Journal of Iranian Medical Council (JIMC) is a free access, peer-reviewed and refereed international journal published by Islamic Republic of Iran Medical Council (IRIMC). The main objective of JIMC is to provide an intellectual platform for the international scholars and medical practitioners. JIMC aims to promote interdisciplinary studies which are of interest to medical societies and are within the range of the responsibilities and activities of Islamic Republic of Iran Medical Council (IRIMC). This includes all professional, scientific, legal and ethical topics. All the manuscripts should be submitted through the Journal Primary Website at http://www.jimc.ir/contacts?_action=loginForm
Islamic Republic of Iran Medical Council
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Copyright (c) 2026 Journal of Iranian Medical Council
Children in Armed Conflict: Lessons from Iran on Cultural and Health System Resilience
Controversial Issues of Criminalizing Abortion from the Perspective of Islamic and Jurisprudential Laws and its Impact on Community Health: A Review Study
Abortion has been criminalized in some countries. International human rights institutions report low-quality health services as a result of the criminalization of abortion, which they consider incompatible with the right to privacy and the right to maternal health. The present study aimed to review controversial issues of criminalizing abortion from the perspective of Islamic and jurisprudential laws in Iran and its impact on community health. In this article, studies published between 1980 and 2023 were searched in reputable scientific databases using the keywords “abortion, rights, criminalization, harm principle, freedom principle, jurisprudence, and Islamic law”. Human rights organizations associate decriminalization with improved quality of care and access to safe abortion. Drawing on insights from reproductive health from the perspective of Islamic and jurisprudential law, this review addresses knowledge gaps related to the health consequences of criminalizing abortion, such as continued pregnancy and increased fertility rates, recognition of the legal personality of the fetus, and other dimensions of health and mental well-being, and demonstrates that the recommendations outlined are consistent with international human rights standards. This review does not show the incompatibility of criminalization with the substantive requirements of international human rights law and the legal protections in the preamble to the Convention on the Rights of the Child have accepted and placed the fetus. The legal personality of the fetus and the sanctity of the human being from the moment of its conception are worthy of respect and the principle of the mother’s free will causes harm and conflicts with the rights of the fetus.
The Effectiveness of Therapeutic Massage in Alleviating Chemotherapy-Induced Nausea and Vomiting: A Scoping Review
Background: Chemotherapy-Induced Nausea and Vomiting (CINV) is a challenging side effect for cancer patients, often impacting their well-being and adherence to treatment. While antiemetic medications are available, some patients continue to experience persistent symptoms. This has led to growing interest in complementary therapies like therapeutic massage to help manage CINV. This scoping review explores the potential of therapeutic massage in alleviating CINV, examines existing research, and highlights areas that require further study. Methods: A systematic search was conducted in accordance with the Arksey and O’Malley framework and PRISMA-ScR guidelines across PubMed, Scopus, Embase, CINAHL, and the Cochrane Library for studies published from 2015 to 2024. Studies were eligible if they involved any type of cancer and chemotherapy regimen where therapeutic massage was administered as a supportive intervention for CINV. Notably, studies were not limited to those showing only positive effects; both supportive and non-supportive evidence were included to ensure an unbiased synthesis of available literature. Given heterogeneity in study designs, a narrative synthesis was employed to integrate findings across diverse methodologies and settings. Results: A range of massage techniques-including Swedish massage, foot massage, abdominal massage, and slow-stroke back massage-were evaluated across different cancer types and treatment protocols. Several studies indicated reductions in nausea and vomiting severity, especially when massage was combined with complementary methods such as aromatherapy or music therapy. However, findings were mixed, and some studies reported no significant differences compared to control groups, emphasizing the need for standardized intervention protocols and improved methodological quality. Conclusion: Therapeutic massage shows potential as an adjunctive intervention to alleviate CINV by enhancing relaxation and reducing psychological distress. However, further rigorous studies are required across diverse cancer types and chemotherapy protocols to confirm efficacy, optimize techniques, and integrate massage into routine cancer care.
