Journal of Iranian Medical Council

Is Springer Nature Repeating the Galileo Affair? Scientific Sanctions and the Erosion of Academic Neutrality

2025-12-17T10:12:57+00:00

The Article Abstract is not available.

Epidemiological Study of Gender Dysphoria in The Forensic Medicine of East of Iran During 2018-23

2025-12-17T10:12:55+00:00

Background: Given the evolving cultural landscape and increased awareness of self-knowledge, particularly sexual identity, societal attitudes towards the Lesbian, Gay, Bisexual and Transgender/Transsexual people (LGBT) community, specifically Gender Dysphoria (GD), remain complex and often characterized by misconceptions. This study aims to investigate the prevalence of individuals who identify as GD, and assess their level of understanding regarding gender identity. This study aims to determine the epidemiology of patients with GD in the forensic medicine of East of Iran in 2018-23.

Methods: In this cross-sectional study, clients with complaints of GD were investigated at East of Iran Forensic Medicine in 2018-2023. After receiving the permission to access the files archived in the branches of examinations and the Forensic Medicine Commission, the demographic and clinical information of the individuals was recorded in the attached checklist. Descriptive statistics for the study variables were presented in tabular and graphical formats.

Results: This study delves into the characteristics and experiences of 344 individuals seeking gender reassignment surgery, with the peak number of inquiries occurring in 2020 and 2021. Of the mentioned individuals, 138 were deemed ineligible for GD. The findings revealed that the majority of these individuals (65.4%) are female, with an average age of 24.22 years. Striking differences were observed in education, field of study, occupation, and psychiatric history between female and male applicants.

Conclusion: This study highlighted significant increase in gender dysphoria disorder, particularly among women and single individuals with diploma and post-graduate education in the East of Iran province. This trend reflects significant cultural shifts.

Prevalence of Functional Neurological Disorders in Iran: A Systematic Review and Meta-Analysis

2025-12-21T08:34:51+00:00

Background: Functional Neurological Disorder (FND) is characterized by neurological symptoms that are incompatible with known neurological diseases. This disorder can be disabling, imposing a significant burden on patients, society, and the healthcare system. There is limited data on the epidemiology of FND in Iran. This study aims to investigate the prevalence and manifestations of FND in Iran.

Methods: Electronic databases, including Embase, ISI, Google Scholar, PubMed, IranDoc, and the Scientific Information Database, were systematically searched in 2024 using keywords related to the epidemiology of FND in Iran. Additionally, other scientific reports, such as national survey reports and dissertations, were reviewed. After screening and assessing the articles, eligible studies were included in the review. A meta-analysis was conducted using the random-effects model.

Results: A total of 578 articles were screened from which 20 full-text articles were assessed. Finally, nine studies were included in the quantitative synthesis. Of these, three were conducted in psychiatric wards, four in general hospitals and non-psychiatric departments, one in a neuropsychiatric service, and one in community and school settings. The reported prevalence of FND across these studies ranged from 3.2 to 8.2%.

Conclusion: Seizures were the most common manifestation of FND. The prevalence rate of FND varied across studies depending on the study setting and methodology.

Culturally-Adapted Psychiatric Interventions among Iranian and Persian Speaking Refugees and Immigrants: A Systematic Review

2025-12-17T10:12:48+00:00

Background: The mental health of immigrants and refugees is an important issue, which may point at cultural differences, baseline mental health problems, and underlying mental states. Culturally adapted psychiatric interventions are designed to meet these problems in countries with different cultures.

Methods: This study is a systematic review. After searching relevant English and Persian papers with keywords of refugee, immigrant, psychotherapy, and Iran in Scopus, Medline, and Google Scholar databases besides IranDoc, ElmNet, Magiran, Iranmedex, SID, and Civilica, as databases indexing Iranian journals and Persian scientific articles until December 2022, the included papers screened by two independent reviewers and their data were extracted in previously-designed forms.

Results: After removing duplicate papers, 1742 papers were screened but only 14 papers met eligibility criteria and their full-texts were available or the corresponding author was available for asking for the full text. Majority of the studies focused on depression and post-traumatic stress disorder and various aspects of culturally-adapted psychiatric interventions, including interventions with similar comparing with different interviewer race, same-race group-therapy approaches, and various cognitive behavioral therapy (CBT).

Conclusion: There are few culturally-adapted interventions reported in the literature, which shows the importance of applying culture-related modifications on therapy methods. However, depression, post-traumatic stress disorder, and grief are three main mental health issues of Persian-speaking immigrants and refugees and face-to-face and internet-based CBT, psychodrama and trauma-focused group therapy were the main interventions among the reported culture-considered ones.

