Javad Kojuri - Academia.edu (original) (raw)

Papers by Javad Kojuri

DOAJ (DOAJ: Directory of Open Access Journals), Feb 1, 2019

Background: This study aims to evaluate the effect of exercise training on heart rate variability... more Background: This study aims to evaluate the effect of exercise training on heart rate variability (HRV) and to determine the correlation between parameters of HRV and the ejection fraction in patients with heart failure after percutaneous coronary intervention. Material and Methods: Fifty patients with left ventricular ejection fraction ≤ 40% undergone percutaneous coronary intervention were randomly allocated in either an exercise training (ET) group or a control group. The ET group performed exercise training for 45 minutes, three times a week for seven weeks. Patients in both groups received a leaflet for daily exercising at home. HRV parameters comprising, the standard deviation of normal R-R intervals (SDNN), the square root of the mean of the squares of successive R-R intervals differences (RMSSD) ,the percentage of successive R-R intervals differing from more than 50 ms (PNN50), using 24-hour Holter electrocardiographic monitoring was measured. Results: After the intervention, the SDNN improved in the ET group (P=0.002), while changes in all remaining HRV indices were insignificant (P≥0.05). The control group showed no significant changes in any HRV parameters (P≥0.05). Changes in SDNN in the ET group were significantly different from the control group (P=0.003). At baseline, our results revealed a significant weak correlation between ejection fraction and SDNN (r =0.279, P=0.047). However, ejection fraction did not correlate significantly with RMSSD and PNN50. Conclusion: Exercise training is safe and feasible in post percutaneous coronary intervention patients, even in those with reduced ejection fraction. In a seven-week period, exercise training was effective in improving HRV in heart failure patients after percutaneous coronary intervention.

DOAJ (DOAJ: Directory of Open Access Journals), Jul 1, 2015

Background and purpose: Residents across the world spend several hours every week teaching medica... more Background and purpose: Residents across the world spend several hours every week teaching medical students and junior residents. Workshops developed with the aim of improving resident teaching skills are becoming increasingly common in the various fields of medicine. The objectives of this study were to evaluate the effect of a resident-as-teacher educational intervention on the resident's knowledge of medical education. Methods: The study was performed in SUMS, Iran, in 2010-2011 on all the junior residents from the different fields, including 104 men and 66 women. For data collection, a questionnaire (pre-test, posttest) was used with 40 questions on medical education. The data were analyzed using descriptive statistics, tables and t test employing the SPSS software. Results: In total, 120 participants completed the questionnaires. According to the pre-test and post-test results, residents received extremely low scores in different subjects before the course implementation, whereas after it was implemented their scores had significantly increased fairly well. The comparison between the participants, average scores before and after the program indicates that the "resident-as-ateacher, researcher and role model" course has been meaningful and significantly effective in improving their knowledge in this area. Conclusions: A few residency programs had instituted the resident teacher training curricula. A resident teacher training workshop was perceived as beneficial by the residents, and they reported improvement in their teaching skills.

PubMed, Feb 26, 2019

Background: Nitric Oxide (NO) which is synthesized by endothelial Nitric Oxide Synthase (eNOS) in... more Background: Nitric Oxide (NO) which is synthesized by endothelial Nitric Oxide Synthase (eNOS) in both vascular tissues and platelets plays an important role as a protective mediator in the cardiovascular system. It modulates blood pressure, vasodilation and thrombosis. In this regard, eNOS activity and gene expression in platelets and NO levels in patients' plasmas with Coronary Thrombosis (CT) and stenosis diseases were determined. Methods: Blood samples were collected from 60 subjects that where divided into three equal groups [without coronary artery disease, with CT and less than 70% Coronary Stenosis (CS)]. NO concentration in plasma was measured by the Griess reagent system. The eNOS activity was assessed based on a fluorimetric detection system in platelets and the gene expression was quantified by the real time-reverse transcription-polymerase chain reaction. Results: There was a significant decrease in the amount of NO concentration in the plasma of subjects with CT (0.53±0.09 μM, p<0.01) and CS (1.31±0.11 μM, p<0.01) compared to the control group (2.6±0.10 μM). The activity levels of eNOS enzyme were significantly lower in patients' platelets with CT (0.68±0.013 UF/mn, p<0.01) and CS (0.85±0.017 UF/mn, p<0.01) than the control cases (1.29±0.019 UF/mn). These data were consistent with the reduction of the expression levels of eNOS in patients with CT (75 folds) and CS (4 folds) lower than the control cases. Conclusion: Patients with CT and CS possessed reduced eNOS activity and gene expression in their platelets. Decreased plasma concentration of NO in these patients confirmed the potential significance of the diagnostic and prognostic value of NO in the subjects' plasma with vascular disease risk.

