

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Shohreh Maleknejad

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Amir Pirooz

Functional constipation is a common disorder of the gastrointestinal tract in children without specific treatment. Ziziphus jujuba has been used in traditional medicine for various diseases such as constipation. A safe and inexpensive treatment with few side effects can be used as an effective alternative to current medications. In this study, we sought to compare Ziziphus jujuba syrup (ZS) with polyethylene glycol (PEG) for the treatment of pediatric functional constipation. A double-blind, randomized clinical trial was performed on children aged 2–10 years with functional constipation who were referred to the gastroenterology clinic of the 17-Shahrivar Hospital in Rasht, Iran. Eligible patients were randomized into two groups: PEG group; 1–5 cc/kg/day (40% w/v solution without electrolytes; average dose: 0.2–1 g/kg), and ZS group; 1–5 cc/kg/day (average dose: 5–25 mg/kg). All patients were followed up for three months, every 2 weeks in the first month, and then monthly for 2 months. At the beginning and end of the study, liver and kidney function tests and blood sugar levels were checked. Data were analyzed using SPSS software version 19 at a significance level of 0.05. Out of 90 eligible children, 32 patients in the PEG group and 30 patients in the ZS group completed the follow-up visits. The mean age of the subjects was 4.31 ± 1.97 years. There was no significant difference between the two groups in terms of age (P = 0.181), gender (P = 0.218), age at onset of constipation (P = 0.083), and weight (P = 0.199). The average therapeutic response score in the ZS group improved prominently compared to the PEG group (P < 0.05). The average number of encopresis and visual analog scale pain scores significantly decreased in the ZS group compared to the PEG group (P < 0.05). Other indices, including frequency of defecation, and medication adherence in the ZS group were significantly improved compared to the PEG group (P < 0.05). Only in the PEG group, a few cases reported self-limiting side effects. ZS can be a treatment choice for functional constipation without any adverse events or liver or kidney injury in children. However, further studies are necessary to find potential side effects. Supplementary Information The online version contains supplementary material available at 10.1038/s41598-025-85801-w.

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Patient selection.
Potassium permanganate in treatment of diabetic foot ulcer: A randomized clinical trial

April 2024

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64 Reads

Background and Aims Diabetic foot ulcers (DFU) are a severe complication in diabetes patients, often resulting in significant morbidity and mortality due to non‐healing. This study investigated the effectiveness of 5% topical potassium permanganate on these ulcers. Methods A clinical trial was conducted on 23 patients with Wagner grade I and II DFU. Patients in the control group received standard treatment, while those in the intervention group also received 5% potassium permanganate topically. Data were recorded at 0, 7, 14, and 21 days for analysis. Results Among 23 patients studied, 7 (30.4%) were male and 16 (43.7%) female, with an average age of 59 ± 4 years. Both groups showed a statistically significant decrease in wound size and infection over time (p < 0.001). The intervention group, however, had a more substantial reduction in wound size and infection rate (p < 0.05). Conclusion Potassium permanganate, when applied topically, is both well‐tolerated and effective in enhancing wound healing and reducing infection in DFU, suggesting its potential as a complementary treatment.


Knowledge, attitude, and sources of information towards burn first aid among people referred to a burn centre in the north of Iran

August 2023

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61 Reads

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5 Citations

Optimal management of burns begins with first aid from the first hours of injury. Adequate knowledge of how to perform first aid for burns can reduce the consequences of injury. Therefore, this study aims to determine the knowledge, attitude, and sources of information assessment towards burn First aid among people referred to a burn centre in the north of Iran. A questionnaire-based survey was conducted to assess knowledge, attitude, and sources of information towards burn first aid among people referred to a burn centre in the north of Iran in 2023. In this survey, a convenience sampling method was adopted. The variables consisted of four items on socio-demographic information, 15 items on knowledge, ten items on attitude, and one item on sources of information related to burn First aid. A total of 371 individuals responded to the survey. The mean age of participants was 31.90 ± 8.49 years old. The mean score of the total knowledge of the participants in the research was 6.04 ± 3.05. There was a statistically significant relationship between the variables of age, sex, marital status, place of residence, level of education, and history of receiving first aid training with the participants' knowledge level. The average score of the total attitude of the participants was 44.08 ± 3.88. Out of 371 participants, 214 people (57.7%) had an average attitude, and 157 people (42.3%) had a good attitude towards burn first aid. There was a statistically significant relationship between place of residence, level of education, and history of receiving first aid training with the participants' attitudes in the research. In addition, the level of knowledge had a statistically significant relationship with the participants' attitude level in the research (p-value <0.001). The majority of participants have limited knowledge of burn first aid. This lack of knowledge could lead to severe consequences. Therefore, healthcare organizations should review and promote consistent guidelines for burn first aid to tackle and minimize the effect of this grave injury.