The Pathophysiological Insights and Emerging Biomarkers in Psoriasis: A Comprehensive Review

2025-12-17T10:12:40+00:00

Psoriasis is a chronic, immune-mediated inflammatory skin disorder affecting 2-3% of the global population. It imposes a substantial burden on patients due to its relapsing nature, lifelong management, and association with systemic comorbidities, including psoriatic arthritis, cardiovascular diseases, and metabolic syndrome. The unpredictable disease course and heterogeneity in treatment response necessitate the identification of reliable biomarkers to enhance clinical decision-making. Biomarkers hold promise in refining diagnosis, assessing disease severity, predicting treatment outcomes, and enabling precision dermatology in psoriasis management. Recent advancements in multiomics research have led to the discovery of potential psoriasis biomarkers, including genetic markers (HLA-C* 06:02), inflammatory cytokines (IL-17, IL-23, TNF-α), proteomic and metabolomic signatures, and skin microbiome alterations. These biomarkers correlate with disease activity, therapy responsiveness, and risk of comorbid conditions, thereby facilitating personalized treatment approaches. Despite promising findings, their routine clinical application remains limited due to variability in study methodologies, lack of standardization, and insufficient large-scale validation. The future of biomarker-driven dermatology in psoriasis depends on the integration of molecular profiling, standardized validation protocols, and clinical trials to establish their predictive and prognostic utility. Regulatory approval and widespread clinical adoption require rigorous validation and harmonization of biomarker assessment techniques. Establishing a clinically reliable biomarker panel could revolutionize psoriasis management by enabling targeted therapies, optimizing treatment efficacy, and minimizing adverse effects. This review aims to provide a comprehensive analysis of the current landscape of psoriasis biomarkers, their clinical relevance, and future directions for their standardization and integration into precision dermatology.

The Effect of a Professional Empowerment Program on ICU Nurses’ Clinical Decision-Making and Attitudes Toward End-of-Life Care: A Quasi-Experimental Study

2025-12-17T10:12:36+00:00

Background: Nurses play a vital role in improving health standards and should remain updated to be capable of making effective clinical decisions in end-of-life period. The present study aimed to determine the effect of a professional empowerment program on Intensive Care Units (ICUs) nurses’ clinical decision-making and attitudes toward end-of-life care.

Methods: This quasi-experimental, a pre-test and post-test design with a control group was conducted on 36 eligible ICU nurses who were randomly assigned to the intervention and control group (18 individuals each). The professional empowerment program on clinical decision making on end-of-life care and attitudes was delivered to the intervention group in 10 weekly sessions, while the control group received no training. Participants in both groups completed the Participation in Decision Activities Questionnaire (PDAQ) and Frommelt’s (1991) Attitude Toward Care of the Dying Scale (FATCOD) before and after the intervention. The collected data were analyzed using IBM SPSS-26 with independent samples t-tests and chi-square tests.

Results: The data revealed no significant differences (p>0.05) between the intervention and control groups regarding clinical decision-making and end-of-life care before the professional empowerment program. However, a significant difference (p<0.05) was found after the intervention, indicating the program’s effectiveness in improving ICU nurses’ clinical decision-making and attitudes towards end-of-life care.

Discussion: The findings suggest that the professional empowerment program significantly improved ICU nurses’ clinical decision-making and attitudes towards end-of-life care for family members. Therefore, empowerment can be used as an effective intervention to enhance nurses’ decision-making and their attitudes towards end-of-life care.

Translation, Cultural Adaptation and Validation of the Persian Version of Bristol Breastfeeding Assessment Tool

2025-12-17T10:12:33+00:00

Background: The Bristol Breastfeeding Assessment Tool (BBAT) is a useful tool to evaluate breastfeeding status in infants. This study aimed to cross-culturally adaptation of the BBAT to the Persian language and to determine its reliability and validity.

Methods: A cross-sectional study was conducted to translate and cross-culturally adapt the BBAT to Persian language following steps described in guidelines. A total of 106 infants participated in this study. Psychometric properties of internal consistency reliability, test–retest reliability, inter-rater reliability, Standard Error of Measurement (SEM), Smallest Detectable Change (SDC), and construct validity were tested. Factor analysis was performed to determine BBAT-Persian structure.

Results: There were no floor or ceiling effects that indicate the content and responsiveness of BBAT-Persian. Internal consistency was high (Cronbach’s α 0.8). Item–total correlations exceeded acceptable standard of 0.3 for the all items (0.71–0.78). The inter-rater reliability was excellent (k=0.80, SE=0.05; p<0.001). SEM and SDC were 0.756 and 2.41, respectively. Construct validity was supported by a significant correlation between the BBAT-Persian score and the Infant Breastfeeding Assessment Tool (IBFAT) total score (r=0.88). Explanatory factor analysis revealed 2 Components for the BBAT-Persian.

Conclusion: The BBAT was cross-culturally adapted to Persian and confirmed to be a reliable and valid tool to measure breastfeeding quickly and easily in infants.

Effectiveness of a Randomized Intervention Trial Utilizing the PRECEDE Planning Model for Brucellosis Prevention and Control in Rural Iranian Communities

2025-12-17T10:12:29+00:00

Background: This study developed a community-based intervention program for brucellosis prevention and control.

Methods: A two-armed parallel cluster randomized controlled trial investigated the effectiveness of the program over six months in a rural population in Ahar, East Azerbaijan, Iran. Sixteen village health houses were randomly allocated to the intervention and control groups (eight per arm), and 400 participants were recruited via household health records in the health houses. The Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) model was employed to design, implement, and evaluate the brucellosis prevention and control program. Knowledge, attitudes, self-efficacy, social support, environmental, enabling, and behavioral factors were measured at the baseline and the six-month follow-up. A generalized mixed-effects model was used to analyze the data.