PubMed, 2018

Introduction: Clinical reasoning is one of the most important skills in the process of training a... more Introduction: Clinical reasoning is one of the most important skills in the process of training a medical student to become an efficient physician. Assessment of the reasoning skills in a medical school program is important to direct students' learning. One of the tests for measuring the clinical reasoning ability is Clinical Reasoning Problems (CRPs). The major aim of this study is to measure psychometric qualities of CRPs and define correlation between this test and routine MCQ in cardiology department of Shiraz medical school. Methods: This study was a descriptive study conducted on total cardiology residents of Shiraz Medical School. The study population consists of 40 residents in 2014. The routine CRPs and the MCQ tests was designed based on similar objectives and were carried out simultaneously. Reliability, item difficulty, item discrimination, and correlation between each item and the total score of CRPs were all measured by Excel and SPSS software for checking psycometeric CRPs test. Furthermore, we calculated the correlation between CRPs test and MCQ test. The mean differences of CRPs test score between residents' academic year [second, third and fourth year] were also evaluated by Analysis of variances test (One Way ANOVA) using SPSS software (version 20)(α=0.05). Results: The mean and standard deviation of score in CRPs was 10.19 ±3.39 out of 20; in MCQ, it was 13.15±3.81 out of 20. Item difficulty was in the range of 0.27-0.72; item discrimination was 0.30-0.75 with question No.3 being the exception (that was 0.24). The correlation between each item and the total score of CRP was 0.26-0.87; the correlation between CRPs test and MCQ test was 0.68 (p<0.001). The reliability of the CRPs was 0.72 as calculated by using Cronbach's alpha. The mean score of CRPs was different among residents based on their academic year and this difference was statistically significant (p<0.001). Conclusion: The results of this present investigation revealed that CRPs could be reliable test for measuring clinical reasoning in residents. It can be included in cardiology residency assessment programs.

PubMed, Apr 1, 2017

Traumatic injuries to the subclavian-axillary artery, although uncommon, are associated with high... more Traumatic injuries to the subclavian-axillary artery, although uncommon, are associated with high morbidity and mortality rates if not managed promptly. The emergence of endovascular techniques offers an alternative to the surgical management of these injuries. We herein present 4 cases of traumatic subclavian-axillary artery injury with limb ischemia successfully managed via the endovascular approach with non-covered self-expandable stents. We achieved excellent immediate results with limb salvage and without complications. At follow-up by duplex sonography, all the patients had good peripheral pulses and patent revascularized arteries.