Interventions in Sport Social Work: A Scoping Review
Background: This research aims to gain insight into applied theories in sport social work, service objectives, sport social workers’ interventions, intervention barriers and the professional competencies required to overcome them. Methods: Using the scoping review method, the concept of sport social work was searched on August 19, 2024, across international (e.g., Scopus, WOS) and national (e.g., Noormags, SID, Magiran, ISC) databases as well as the Sport Social Work Journal, search engines and relevant websites, without time restrictions. Ultimately, 73 scientific records were identified. Documents that addressed both social work and sport/athletes, were included. Non-athlete interventions, non-English records, and studies without accessible full texts were excluded. Results: Finally 73 records of 668 ones were included and the results showed that ecological theory is the most commonly applied framework in sport social work, and a methodical alignment is observed between service objectives, sport social work theories, and intervention types across three levels: micro (individual athletes and casework social work interventions); mezzo (groups and support systems such as families, coaches, sports teams, and group social work interventions); and macro (sociocultural and economic institutions, and community-based social work interventions). Also, three categories of barriers: profession-related, socio-cultural, and sports system barriers were identified within the context of sports, and to address them, acquiring professional competencies is essential for sport social workers. Conclusion: This study introduces sport social work in Iran as a novel entry point for advancing education, research, and practical interventions in the sports sector. By addressing psychosocial harms, reducing inequalities, promoting social change, and supporting athlete well-being and performance, sport social work can make a significant contribution to both individual and social development
Abortion Tourism: Extraterritorial Application of Criminal Laws, a Narrative Review
Although the laws of some countries, including Iran, contain regulations regarding the entry and exit of Iranian and foreign nationals, there is no specific law regarding the purposes of tourist travel. Legal abortion tourism can be interpreted as fraud against the law. The aim of this study is to examine the extraterritorial application of criminal laws for abortion tourism. In this narrative review, the extraterritorial application of criminal laws for abortion between 1990 and 2023 was investigated using the keywords of “abortion, law, jurisprudence tourism, and criminal law”. Abortion tourism is a travel abroad with the intention of participating in an abortion that is prohibited in one’s own country but permitted in the destination country. In response to the question of whether the country of origin has allowed or obliged to extend its existing criminal prohibition extraterritorially, three perspectives are examined: 1. Considering legal punishment 2. Passing shield laws, and 3. Applying the rule of tolerance in the decisions of the actors of the criminal process. Considering the negative functions of abortion tourism, such as violating the mother’s right to life, physical integrity and maternal deaths in inappropriate logistical conditions, supporting the right to life of the fetus, it is necessary to try to draw the attention of countries to each other’s ethical and legal considerations in order to reduce the grounds for the emergence of illegal tourism in the field of abortion.
Detection of Mandibular Incisive Canal Using CBCT and its Anatomical Relationships in Different Nationalities: A Review Study
Background: The Mandibular Incisive Canal (MIC) is the mesial extension of the inferior alveolar nerve, frequently encountered during surgical procedures such as implant placement and bone graft harvesting. Thorough radiographic evaluation, particularly using three-dimensional imaging modalities like Cone-Beam Computed Tomography (CBCT), is crucial to prevent nerve injury and related complications. This review summarizes studies that investigated MIC detection using CBCT. Methods: Following the PRISMA guidelines, an electronic search was performed in PubMed/MEDLINE and Scopus, identifying 45 studies, of which 35 met the inclusion criteria. An electronic search was conducted in August 2023 using PubMed/MEDLINE and Scopus with MeSH terms and keywords: “mandibular incisive canal,” “incisive canal,” “computed tomography, cone beam,” “CBCT,” “inferior alveolar nerve,” and “mental foramen.” Relevant studies published in English up to August 28, 2023, were included. Results: MIC was detected in 87.11% of the cases examined by CBCT. The canal was more prevalent in females (F:M =1.12:1), with a mean patient age of 45.11 years (range 10-88). The average MIC length and width were 11.30 mm and 1.72 mm, respectively. The mean distances from the MIC to the buccal cortex, lingual cortex, inferior mandibular border, and alveolar crest were 3.71, 4.98, 9.37, and 15.76 mm, respectively. The longest and widest MICs were observed in the Chinese population, whereas the smallest dimensions were found in the Brazilian population. MIC prevalence was highest among Malays (100%) and lowest among Indians (86.22%). Conclusion: CBCT is a valuable tool for detecting the MIC. Careful assessment of the MIC and interforaminal region is recommended to prevent nerve injury and associated complications such as sensory disturbances and hemorrhage.