Results: The intervention led to significant improvements in individual factors such as attitudes and self-efficacy. In the intervention group, attitudes increased from 51.1 to 57.1, while in the control group, there was minimal change from 41.1 to 41.3. Similarly, self-efficacy improved in the intervention group (from 27.6 to 33.2) but decreased in the control group (from 24.3 to 19.8). These changes were statistically significant. Furthermore, behavioral factors also showed significant positive changes in the intervention group compared to the control group (p<0.001).

Conclusion: The intervention program, guided by the PRECEDE model, proved effective in enhancing brucellosis prevention and control in a rural population. The six-month randomized controlled trial demonstrated significant improvements in individual factors, including attitudes and self-efficacy, among the intervention group compared to the control group.

Transportation Modes and Prehospital Care: A Secondary Analysis of Vertebral Injury Patients

2025-12-17T10:12:27+00:00

Background: Adequate prehospital care for Spinal Cord Injuries (SCI) is vital, influencing patient outcomes. Proper transportation plays an important role in minimizing delays and optimizing care. Thus, this study was aimed at evaluating the impact of transportation mode of vertebral injury patients on SCI.

Methods: In this secondary study of Jahrom city’s vertebral injury cases (March 2021 to 2023), demographics, accident details, prehospital timelines, and classifying cases by transportation mode were highlighted. The key outcomes were spinal cord injury and the need for surgical intervention. Emphasizing spinal cord injury as the primary outcome, the aim was to find its correlation if exist with transportation type, adjustments were made on the severity and mechanism of accidents.

Results: There were 44 cases (58.6%) brought to hospital by Emergency Medical Services (EMS) and 31 cases (41.4%) who self-walked-in. There was a significant negative correlation between the time from admission to surgery and the time it takes for EMS to arrive at the scene (r=-0.409, p=0.006). There was a significant negative correlation between the GCS score during ambulation to the hospital and the time it takes for EMS to arrive at the scene (r=-0.290, p=0.041). Getting transferred between two hospitals was associated with delays in hospital arrival (p=0.036). EMS-referred patients had a higher incidence of spinal cord injury (25%) compared to self-referred patients (9.68%), though this difference was not statistically significant (p=0.134). Incidence of SCI in self-walked-in patients was statistically higher than EMS brought patients (p=0.013) only in falling down patients.

Conclusion: The data remains non conclusive about the issue that which method of arrival to hospital of being self-referred or being brought by EMS are superior.

Assessment of Medical Advertisement Oversight in Iran’s Medical Council: Compliance Evaluation with Medical Ethics Standards

2025-12-17T10:12:22+00:00

Background: One of the most important ways to protect consumer health is to regulate the advertising and marketing of pharmaceutical and healthcare products and to promote professional ethics in the trade of these products. Ethical and legal liability can protect consumers’ corporeal and spiritual interests and help the profession maintain the market.

Methods: The initial phase of this cross-sectional study, a literature review was conducted to identify the ethical principles and criteria relevant to advertising in healthcare services. Following this, a researcher-developed checklist was created, incorporating the ethical standards derived from these principles. This checklist was then used to evaluate the existing and completed files within the Iran`s medical council, which were utilized by the technical and supervisory deputy of the Iran`s medical council to monitor medical advertising across the country during the period from 2021 to 2022. After the data collection, all the information was analyzed using SPSS version 26 statistical software.

Results: In this study, 561 advertising content published in the field of healthcare services in cyberspace was examined. Finally, in evaluating the compliance of the monitoring conducted by the Iran`s medical council with the established ethical criteria, it was found that out of the 17 criteria identified, 7 criteria (41.2%) were monitored during oversight by the Iran`s medical council, while 10 criteria (58.8%) were not addressed.

Conclusion: In conclusion, while this study shed light on various aspects of medical advertising within healthcare services, it also revealed critical areas requiring attention to enhance ethical compliance.

Preparedness Against Pandemic in Iran-Based on the Gronded Theory

2025-12-17T10:12:17+00:00

Background: The COVID-19 pandemic has posed a major challenge for all countries. Iran is exposed to a wide range of natural and human-made hazards due to its geographical location. Therefore, preparedness is essential for a successful response to pandemics. In this study, the state of preparedness against COVID-19 in Iran was investigated.

Methods: This study is of an applied and analytical type. Qualitative data were collected using grounded theory. Semi-structured interviews were conducted with 23 individuals with a background in health management in accidents and disasters, infectious diseases, epidemiology, and passive defense. Participants were selected purposively. Qualitative data were analyzed using the continuous comparison method, and a conceptual model of national preparedness against epidemics in Iran was designed.

Results: Causal factors affecting preparedness were prerequisites, leadership, planning system, and promoters. Resilience, health system infrastructure, political situation, local situation, and nature of the disease were categorized as essential factors and adaptive and maladaptive strategies were categorized into action/interaction strategies. Consequences included social empathy, improved infrastructure, community dissatisfaction, increased psychosocial harms, reduced health system credibility, and environmental consequences.

Conclusion: The resulting framework showed that for preparedness, laws and structures need to be reformed and long-term planning should be carried out with a community-based, all-hazards and One Health approach. Information and communication management should be improved to promote community participation. Strengthening surveillance systems, establishing a single chain of command, using expert ideas and improving resilience are essential. In addition, it is possible to provide an appropriate response to future pandemics by preventing arbitrary and unscientific measures.

