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Articles by Hadi Mirfazaelian
Total Records ( 3 ) for Hadi Mirfazaelian
  Hadi Mirfazaelian , Shekoufeh Nikfar , Saeed Derakhshani and Mohammad Abdollahi
  Anal fistula is an abnormal connection between the anal or rectal lumen and perianal skin that reduce quality of life. There are various surgical options for treatment with variable success rate. A novel treatment is to seal the fistula tract using biomaterials (fibrin glue and fibrin plug). Objective of this study was to evaluate the healing efficacy and incontinence rate of biomaterials (fibrin glue and fibrin plug) in comparison to surgical interventions in the treatment of cryptoglandular perianal fistula using meta-analysis of randomized controlled trials. PubMed, Scopus, Google Scholar and Web of Science were searched for clinical trial studies investigated the effects of biomaterials in the treatment of fistula-in-ano. Studies on patient with anal fistulae underwent fibrin glue, fibrin plug or other biomaterials application and surgical management for healing of fistula were included. Clinical response and incontinence were the key outcomes of interest. Six randomized placebo-controlled clinical trials consisting 315 patients in various arms met our criteria (comparing biomaterial with surgical interventions) and were included in the analysis. Pooling of data showed that effectiveness of biomaterials in comparison to surgical interventions was non-significant with relative risk (RR) of 0.73 (95% CI of 0.31-0.89, p = 0.096). The incontinence rate RR in biomaterials and intervention was also non significant with RR of 0.35 (95% CI = 0.05-2.28, p = 0.27). The included clinical trials had different follow-up durations, causes of fistula and method of intervention in treated patients. This meta-analysis demonstrates that the effectiveness and incontinence rate of biomaterials and conservative treatment is not significantly different.
  Hadi Mirfazaelian , Shekoufeh Nikfar , Mohammad-Amin Rezvanfar and Mohammad Abdollahi
  The present study is a meta-analysis of clinical studies evaluating the efficacy of Fresh Frozen Plasma (FFP) in the treatment of organophosphorus (OP) poisoning. PubMed, Scopus, Google Scholar and clinicaltials.gov were searched for studies investigating the effects of FFP in the treatment of OP poisoning. Mortality, intermediate syndrome (IMS) and hospital stay duration were the key outcomes of interest. Data were searched in the time period of 1966 through April 2014. Three studies that met our inclusion criteria were included in the analysis. Pooling of data showed that the Relative Risk (RR) of mortality in OP poisoning for three included trials comparing FFP to placebo was 0.77 (95% CI = 0.28 to 2.07 (P = 0.6)). The summary of RR for IMS in 2 studies was 0.74 with 95% CI = 0.05 to 10.99 (P = 0.83). The summary of a standard effect for the hospital stay duration in OP poisoning for two trials comparing FFP with placebo was -0.37 with 95% CI = -4.68 to 3.94. According to these data, FFP effect on OP poisoning in mortality, hospital stay duration and IMS incidence was not significant.
  Hadi Mirfazaelian , Shekoufeh Nikfar , Amir-Ahmad Salarian and Mohammad Abdollahi
  The present study is a meta-analysis on clinical trials evaluating the efficacy of oximes on organophosphorus (OP) intoxication treatment. PubMed, Scopus, Google Scholar and clinicaltrials.gov were searched for studies investigating the effects of oximes in the treatment of OP poisoning. Mortality, intermediate syndrome, Intensive Care Unit (ICU) admission rate, hospital stay duration and intubation rate were the key outcomes of interest. Data were searched in the time period of 1966 through April 2014. Thirteen studies (eleven clinical trials and two historical cohorts) that met our criteria were included in the analysis. Pooling of data showed that Relative Risk (RR) of need for intubation in OP poisoning for ten included trials comparing oximes with placebo was 1.18 with 95% CI = 0.76 to 1.84 (p = 0.27). RR of the single observational study was 1.57 (95% CI = 0.79 to 3.2, p>0.05). The summary of RR for mortality rate in 11 studies was 1.4 (95% CI = 0.77 to 2.54, p = 0.41) and for two observational studies was 1.19 (95% CI = 0.5 to 2.85, p>0.05). The RR for ICU admission rate in OP poisoning for three trials comparing oximes to placebo was 2.12 with 95% CI = 0.89 to 5.03 (p = 0.09). For the single observational study, RR was 0.81 (95% CI = 0.49 to 1.25, p>0.05). For intermediate syndrome while the RR of only trial comparing oximes with placebo was 1.89 (95% CI = 1.27 to 2.91, p<0.05), for the single observational study, it was 1.43 (95% CI = 0.7 to 2.96, p>0.05). For hospital stay duration (difference), the RR of four studies was 0.75 with 95% CI = -0.51 to 1.99. According to these data, oximes beneficence in OP poisoning is unclear and there is a potential increase in the incidence of intermediate syndrome.
 
 
 
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