Frequency and Causes of Complaints against Orthopedics, Emergency Medicine Specialists, and Neurosurgeons in Guilan Province: A Cross-Sectional Study
Background: To enhance healthcare delivery in sensitive medical fields, it was aimed to investigate common medical errors in orthopedics, neurosurgery, and emergency medicine. By analyzing the frequency and diversity of registered complaints and expert requests from the legal medicine organization, some strategies were proposed to reduce complaints against the mentioned specialists. Methods: This descriptive cross-sectional study was conducted to examine the complaints lodged against orthopedic surgeons, emergency medicine physicians, and neurosurgeons practicing in Guilan Province. Variables included complainant gender, age, education, occupation, complainant relationship to the patient, specialist gender/specialty, negligence cause/percentage, verdict, medical error location, complaint reason, injury severity, fatal injury, and healthcare errors. All the statistical analyses were carried out by using SPSS (version 22.0). A two-tailed p<0.05 was considered to be of statistical significance. Results: In this study, 190 complaint files were reviewed against medical specialists in orthopedics (62.1%), neurosurgery (21.6%), and emergency medicine (16.3%). The complainants were predominantly male (70.5%), with an average age of 42.01 years. Court verdicts resulted in acquittal in 62.6% of the cases and negligence in 37.4%, with carelessness and wrong treatment major causes. The court verdicts did not differ significantly based on the specialist’s gender, medical specialty and fatal injuries (p>0.05). However, a statistically significant association was observed between negligence rulings and healthcare errors (p=0.019). Conclusion: The findings underscore the need for enhanced clinical oversight, healthcare quality improvement, continuous physician training, and streamlined complaint processes to reduce grievances and improve patient satisfaction.
Early Exposure to Research Program: An Approach to Improve the Academic Success and Performance of Postgraduate Students
Background: Early exposure to research activities is recognized as a key factor in enhancing research skills and academic achievement. This study aimed to evaluate the effect of the Early Exposure to Research Program (EERP) on research performance and academic success in postgraduate students. Methods: This educational intervention utilized a quasi-experimental, case-control design with pre- and post-test assessments. The study was conducted from September 2021 to October 2023 at the School of Nutritional Sciences and Dietetics. Thirty-four students participated in the intervention group and 34 in the control group. Valid and reliable researcher-developed questionnaires assessed student satisfaction and research performance. Academic achievement was measured by mean course scores. Statistical analysis was conducted using Chi-square and independent t-tests, and effect sizes were interpreted for mean differences. Results: The EERP significantly improved research performance among the postgraduate students, with notable increases in published articles (60.7 vs. 25.0%, p=0.005), research training participation (35.7 vs. 3.6%, p=0.003), and other research activities for MSc students, and enhanced training (50.0 vs. 0%, p=0.046) and article reviewing (66.7 vs. 16.7%, p=0.079) for PhD students. Academic achievement was higher in the intervention group, with mean course scores for MSc students of 18.16 compared to 16.29 in the control group (d=1.78), and for PhD students, 17.96 vs. 16.66 (d=1.32). No significant differences were observed in baseline characteristics between groups. Conclusion: Implementing similar programs can enhance research performance and academic achievement among postgraduate students. It is recommended that such approaches be incorporated into postgraduate educational curricula. Future research should use randomized designs and longer follow-up to confirm and expand these findings.