What are the Dimensions of “Disasters Are not Natural” Approach in the Context of Iran? Implications for the Health System

2025-12-17T10:12:16+00:00

Background: Using the adjective “natural” with “disaster” can result in neglecting human-made vulnerabilities. In Iran, applying the “natural disaster” term is almost common in all disaster management settings. The present study is aimed to explore the aspects/dimensions of the “disasters are not natural” approach in the context of Iran and then suggest implications for the health system in regard to the findings.

Methods: The current research is a qualitative study utilizing conventional content analysis. 19 participants were purposively selected, and data were gathered through in-depth semi-structured interviews. Data analysis occurred concurrently with data collection, following the content analysis method outlined by Graneheim and Lundman.

Results: Human roles and interventions theme, as well as five categories and 16 subcategories, were extracted from data. The categories include environmental degradation (e.g., deforestation/desertification), economic vulnerability (e.g., poverty and economic difficulties), political/governance vulnerability (e.g., reactive approach to disasters), socio-cultural barriers (e.g., religious beliefs), and vulnerability of disaster management infrastructure (e.g., insufficient educational resources and programs).

Conclusion: This study highlights the human roles in disasters and the critical need for re-consideration of applying the “natural disasters” term. Using “disasters” instead of “natural disasters” can be facilitated through the increase in community-based programs and interventions such as education and training, public awareness, and exercises.

Comparative Effects of Cognitive Behavioral Therapy (CBT) And Myofascial Release (MFR) along with Conventional Therapy in Patients with Cervicogenic Headache

2025-12-17T10:12:11+00:00

Background: Cervicogenic Headaches (CGH) are a secondary headache disorder arising from musculoskeletal issues in the cervical spine. This study explores whether combining Cognitive Behavioural Therapy (CBT) with Myofascial Release (MFR) and conventional therapy can better reduce pain, headache severity, disability, and improve sleep and quality of life in CGH patients.

Methods: A sample of 30 participants aged 25-45 yr, diagnosed with cervicogenic headache, were recruited and randomly assigned to two groups: Group A (CBT with conventional therapy) and Group B (MFR with conventional therapy). Both groups received 60-min treatment sessions, 3 days per week for 4 weeks. Outcome measures included Numeric Pain Rating Scale, Neck Disability Index (NDI), Headache Disability Index (HDI), Pittsburgh Sleep Quality Index, and quality of life. A mixed-design ANOVA was conducted to analyze the main effects of group (G), time (T), and the group-by-time interaction (G×T) for all the outcome measures.

Results: Both groups showed significant improvements post-intervention, with notable time (T) and interaction (G×T) effects across all the parameters (p<0.001). Group A demonstrated greater reductions in pain [Numeric Pain Rating Scale (NPRS), p<0.001], disability (NDI, HDI, p<0.001), and sleep disturbances [Pittsburgh Sleep Quality Index (PSQI), p<0.001], along with improved quality of life [WHO Quality of Life Scale (WHOQOL), p<0.001] and cervical posture (CV Angle, p=0.004). These findings highlight the added benefits of CBT in addressing cognitive and emotional aspects of CGH.

Conclusion: Integrating CBT with conventional therapy provides a more effective approach for managing CGH than physical therapy alone. By addressing both physical and cognitive-behavioral aspects, this multimodal approach offers promising benefits in reducing headache severity and improving functional outcomes in patients with CGH. Future studies with larger sample sizes are recommended to validate these findings and explore long-term outcomes.

Comparison of Blood Indices, Including Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Mean Platelet Volume (MPV), and Red Cell Distribution Width (RDW), in Patients with Pulmonary Thromboembolism Versus Deep Vein Thrombosis in H

2025-12-17T10:12:07+00:00

Title:

Comparison of Blood Indices, Including Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Mean Platelet Volume (MPV), and Red Cell Distribution Width (RDW), in Patients with Pulmonary Thromboembolism Versus Deep Vein Thrombosis in Hospitalized Patients

Background: Venous Thromboembolism (VTE) is the most common preventable cause of death in hospitalized patients. Inflammatory conditions and blood cells play a direct role in the thrombosis process. This study aimed to investigate the effect of some blood indices on VTE.

Methods: 141 patients with Pulmonary Thromboembolism (PTE) and 138 patients with Deep Vein Thrombosis (DVT) with standard diagnostic methods were assessed. The patients were hospitalized at Imam Khomeini Hospital Complex during 2018-2020. The analysis was performed by IBM SPSS version 22 software.

Results: The mean rank of all the blood indices [Red Cell Distribution Width (RDW), Platelet-to-Lymphocyte Ratio (PLR), Mean Platelet Volume (MPV), and Neutrophil-to-Lymphocyte Ratio (NLR)] in the PTE group was higher than in the DVT group. But only NLR (p=0.00) and MPV (p=0.022) were significantly higher in patients with PTE. In the multivariate analysis, diabetes, NLR, and MPV indices were independently higher in the PTE group.

Conclusion: NLR and MPV were independently and significantly higher in patients with PTE than in those with DVT, and they can indicate an increased likelihood of developing PTE in patients with DVT and lead to an early diagnosis of PTE. To improve the clinical application of these indices, further studies should be conducted to determine their normal range, sensitivity, and specificity with a large number of participants in multiple centers to accurately identify other conditions that affect these blood indices.