PubMed, Apr 1, 2020

Introduction: The internet is an essential and widely used tool for college students; however, hi... more Introduction: The internet is an essential and widely used tool for college students; however, high internet dependency can have negative consequences for students, especially regarding academic careers. Such students may tend to postpone their academic tasks. Hence, the current study examines the effect of Internet addiction on academic procrastination among medical students. Methods: We applied a cross-sectional correlational research design. 233 medical students of Shiraz University of Medical Sciences were selected through convenience sampling and participated in this study. To collect the data, we used two valid and reliable questionnaires. The first was Young's Internet addiction questionnaire (IAT-20), which consists of 20 items based on a 5-point Likert-type scale. The second was Solomon and Rothblum academic procrastination questionnaire, which consists of 18 items based on a 5 point Likert-type scale. We used Pearson correlation, independent T-test, and One-Way ANOVA to analyze the data in SPSS version 22, and considered a significance level of p < 0.05. Results: Results showed that 57.1% of the respondents were females, and the remaining were males. Findings indicated that 8 (3.43%) of the participants were classiﬁed as severe internet-addicted, and 28.85% of them had a high level of academic procrastination. The results indicated that there was a positive and significant correlation between Internet addiction and academic procrastination (r=0.39, with p<0.01). Also, there was a positive correlation between academic procrastination dimensions (writing a term paper, studying for an exam, keeping up with weekly reading assignments, performing administrative tasks, attending meetings and performing academic tasks in general) and Internet addiction (r=0.22, r=0.32, r=0.21, r=0.29, r=0.33, and r=0.23, respectively, with p<0.01). Finally, the results revealed that male students and those living in the dormitory had a higher level of Internet addiction and procrastination compared to female ones and those living at home (p<0.01). Conclusion: The findings of the current research reveal that a considerable number of students have levels of Internet addiction and procrastination; the study highlights that students with high levels of Internet addiction are more likely to be at an increased risk of negative outcomes such as insufﬁciently controlled Internet use.

Advanced Pharmaceutical Bulletin, Aug 29, 2018

Studies have revealed that patients with chronic kidney disease (CKD) are more susceptible to adv... more Studies have revealed that patients with chronic kidney disease (CKD) are more susceptible to adverse effects of percutaneous coronary intervention (PCI). In addition, the role of elevated high sensitive C-reactive protein (hs-CRP) in the prediction of adverse cardiac outcomes after coronary stent implantation has already been shown. Therefore, in this study, we aimed to evaluate the effect of omega-3 supplementation on hs-CRP and 30day major adverse cardiac events (MACE) in patients with CKD undergoing elective PCI. Methods: In this randomized trial, 80 CKD patients who were candidates for elective PCI, were randomly assigned to two groups; the first group received a single dose of omega-3 (2500 mg, 12 h before PCI) as well as the standard drug regimen of PCI and the second group received placebo plus the standard therapy (325 mg loading dose of aspirin, 600 mg loading dose of clopidogrel, and weight-adjusted intravenous heparin). Hs-CRP levels were measured at baseline and 24 h after the intervention as a primary endpoint. The secondary endpoint was the incidence of MACE over a 30-day period after PCI. Results: Omega-3 did not significantly decrease post-PCI serum level of hs-CRP; however, the overall 30-day MACE was significantly lower in the omega-3 group compared to the control group (p=0.05). Conclusion: Our results revealed the positive effect of the omega-3 supplement on decreasing 30-day MACE; hence, omega-3 may be considered as an effective adjunctive therapy to the standard drug regimen used before PCI. The evaluation of the effect of omega-3 on long-term MACE is recommended for future studies.

Ethiopian journal of health sciences, Mar 1, 2021

BACKGROUND፡ Fostering critical thinking (CT) is one of the most important missions in medical edu... more BACKGROUND፡ Fostering critical thinking (CT) is one of the most important missions in medical education. Concept mapping is a method used to plan and create medical care through a diagrammatic representation of patient problems and medical interventions. Concept mapping as a general method can be used to improve CT skills in medical students. The aim of this study was to explore the effect of concept mapping on CT skills of medical students. METHODS: This quasi-experimental study was conducted on 100 second-year medical students which take an anatomy course. Participants were randomly assigned into a control group (lecture-based) and an intervention group (concept mapping). CT levels of medical students were assessed using the California Critical Thinking Skills Test. Data were analyzed using independent sample t-test. RESULTS: Before intervention, CT scores of the intervention and control groups were 6.68 ± 2.55 and 6.64 ±2.74, respectively, and after intervention, they were 11.64 ±2.29 and 10.04 ± 3.11, respectively. Comparison of mean score differences for both groups before and after intervention demonstrated that CT scores in the experimental group significantly increased after intervention (P=0.021). CONCLUSIONS: Medical students who were taught through concept mapping showed an increase in CT scores, compared with those in the control group. Medical students require effective CT skills in order to make sound knowledge-based assessment and treatment choices during patient care. Therefore, instructors and planners of medical education are expected to apply this educational strategy for developing CT skills in medical students.