Epidemiology of work-related burn injuries: A ten-year retrospective study of 429 patients at a referral burn centre in the north of Iran

May 2023

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81 Reads

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14 Citations

Work-related burns can have a destructive impact; however, knowledge of the epidemiology of work-related burn injuries in Iran is limited. This study aimed to describe epidemiological characteristics of work-related burn injuries in a burn centre in the north of Iran. This study was a retrospective single-centre study of the medical records of work-related burns between 2011 and 2020. Data collection was done using the hospital information system (HIS). The data were analysed by using descriptive statistical methods and SPSS 24.0 soft�ware. Of the 9220 cases treated in the burn centre, 429 (4.65%) had work�related burns. There was an increasing trend of work-related burns during the ten years. The mean age of patients was 37.53 (SD = 13.72). Most patients were male (n = 377, 87.9%), with a male-to-female ratio of 7.25/1. The mean total body surface area burn was 23.39% (SD = 20.03). Most work-related burns occurred in the summer season (46.9%, n = 201), and the upper limb was the most common anatomical site of burns (n = 123, 28.7%). The most common mechanism of injury was fire & flames (266, 62.0%). Inhalation injury was observed in 52 (12.1%) patients, and mechanical ventilation was undertaken in 71 (16.6%) patients. The mean length of stay in the hospital was 10.38 (SD = 10.37) days, and the overall mortality rate was 11.2%. The most common activities associated with burns at the time of the incidents were food preparation and serving related (108, 25.2%), followed by welders (n = 71, 16.6%) and electricians (n = 61, 14.2%). This research is the basis for evaluating work-related burns and identifying the causes of these injuries to develop education and prevention programmes, especially for young male workers.


Incidence rate and risk factors of surgical wound infection in general surgery patients: A cross-sectional study

March 2023

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89 Reads

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12 Citations

Hospital-acquired infections (HAIs) are considered a major challenge in health care systems. One of the main HAIs, playing an important role in increased morbidity and mortality, is surgical wound infection. Therefore, this study aimed to determine the incidence rate and risk factors of surgical wound infection in general surgery patients. This cross-sectional study was performed on 506 patients undergoing general surgery at Razi hospital in Rasht from 2019 to 2020. Bacterial isolates, antibiotic susceptibility pattern, antibiotic administration, and its type, operation duration and shift, the urgency of surgery, people involved in changing dressings, length of hospitalisation, and levels of haemoglobin, albumin, and white blood cells after surgery were assessed. The frequency of surgical wound infection and its association with patient characteristics and laboratory results were evaluated. The SPSS software package (version 16.0, SPSS Inc., Chicago, IL, USA) was used to analyse the data. Quantitative and qualitative variables were presented using mean (standard deviation) and number (percentage). The Shapiro-Wilk test was used to evaluate the normality of the data in this study. The data did not have a normal distribution. Hence, χ2 and Fisher's exact tests were used to evaluate the relationship between variables. Surgical wound infection occurred in 4.7% (24 cases) of patients with a mean age of 59.34 (SD = 14.61) years. Preoperative (>3 days) and postoperative (>7 days) hospitalisation, history of immunodeficiency (P < 0.001), and interns responsible for changing dressings (P = 0.021) were associated with surgical wound infection incidence. About 9.5% and 4.4% of surgical wound infection cases were significantly associated with pre- and postoperative antibiotic use. Gram-positive cocci were the most prevalent strains isolated from 24 surgical wound infection cases (15/24, 62.5%). Among these, Staphylococcus aureus was the predominant species, followed by coagulase-negative staphylococci. In addition, the most common Gram-negative isolates identified were Escherichia coli bacteria. Overall, administration of antibiotics, emergency surgery, surgery duration, and levels of white blood cells and creatinine were identified as surgical wound infection-associated risk factors. Identifying important risk factors could help control or prevent surgical wound infections.