Vitamin D Deficiency in Pediatric with Thermal Injury: A Prospective Cohort Study

2025-12-17T10:12:03+00:00

Background: Vitamin D deficiency is frequently observed in children with burn injuries and can influence clinical outcomes. This study aimed to explore the relationship between vitamin D status and clinical results in children with severe thermal injuries.

Methods: This study was a prospective cohort involving 220 children (aged 0–18 yr) who experienced severe thermal burns [≥20% Total Body Surface Area (TBSA)] and were hospitalized between July 2021 and October 2022. The participants were categorized into two groups based on their admission 25-hydroxyvitamin D [25(OH)D] levels: a sufficient vitamin D group (n=110) and an insufficient vitamin D group (n=110). The primary outcome was the incidence of infections. Secondary outcomes included hospital Length of Stay (LOS), the number of surgical procedures, wound pain scores, itching, Body Mass Index (BMI), blood glucose levels, and albumin levels.

Results: Children with low vitamin D levels experienced a longer length of stay (11.43 vs. 10.7 days, p=0.045) and a considerably higher incidence of infections (90.9 vs. 62.7%, p<0.001) compared to children with sufficient vitamin D levels. However, the groups showed no statistically significant difference regarding the number of surgical procedures. Similarly, no significant differences were found in wound pain, pruritus, BMI, albumin, or blood sugar levels.

Conclusion: This research indicated that vitamin D deficiency in children with thermal injury may be linked to a higher risk of infections and extended hospital stays. Understanding the underlying mechanisms and evaluating the possible benefits of vitamin D supplementation in this population requires more research.

Validity and Reliability of the Modified Persian Version of the iHOT-12 Questionnaire in Iranian Professional Soccer Players with Chronic Groin Pain

2025-12-21T08:34:34+00:00

Background: The iHOT-12 questionnaire is designed to evaluate pelvic pain in various populations. This study aimed to translate and validate the Persian version of the iHOT-12 questionnaire for assessing chronic groin pain in Iranian professional soccer players, while also evaluating its validity and reliability.

Methods: This study was conducted on 809 Iranian professional soccer players who were referred to the Iranian National Football Center (IFMARC) between April 2022 and April 2024. The measurement error was assessed by calculating the Smallest Detectable Change (SDC), which helps determine the smallest amount of change that can be reliably detected by the questionnaire. Reliability was evaluated using the Intraclass Correlation Coefficient (ICC) through the test-retest analysis conducted two weeks apart in 86 athletes, and internal consistency was measured using Cronbach’s alpha. Structural validity was assessed using a principal factor analysis.

Results: The ICC, calculated using Cronbach’s alpha, was 0.7 (95% CI). Repeatability was excellent, with a score of 0.99. The standard error of measurement was 0.83 (8.9%), and the SDC was 2.3 (24.8%). Factor analysis confirmed the structural validity of the questionnaire.

Conclusion: The modified Persian version of the iHOT-12 questionnaire demonstrated acceptable validity and reliability for assessing chronic groin pain in professional soccer players.

Developing a Total Knee Arthroplasty Simulator: A Qualitative Study to Find the Best Model

2025-12-17T10:11:52+00:00

Background: Concerns about patient safety, resident work hour restrictions, and recent technology improvements have increased interest in surgical simulations. This study was designed to find the most effective and applicable model for total knee arthroplasty simulator.

Methods: This is a qualitative study using Focus Group Discussion (FGD) to collect data and grounded theory for analysis. A topic guide including main questions in a structured approach was used by the moderators. Three FGD sessions were held using video chat. Session’s content was recorded and extracted data was analyzed by inductive content analysis method.

Results: Eligible 5 orthopedic residents, 4 orthopedic fellowships, and 7 academic professors from referral tertiary center hospital were interviewed. The main domains of discussion were about the necessity of a Total Knee Arthroplasty (TKA) simulator, virtual vs. physical model, bone and soft tissue characteristics, and the feedback system. Twelve percent of the participants believed a virtual model has more advantages while the others thought physical model is more applicable and 12% of them suggested a mixed model. Gap balancing was noticed as a crucial part by 40% of the participants to be included in the model.

Conclusion: All the participants deemed the existence of a simulator for TKA necessary. The essential parts of the TKA simulator like foot, ankle, hip, soft tissue elements, ligaments and tendons (especially collateral ligaments) were emphasized. To improve the simulator, the participants suggested that it should have a modular design and also sensors to alarm any damage to the vital elements. Also, they pointed out having feedback option for development of TKA simulator.

Translation and Evaluation of the Content Validity and Reliability of the Persian Version of the Modified-Restless Legs Syndrome Diagnostic Questionnaire

2025-12-17T10:11:45+00:00

Background: Restless Legs Syndrome (RLS) is a common disease with an estimated overall prevalence of 3% based on findings from a recent meta-analysis. Due to the lack of a reliable Persian questionnaire for the diagnosis of RLS, this study aimed to translate and evaluate the content validity and reliability of the Persian version of the modified-Restless Legs Syndrome Diagnostic Questionnaire (m-RLS-DQ).

Methods: The m-RLS-DQ, a reliable and accurate tool for diagnosing RLS was selected. Three bilingual physicians translated it into Persian, then unified by the fourth expert. Eight specialists evaluated the content validity using a Likert scale for relevance. Reliability was tested by administering the final version to 10 RLS the patients.