Bulletin of emergency and trauma, Jul 1, 2022

International Journal of Community Based Nursing and Midwifery, 2021

Background: Non-adherence complicates the management of patients with cardiovascular disease. Thi... more Background: Non-adherence complicates the management of patients with cardiovascular disease. This study aimed to determine the effect of applying the information-motivation-behavioral skills (IMB) model on the treatment adherence among these patients Methods: This quasi-experimental study was conducted on 112 patients with cardiovascular disease in Nemazee and Al-zahra hospitals in Shiraz, Iran, from October 2019 to July 2020. Eligible patients were selected and divided into intervention and control groups. The intervention was based on an integration of IMB model constructs and included 10 motivational-educational sessions for three months, followed by telephone consultations for six months. Data were collected before, and three and six months after the end of the motivational-educational sessions using adherence questionnaire in patients with chronic diseases, and adherence in chronic disease scale for medication adherence. Data were analyzed using SPSS 22, and descriptive statis...

Surprisingly, the number of human genes seems to be almost equal to lower mammals like rodents, a... more Surprisingly, the number of human genes seems to be almost equal to lower mammals like rodents, and less than a factor of two greater than that of many much simpler organisms, such as the roundworm and the fruit fly. On the other hand,

Background: Mesenchymal stromal cell (MSC) transplantation can improve the left ventricular eject... more Background: Mesenchymal stromal cell (MSC) transplantation can improve the left ventricular ejection fraction (LVEF) after an acute myocardial infarction (AMI). Transplanted MSCs apparently exert a paracrine effect, which might be augmented if repeated doses are administered. This study aimed to compare the effects of single vs.double transplantation of Wharton’s jelly MSCs (WJ-MSCs) on LVEF post-AMI. Methods: We conducted a single-blind, randomized, multicenter trial. After 3-7 days of an AMI treated successfully by primary PCI, 70 patients younger than 65 with LVEF <40% on baseline echocardiography were randomized to receive conventional care, a single intracoronary infusion of WJ-MSCs, or a repeated infusion ten days later. The primary endpoint was the six-month LVEF improvement as per cardiac magnetic resonance (CMR) imaging. Results: The mean baseline EF measured by CMR was similar (~40%) in all three groups. By the end of the trial, while all patients experienced a rise in ...

BMC Cardiovascular Disorders, Mar 29, 2023

Background Diverse ethnic groups that exist in Iran may differ regarding the risk factors such as... more Background Diverse ethnic groups that exist in Iran may differ regarding the risk factors such as hypertension, hyperlipidemia, dyslipidemia, diabetes mellitus, and family history of non-communicable disease. Premature Coronary Artery Disease (PCAD) is more endemic in Iran than before. This study sought to assess the association between ethnicity and lifestyle behaviors in eight major Iranian ethnic groups with PCAD. Methods In this study, 2863 patients aged ≤ 70 for women and ≤ 60 for men who underwent coronary angiography were recruited in a multi-center framework. All the patients' demographic, laboratory, clinical, and risk factor data were retrieved. Eight large ethnicities in Iran, including the Farses, the Kurds, the Turks, the Gilaks, the Arabs, the Lors, the Qashqai, and the Bakhtiari were evaluated for PCAD. Different lifestyle components and having PCAD were compared among the ethnical groups using multivariable modeling. Results The mean age of the 2863 patients participated was 55.66 ± 7.70 years. The Fars ethnicity with 1654 people, was the most subject in this study. Family history of more than three chronic diseases (1279 (44.7%) was the most common risk factor. The Turk ethnic group had the highest prevalence of ≥ 3 simultaneous lifestyle-related risk factors (24.3%), and the Bakhtiari ethnic group had the highest prevalence of no lifestyle-related risk factors (20.9%). Adjusted models showed that having all three abnormal lifestyle components increased the risk of PCAD (OR = 2.28, 95% CI: 1.04-1.06). The Arabs had the most chance of getting PCAD among other ethnicities (OR = 2.26, 95%CI: 1.40-3.65). While, the Kurds with a healthy lifestyle showed the lowest chance of getting PCAD (OR = 1.96, 95%CI: 1.05-3.67)). Conclusions This study found there was heterogeneity in having PACD and a diverse distribution in its well-known traditional lifestyle-related risk factors among major Iranian ethnic groups.