Fig. 3. Schematic view of normal anatomy of duodenal folded mucosal layer (A) and unfolded mucosal layer after unfolding Gilan maneuver (B).
Duodenal dislodgement of an ingested sharp foreign body by mucosal unfolding “Gilan maneuver”; A novel surgical approach

December 2021

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26 Reads

International Journal of Surgery Case Reports

Introduction and importance Foreign body (FB) ingestion is a common challenge for pediatric health care providers globally. Although endoscopic approach for FB extraction is recommended, surgery remains life giving specifically in developing countries. We presented a novel surgical approach called ‘Gilan maneuver’ for removal of FB which lodged in duodenal loop. Case presentation An eighteen months old male infant referred to emergency department while he lied on his mother's arm. Parents stated their son has ingested a sharp metallic pointy thick needle which applies for cattle injection. On examination mid epigastric tenderness was remarkable. Laboratory finding was normal. Plain thoracoabdominal radiologic study confirmed the diagnosis. Patient underwent explorative laparotomy and the needle was removed through ‘Gilan maneuver’ in which mucosal unfolding of duodenal loop facilitated dislodgement of the FB and it was extracted on the jujenal side. Clinical discussion Duodenal lodge of sharp FB is rare and could be masked by gastric deposition diagnosis. Mucosal folding, narrow luminal diameter, retroperitoneal adherence, and hard surgical anatomy of the duodenal loop make both sharp and large FBs spontaneous dislodgement and favorable surgical outcome relatively unanticipated. Conclusion Despite rarity of duodenal deposition of FB it is possible and could be harmful due to adjacent unforgiving organs. Although endoscopic extraction of FB is generally recommended in guidelines, surgical approach is safe and could be considered.

Citations (4)


... Symptoms typically include abdominal distension, which may be accompanied by a palpable mass or pain [1,4]. Diagnosis can be challenging, often requiring multiple imaging modalities [4,5]. The report presents a case of a patient with a large omental lymphangioma, in which contrast-enhanced computed tomography (CT) was effective in localizing the lesion. ...

Reference:

Utilizing Contrast-Enhanced Computed Tomography for Accurate Localization of an Omental Lymphangioma: A Case Report
Abdominal Lymphatic Malformation Misdiagnosed as Ascites: A Case Report and Review of Literature

Turkish Archives of Pediatrics

... The results of this study highlighted the importance of designated nurses in educating patients about burns and their treatment because most of studied patients had only an elementary school education and little knowledge of other sources (e.g., mass media). the overall mean score for first aid knowledge for burn patients as (Tolouei et al., 2024) reported that there was a statistically significant difference between the variables of age, sex, marital status, place of residence, level of education, and history of receiving first aid training with the participants' knowledge level and that was in same line with current study. ...

Knowledge, attitude, and sources of information towards burn first aid among people referred to a burn centre in the north of Iran
  • Citing Article
  • August 2023

... Burn injuries represent a significant global health challenge, with millions of cases annually leading to substantial morbidity and mortality [1][2][3][4][5][6][7][8][9][10][11][12][13]. These injuries can result from exposure to thermal, chemical, electrical, or radiation sources, causing extensive tissue damage and affecting essential physiological functions [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. Burn injuries are classified based on the depth and extent of tissue involvement, ranging from superficial partial-thickness burns to deep full-thickness burns, with the latter posing significant risks of morbidity and mortality [31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49]. ...

Epidemiology of work-related burn injuries: A ten-year retrospective study of 429 patients at a referral burn centre in the north of Iran

... Currently, the rising number of surgical procedures has elevated SSIs to a critical public health issue (3). The global incidence of SSI is 2.5% (4). ...

Incidence rate and risk factors of surgical wound infection in general surgery patients: A cross-sectional study