Results: The reliability index (i.e., Cronbach’s alpha coefficient) was also obtained as 0.78. The content validity was determined with the help of Microsoft Excel software, showing a Content Validity Index (CVI) of 0.98.

Conclusion: In this study, the appropriate validity and reliability of the Persian version of m-RLS-DQ was confirmed.

Predictive Factors Influencing Length of Hospital Stay in Patients with Thrombocytopenia Following Pesticide Poisoning: A Retrospective Analysis

2025-12-17T10:11:43+00:00

Background: Acute pesticide poisoning, particularly from suicide attempts or accidental exposure, is a growing issue, especially in developing countries. This study explores predictive factors for the Length of Stay (LOS) in patients with pesticide-induced thrombocytopenia.

Methods: This cross-sectional retrospective study was conducted at Khorshid Hospital, Isfahan University of Medical Sciences. It included patients aged 18 or older admitted between 2020 and 2021 with acute pesticide intoxication who experienced thrombocytopenia upon admission or during hospitalization, excluding those with significant pre-existing hematological conditions or a history anti-platelet medication. Data was collected on demographics, toxicological features, clinical and laboratory findings, and LOS. Data were extracted from patients’ clinical records.

Results: Among the 240 patients studied, the average age was 36.3 years, with a majority being male. Most patients had an LOS of over 72 hours. Significant factors of longer LOS included the type of pesticide (with herbicides and fungicides associated with extended stays), higher white blood cell counts, and lower magnesium levels. There was no significant association between LOS and clinical outcomes. Multivariable linear regression revealed that benzodiazepine administration, and magnesium were associated with reductions in LOS and ICU admission, endotracheal intubation was associated with a longer length of stay (p<0.05).

Conclusion: The findings of this study suggest that targeted treatment with benzodiazepine may reduce hospital LOS. Additionally, monitoring of laboratory data such as WBC and magnesium level could also influence LOS. Future multicenter studies with larger sample sizes are necessary to further evaluate the predictive factors of LOS in these patients.

Effectiveness of Using a Desensitizing Gel before Home Bleaching on Tooth Sensitivity and Color Change: A Clinical Trial

2025-12-17T10:11:33+00:00

Background: With the rise in living standards, the significance of a captivating smile in one’s appearance has become more apparent. On the other hand, tooth bleaching is very popular as a conservative esthetic treatment. Investigating the effect of desensitizing gel before home bleaching on tooth sensitivity and color change.

Methods: This clinical trial study was conducted on 30 women assigned into two experimental groups: Control (CG) and Desensitizing (DG) Groups, who were treated with placebo gel and 2% KF desensitizing gel (2% sodium fluoride and 5% potassium nitrate), respectively. The primary color of the upper right central tooth was recorded using a ShadeStar digital colorimeter before bleaching. Tooth sensitivity was evaluated using the Visual Analog Scale on 1, 4, 7, 10, and 14 days. The tooth color was also tested on day 14 and at months 1, 3, and 6 intervals of bleaching.

The Friedman, Cochran’s, Chi-Square, and Mann-Whitney U tests were used. A significance level of p < 0.05 was set.

Results: Tooth sensitivity was significantly higher in the CG than in the DG at all time points (p<0.05). There was no significant difference regarding the degree of color change in the DG and CG (p>0.05). Intragroup comparison at different time points showed that the difference in color stability at six months after bleaching was significant in the DG (p=0.005) but not substantial in the CG (p=0.585).

Conclusion: Desensitizing gel before home bleaching has been found to significantly reduce sensitivity. However, it does not affect color stability.

Relation between Consequences of Untreated Dental Caries (Pufa Index) and Oral Health Related Quality of Life in 4 to 6 Years Old Children

2025-12-17T10:11:28+00:00

Background: Caries is one of the most common childhood diseases. PUFA/pufa index, as a consequence of untreated caries (describes as pulp involvement, ulcers, fistulas and abscesses) affect oral functions and social interactions of children and reduce their Oral Health-Related Quality of Life (OHRQoL). The aim of this study was to investigate the relationship between the pufa index and OHRQoL in children aged 4 to 6 years.

Methods: This descriptive-analytical, cross-sectional study was conducted on 200 children referred to the School of Dentistry and Dental Clinics of Isfahan University of Medical Sciences. The children were examined, and their parents completed an OHRQoL questionnaire. The examination was conducted by a practitioner. The data were then analyzed using SPSS 26 software, including mean and standard deviation, Spearman correlation coefficient, and T-Test. The significance level was set at <0.05.

Results: 200 children consisting of 95 boys (47.5%) and 105 girls (52.5%) were participated in this study. The mean score of OHRQoL was 59.77±9.66. There was a significant and inverse relation between p and pufa score with OHRQoL (p<0.001). u, f, and a indices had a negative relation with OHRQoL (p<0/001).

Conclusion: Based on the findings of this study, the consequences of untreated caries, including caries with pulp involvement, ulcers, fistulas and abscesses, have a significant and negative impact on children, reducing OHRQoL.

The Role of CD38 in Predicting Outcomes for Non-M3 Acute Myeloid Leukemia Patients

2025-12-17T10:11:22+00:00

Background: Acute Myeloid Leukemia (AML) is a rare but aggressive type of cancer with different survival rates around the world. While factors such as age, cytogenetic, and molecular abnormalities play an important role that impacts the prognosis of AML patients, the correlation between CD38 and other hematologic markers and the survival of AML patients for therapy initiation was investigated in this study.