International journal of cardiology cardiovascular risk and prevention, Mar 1, 2023

Clinical Case Reports, May 1, 2022

The coronavirus disease 2019 (COVID‐19) pandemic originated from Wuhan, China, in late 2019. In a... more The coronavirus disease 2019 (COVID‐19) pandemic originated from Wuhan, China, in late 2019. In addition to the respiratory system, COVID‐19 also affects other organ systems. The disease can lead to cardiovascular complications such as myocarditis, acute myocardial infarction, acute heart failure, and venous thromboembolism; patients with COVID‐19 experience more thrombotic events than non‐COVID‐19 patients. A 50‐year‐old male cigarette smoker presented to the emergency department (ED) with typical chest pain. His electrocardiography (ECG) showed an anterior STEMI. He developed multiple episodes of ventricular fibrillation (VF) and received defibrillator shocks. His angiogram showed thrombotic severe in‐stent restenosis (ISR) of the left anterior descending (LAD) artery stents. A 70‐year‐old diabetic hypertensive woman presented to the ED with dyspnea and chest pain. The patient had undergone angioplasty two times beforehand, and a fresh angiogram revealed severe thrombotic ISR of LAD stents and another far midpart lesion after the stents. She underwent successful percutaneous coronary intervention (PCI). A 54‐year‐old man presented to the ED with typical chest pain commencing an hour beforehand. He had undergone angioplasty about 10 years earlier. The patient received the Oxford/AstraZeneca COVID‐19 vaccine 36 h before developing chest pain. The ECG revealed an infero‐posterior STEMI, and the angiogram depicted thrombotic occluded ISR in the RCA. The patient underwent successful PCI. Patients with COVID‐19 or even with COVID‐19 vaccination experience stent thrombosis due to a hypercoagulable state. Hence, we need standard guidelines to prevent stent thrombosis.

Journal of education and health promotion, 2023

Background: Accountability refers to a set of concepts and social actions by which individuals or... more Background: Accountability refers to a set of concepts and social actions by which individuals or organizations have a sense of commitment to explain and to justify their behavior towards the others. Since it is one of the overall objectives of each university, the present study conducted to evaluate the effect of interdisciplinary education of social accountability in short-term workshops on medical student’s knowledge. Methods : The present study followed a qualitative-quantitative method with the qualitative stage conducted as group interview. In the first phase, eight faculty members were selected in order to determine the scope and the main topics of social accountability. The second phase was training workshops of social accountability using intervention method. Before and after the course, the knowledge of concepts was assessed using a valid and reliable questionnaire. Results: The main scope and criteria of the social accountability were extracted based on the results of the...

Background and Objective: In mentorship project, a wise and reliable person (mentor) guide anothe... more Background and Objective: In mentorship project, a wise and reliable person (mentor) guide another person (mentee) in all areas of academic achievements. The purpose of this study, is designe, perform and evaluate mentoring project for medical students whom entrance was the second half-year of 1393 and then. Methods and Materials: In mentoring project, pathophysiology and clinical students was second level mentors, and reference teachers was excellent level and sample mentors and some of teachers was supporter mentors. Mentoring schemes include the following steps: Need assessment, explore the facilities, programming, preparation, performing the project, evaluation. Results: Interview was done for testing the satisfaction of mentors and mentees in this study. Finally averages of students has been evaluated. The results of SBD survey test also showed that the motivation of students for studying medical courses, the desire to continue to participate in meetings and students’ overall s...