Evaluation of Dental Environment Stress and Dental Student’ Characteristics
Background: Dentistry is a stressful profession. This stress is related to educational and clinical factors. This study assessed stress levels among dental students in clinical departments at Shahid Beheshti University of Medical Sciences and explored its association with personal characteristics. Methods: In this cross-sectional study, 231 dental students from clinical semesters (7th to 12th) at Shahid Beheshti University of Medical Sciences were surveyed using three tools: a demographic questionnaire, the Dental Environment Stress (DES) questionnaire covering six domains of academic and clinical stress, and the neuroticism subscale of the Eysenck Personality Questionnaire. Data were analyzed using independent t-tests for binary variables, one-way ANOVA for multi-group comparisons, and Pearson correlation to assess the relationship between neuroticism and stress, with significance set at p<0.05 in SPSS version 26. Results: The mean total perceived stress score was 2.42±0.41 on a 1–4 scale. The highest stress was reported in the domain of academic performance (mean=3.00±0.75), while the lowest was in the “other factors” domain (mean=2.13±0.59). The female students reported significantly higher total stress scores than males (80.51±12.47 vs. 74.05±13.72; p<0.001). Fourth-year students exhibited the highest stress levels compared to other academic years (p<0.05). A significant positive correlation was found between neuroticism scores and perceived stress (r= 0.40, p<0.001). No significant relationship was observed between overall stress and marital status, age, systemic disease, or medication use (p>0.05). Conclusion: This study identified significant levels of stress among dental students, particularly in academic and clinical domains, with female and fourth-year students experiencing the highest levels. The strong correlation between neuroticism and perceived stress suggests the need for psychological support and stress management interventions tailored to student personality traits. Implementing targeted mental health programs and curriculum adjustments may help reduce stress and improve student well-being and academic performance.
Psychiatrists’ Experiences in Managing Medications via Online Platforms during the COVID-19 Pandemic in Iran: A Qualitative Study
Background: The COVID-19 pandemic disrupted traditional psychiatric practices that depend on face-to-face interactions. Patients with psychiatric disorders often have higher rates of other health issues, which worsen their outcomes when infected with COVID-19. This underscores the need for timely diagnosis and treatment, as well as accessible psychiatric services, especially considering the possibility of future pandemics. Methods: A qualitative study conducted in 2024 involved selected psychiatry faculty members from Tehran’s psychiatry departments, who were experienced in online consultations. Semi-structured interviews continued until data saturation was reached. Interviews were recorded, transcribed, and analyzed using qualitative content analysis (Graneheim and Lundman approach). Ethical considerations and informed consent were ensured. Results: The study involved 14 faculty members from the Psychiatry Department of Iran University of Medical Sciences. Their experiences with telepsychiatry consultations in medication management were examined. Among the participants, four were women and 10 were men. Data analysis using conventional content analysis produced 7 main themes and 13 subcategories. The main themes included advantages of telepsychiatry, challenges of telepsychiatry, impact on doctor-patient relationships, effects on diagnosis and treatment, job satisfaction of psychiatrists, ethical and privacy concerns, and training and preparedness of psychiatrists. Conclusion: Telepsychiatry can improve access to mental health care. This study offers insights for policymakers and healthcare leaders on the practicality and infrastructure needed for widespread telepsychiatry adoption, especially in future crises. Adopting telepsychiatry can enhance community mental health and ensure reliable access to psychiatric services.
Effect of Remote Monitored Home-Based Exercise Therapy via Telerehabilitation on Balance of Patients with Stroke: A Randomized Controlled Trial
Background: Rehabilitation has positive physical effects on balance impairments after stroke. In recent years, special attention has been paid to telerehabilitation mainly due to difficulties in access to rehabilitation centers, and the cost of rehabilitation sessions. Preliminary results have shown the positive effects of telerehabilitation on balance of patients post stroke. The aim of this study was to evaluate the effect of remote monitored exercise programs via telerehabilitation compared with unmonitored home-based exercise programs on the balance of patients with late-sub acute and chronic stroke. Methods: In this randomized clinical trial, 28 post stroke patients were randomly allocated to two groups. They received either 12 sessions of remote monitored home-based exercise programs via telerehabilitation or 12 sessions of the unmonitored home-based exercise programs over four weeks. The patients were evaluated using Berg Balance Scale (BBS) and Timed Up and Go (TUG) test before intervention, one month later, as well as one and three months after the end of the intervention. Results: TUG test scores significantly improved only in the intervention group (p=0.002 vs. p=0.37), while BBS score significantly improved in both intervention and control groups (p=0.001, p=0.02, respectively). The effect of group-by-time interaction was not significant for either TUG [6.38 (-1.39, 14.15), p=0.121] or BBS [1.64 (-1.32, 4.60), p=0.171]. Conclusion: With the rehabilitation approach implemented in this study, unmonitored home-based exercise training is as effective as tele-monitored exercise programs on improving balance of late sub-acute and chronic stroke survivors.