Methods: In this retrospective cohort study, we relied on flow cytometry to examine CD38 expression on AML blasts and evaluated its correlation with Overall Survival (OS) and one-year survival in newly diagnosed AML patients at the Hematology-Oncology Research Center, Iran, Tabriz.

Results: Seventy-two newly diagnosed non M3-AML patients were followed in this study. The results showed there was a significant relationship between the OS and one year survival CD38 levels. Besides, increasing the CD38 level by 1% increased the hazard of mortality by 1 percent (HR=0.99; 95% CI: 0.98 to 1.01).

Conclusion: The expression of certain membrane molecules like CD38 on leukemic cells can provide valuable information about the prognosis of AML patients and their treatment options.

Combined Treatment with Adipose-Derived Stem Cells and Crocin Improved Cardiac Markers in Rat Model of Isoproterenol-Induced Myocardial Infarction

2025-12-17T10:11:19+00:00

Background: Stem cell transplantation after acute myocardial infarction is a new therapeutic strategy that has been claimed to restore heart function. Some studies have reported that the cardioprotective effects of crocin are related to the regulation of the antioxidant enzymes activity and cardiac biomarkers. Accordingly, the aim of this study was to investigate the effect of the combined treatment with mesenchymal stem cells derived from adipose tissue and crocin in the isoproterenol-induced myocardial infarction model.

Methods: Forty rats were randomly divided into the control, acute myocardial infarction, acute myocardial infarction plus cellular therapy, acute myocardial infarction plus cellular therapy and crocin, and the group receiving crocin. Cardiac damage biomarkers and oxidative stress indexes such as, Malondialdehyde (MDA) and TACrolimus (TAC) levels were evaluated in all the groups.

Results: A significant elevation in serum concentrations of troponin T, creatine kinase, lactate dehydrogenase, and alanine aminotransferase were observed as the primary indicators of cardiac injury in the ischemia model group when contrasted with the control rats. These findings correlated with a marked reduction in total antioxidant capacity and a significant rise in MDA levels in the group treated with Isoproterenol compared to the control group. The administration of mesenchymal stem cells in conjunction with crocin demonstrated improvements in cardiac biomarkers, which were associated with a decrease in MDA levels and an increase in total antioxidant capacity.

Conclusion: Based on the results of this study, antioxidant compounds along with cell therapy is suggested as an effective therapeutic strategy in ischemic heart damage. Cellular and molecular studies are necessary to identify the exact mechanism of effectiveness of this therapeutic strategy.

Development and Psychometric Testing of Patient Education Information Materials Evaluation Tool (Persi-PEIMET): An Exploratory Factor Analysis

2025-12-17T10:11:14+00:00

Background: To have an efective patient education material, health professionals need a comprehensive tool to evaluate these materials. The Evaluation of the Patient Education Information Materials scale (PERSI-PEIMET) evaluates patient education materials and enables nurses and healthcare professional to assess and optimize the Patient Education Information Material (PEIM) according to scientific criteria. This paper describes the development and psychometric testing of PERSI- PEIMET.

Methods: The psychometric properties of PERSI-PEIMET (with 42 items) including face, content, and construct validity and reliability were done. Exploratory factor analysis was used in order to evaluate construct validity and 527 experts in Medical library and information sciences, nursing education and clinical experts who were faculty member in Tehran, Iran, Tabriz, Boushehr, Isfahan, Zahedan and Ahvaz medical universities, were recruited randomly.

Results: Exploratory factor analysis identified 10 factors including readability, design, structure, coherence, suitability, appropriateness, actionabiity, quality, formatting and reliability that together accounted for 83.92% of the total variance of the factors. The Cronbach’s alpha of these ten factors and the total scale were 0.922, 0.917, 0.836, 0.831, 0.816, 0.717, 0.749, 0.781, 0.737 and 0.951, respectively. The intra-class correlation coefficient based on test-retest was 0.85 which showed entire scale reliability is high.

Conclusion: The PERSI- PEIMET appears to have acceptable validity and reliability and it is considered as a good instrument for evaluatin PEIM. PERSI_PEIMET comprehensively evaluates all the characteristics and variables affecting the efficiency of PEIMs. Instrument development is an iterative process and further testing with other cohorts and in other settings is required.

Magnetic Resonance (MR) Liver Fat Quantification in Patients with Obesity: A Comparative Study with Ultrasound, Body Mass Index (BMI) and Alanine Transaminases (ALT)

2025-12-17T10:11:12+00:00

Background: Non-Alcoholic Fatty Liver Disease (NAFLD), strongly linked to obesity and metabolic syndrome, is a leading cause of liver cirrhosis. Early and accurate diagnosis is essential to prevent progression. NAFLD is commonly diagnosed using ultrasound, and obesity is known to limit the quality of ultrasound assessment. This disadvantage may be eliminated with Magnetic Resonance (MR) modality. MR fat quantification is potentially effective in directly determining hepatic steatosis. This study aimed to evaluate if MR is a suitable option to ultrasound with correlation to Body Mass Index (BMI) and Alanine Transaminase (ALT) in patients with obesity.

Methods: A prospective cohort pilot study was conducted in Malaysia between January 2020 and July 2021, involving 34 adult obese patients (BMI range: 30–45 kg/m²). All the patients were subjected to ultrasonography, MR, anthropometrics, and serum ALT measurements. MR Fat fraction (MR-PDFF) and spectroscopy using Stimulated-Echo-Acquisition-Mode (MRS-STEAM) and Point-Resolved-Spectroscopy (MRS-PRESS) were used for fat quantification. The results were analysed using Pearson and Spearman correlation tests.

Results: The mean values for BMI and ALT are 37.91 and 20.50 respectively. MR showed a significant positive correlation with ultrasound in quantifying liver fat (MRS-STEAM r=0.713, MRS-PRESS r=0.882 and MR-PDFF r=0.961, p<0.05). MRS-PRESS, MR-PDFF and ultrasound indicated a positive correlation with BMI (MRS-PRESS r=0.408, MR-PDFF r=0.385 and ultrasound r=0.477, p<0.05). MRS-STEAM showed no correlation with BMI. All the three MR acquisitions and ultrasound demonstrated positive correlation with ALT level (MRS-STEAM r=0.389, MRS-PRESS r=0.483, MR-PDFF r=0.478 and ultrasound r= 0.487, p<0.05).

Conclusion: Magnetic resonance can be potentially used as a safe alternative tool in managing NAFLD in obese patients. A study with larger sample size with adjustments to confounding parameters is required to evaluate the MR as an effective diagnostic tool for NAFLD in obese patients.

Efficacy of Ozone Therapy in Patients with Knee Osteoarthritis Referred to the Pain Clinic

2025-12-17T10:11:02+00:00

Background: Knee Osteoarthritis (KOA) is a common degenerative joint disease that causes significant pain, disability, and impaired quality of life. Conventional therapies, including analgesics and physiotherapy, offer minimal alleviation. However, the emergence of ozone therapy, with its possible anti-inflammatory and regenerative properties, provides a promising and hopeful alternative.

Methods: The present study was conducted on 30 patients with KOA. They received weekly intra-articular ozone injections for 8 sessions for ozone injections, and their pain and functional outcomes were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Inventory. In this study, SPSS was used, with a significance of p< 0.05. Baseline and post-treatment scores after one month were compared.

Results: The study involved 30 participants aged 71.80±8.38 yrs, with a majority of females (93. 3%). The WOMAC pain subscale was used to measure pain severity before and after ozone therapy. Significant improvements post-treatment, decreasing pain scores from 63.77±9.84 to 37.81±14.57 were observed.

Conclusion: Physical function and stiffness components also improved. The WOMAC Pain Questionnaire showed a significant reduction in pain intensity, indicating a substantial and reassuring improvement in pain management after ozone therapy. These results provide confidence and assurance regarding the possibility of ozone therapy. According to the existing results, the effectiveness of intra-articular ozone injection was significant. Therefore, ozone can be recommended as an efficient, durable treatment for mild or moderate KOA.

Maxillary Protraction through Posterior Miniplate Anchorage in a 10-Year-Old Class III Patient

2025-12-17T10:10:59+00:00

Background: In this study, treatment of maxillary deficiency through posterior maxillary miniplates connected to facemask was presented. Using skeletal anchorage rather than tooth-borne device, facilitated maxillary protraction with minimum dental changes. Also, the patient exhibited vertical growth pattern, which could be aggravated through tooth-borne devices. But through skeletal anchorage, clockwise rotation of mandible and counterclockwise rotation of maxilla were prevented. Desired results were obtained after 9 months of treatment including positive overjet, without any mandibular backward rotation and improved midface deficiency, followed by 10 months of retention period through using facemask only night time. Then, fixed orthodontic treatment was initiated to stabilize the results.

A Practical Guide for Designing and Conducting Knowledge, Attitude, and Practice Studies Focusing on Audio-Speech Field

2025-12-21T08:34:33+00:00

The Knowledge, Attitude, and Practice (KAP) model help understand behavioral trends by analyzing the intersection of knowledge acquisition, attitudinal shifts, and behavioral implementation in a target population. This study explores the significance of KAP studies, particularly in the context of audio-speech fields, offering a practical guide for health professionals. This study outlines critical components of KAP questionnaire design and emphasizes its role in effectively gauging and impacting behaviors and beliefs concerning audio-speech practices. The current study also provides a practical guide for designing, administering, and validating KAP studies to improve its validity and comparability. Through illustrative examples, the study advocates for the careful formulation of questions to ensure clarity and relevancy tailored to the specifics of the target population. Moreover, it underscores the importance of preliminary literature reviews, expert panel consultations, and pilot testing to refine the questionnaire and enhance its effectiveness. Practical steps for conducting a KAP study, such as sample size determination, data collection procedures, and ethical consideration, are detailed to ensure rigorous research methodology. This approach helps collect baseline data, allocate resources effectively, and evaluate interventions. Ultimately, by following this structured guide, researchers can conduct more informative KAP studies, contributing valuable insights into the field of audio-speech sciences.

Formalin in the Dissection Hall: A Fear Factor or a Catalyst for Teaching the Science of Anatomy

2025-12-17T10:10:51+00:00

The Article Abstract is not available.

Methadone Maintenance Therapy and Complementary Medicine: A New Frontier in Holistic Addiction Treatment?

2025-12-17T10:10:46+00:00

The Article Abstract is not available.