Iranian Psychiatrists’ Attitudes toward Methamphetamine Use Disorder and Prescribing Patterns: A Cross-Sectional Survey
Background: Methamphetamine Use Disorder (MUD) has emerged as a major public health concern in Iran, driven by a shift in substance use patterns from opioids to methamphetamine. Despite its rising prevalence, there is scarce data on Iranian psychiatrists’ therapeutic approaches. This study evaluated their prescribing practices and attitudes toward managing MUD. Methods: This cross-sectional study was conducted in 2024 among 150 practicing Iranian psychiatrists, recruited via convenience sampling through social media platforms until the target sample size was reached. The participants completed a researcher-made, structured questionnaire featuring four clinical scenarios representing MUD cases (methamphetamine-induced psychosis, intoxication, craving, and recurrent psychosis). Scenarios were developed by a panel of four psychiatrist faculty members with ≥3 yr. of experience, based on DSM-IV-TR and DSM-5 criteria, and refined by a separate panel of five experts for clarity and relevance. Responses, collected via Google Forms, were analyzed using SPSS v26. Results: For methamphetamine-induced psychosis, 88% prescribed medications, primarily atypical antipsychotics (55.3%). For aggression, 50% prescribed adjunctive medications, predominantly sedatives (28%) and mood stabilizers (20%). Craving management involved pharmacotherapy in 66.7% of the cases, with bupropion (50%) and pregabalin/gabapentin (27.9%) most frequently prescribed. Half prescribed medication for intoxication, primarily benzodiazepines (28%). For recurrent psychosis, 80% recommended combining psychotherapy with pharmacotherapy, while 35.3% prescribed long-acting antipsychotics. Conclusion: While prescription of atypical antipsychotics (for psychosis) and bupropion (for craving) align with partial evidence, underutilization of medications like mirtazapine and buprenorphine highlights knowledge-practice gaps. Findings emphasize the need for regional treatment guidelines, targeted educational interventions addressing evidence-practice discrepancies, and further research to optimize therapeutic strategies.
Effectiveness of Cueing of Cadence with Ambulation Training in Hemiplegic Stroke Patients
Background: Stroke remains a significant global health challenge, causing long-term impairments that substantially impact patients’ quality of life and healthcare costs. Hemiplegia, characterized by paralysis or weakness on one side of the body, particularly challenges rehabilitation efforts, especially in restoring gait and mobility. This study investigates the effectiveness of cadence cueing in ambulation training for post-hemiplegic stroke patients. Methods: The research employed an experimental design involving 30 hemiplegic stroke patients divided into two groups: a conventional gait training group (n=15) and an experimental cadence cueing group (n=15). Both groups underwent a 4-week intervention, with the experimental group receiving specialized rhythmic auditory and visual cueing during ambulation training. The Dynamic Gait Index (DGI) was used to assess gait, balance, and fall risk. Results: The findings suggested that cadence cueing with ambulation training offers a promising approach to improving gait and balance in hemiplegic stroke patients. It demonstrated statistically significant improvements in both groups, with the experimental group exhibiting substantially greater enhancements. The post-test mean values were 19.8 for the conventional group and 21.06 for the experimental group, with p-values <0.5 indicating significant statistical differences. Conclusion: This study contributed valuable insights into innovative rehabilitation strategies, highlighting the potential of cadence cueing as a supplementary technique in stroke rehabilitation protocols.
Investigation of Risk Factors for Recurrent Falls in Iranian Older people: A Cross-Sectional Study
Background: Recurrent falls among the older people can have serious consequences. Frequent falls are a significant health concern for the older people and can lead to serious injuries and reduced quality of life. This cross-sectional study aimed to identify the risk factors associated with frequent falls among older people in Iran. Methods: 160 older people with a history of falling were recruited. Data was collected using a questionnaire that consisted of three sections: demographic information and falling characteristics, the Activities-Specific Balance Confidence Questionnaire, and the International Short-Form Scale of Efficiency in Falling. Descriptive and analytical statistics, including univariate and multiple logistic regression, were employed to analyze the data in this study. Results: The most common diseases among the participants were hypertension (35%), heart disease (26.3%), and diabetes (26%). Based on the results of multiple logistic regression analysis, hearing loss (OR=2.36; 95% CI: 1.51–4.38), overweight (OR=1.04; 95% CI: 0.80–1.95), and fear of falling (OR=1.13; 95% CI: 1.01–1.27) were identified as significant predictors of recurrent falls. Conclusion: This study identified hearing loss, fear of falling, and weight as risk factors for recurrent falls among Iranian older people. Regular screenings for hearing and weight loss in older people help reduce the risk of recurrent falls and improve healthcare.
Role of Scapular Muscle Strengthening on Grip Strength and Handwriting Speed among Physiotherapy Students
Background: The study aimed to investigate the effectiveness of scapular muscle strengthening exercises on grip strength and handwriting speed among physiotherapy students. Methods: A pre-post study was conducted with 40 participants both male and female aged 18-24 years, who were right-handed and were able to read and write in English. The participants were recruited through convenient sampling, and then, randomly allocated into two groups i.e., Group A (Control) and Group B (Experimental). The experimental group B (20 participants) received scapular muscle strengthening exercises for three days per week for six weeks, whereas the control group A (20 participants) practiced one-page handwriting for the same frequency and duration. Then grip strength and handwriting speed were measured following intervention by hand dynamometer and handwriting speed test, respectively. Results: The mean age of the participants was 21.72 and 21.67 in the group A and group B, respectively. The data was analysed using the paired t-test and independent t-test which revealed that Group B’s handwriting speed and grip strength improved significantly when compared to Group A (p<0.05). Conclusion: The scapular exercise receiving group significantly showed an increase in grip strength and handwriting speed (words per min), therefore to increase handwriting speed and grip strength, scapular strengthening exercises are effective.
Primary Cutaneous Mucinous Carcinoma: A Case with Diagnostic Dilemma
Primary Cutaneous Mucinous Carcinoma (PCMC) is a rare adnexal malignancy with indolent behavior but significant diagnostic challenges, particularly in distinguishing it from metastatic mucinous adenocarcinoma. We report a diagnostically complex case of PCMC in a 43-year-old man, initially suspected to represent metastatic breast carcinoma. The patient presented with incidental left axillary lymphadenopathy detected during staging for a small bowel neuroendocrine tumor. Clinical examination revealed a long-standing, painless wart-like axillary skin lesion with recent serous discharge. Imaging demonstrated multiple axillary and intramammary lymph nodes without a definite breast primary. Histopathological analysis of the excised lesion showed mucinous adenocarcinoma with regional nodal metastasis. Immunohistochemistry revealed positivity for ER, PR, GATA3, and mammaglobin, raising strong suspicion for metastatic breast carcinoma. However, absence of a detectable breast lesion and lack of definitive mammary tissue origin created a diagnostic dilemma. Following multidisciplinary review and correlation of clinical, radiological, and pathological findings, a diagnosis of PCMC of the axilla was established. The patient underwent completion axillary lymph node dissection and was commenced on tamoxifen due to hormone receptor positivity. He remains disease-free after 18 months of follow-up. This case highlights the diagnostic difficulty of PCMC, particularly in atypical locations such as the axilla, where it closely mimics metastatic breast carcinoma. Accurate diagnosis requires comprehensive clinicopathological correlation. Recognition of this entity is essential to guide appropriate management
Association between Non-Alcoholic Fatty Liver Disease and Carotid Intima-Media Thickness: A Clinical Investigation
Background: This study investigates the relationship between Non-Alcoholic Fatty Liver Disease (NAFLD) and Carotid Intima-Media Thickness (CIMT), a key indicator of cardiovascular risk. It aims to provide insights for developing strategies to address the growing impact of NAFLD on cardiovascular health. Methods: This cross-sectional study included 138 participants, 69 with non-alcoholic fatty liver disease and 69 healthy controls aged 18–50. Data were collected from medical records, diagnostic tests, and liver and carotid ultrasounds. Statistical analysis was conducted using SPSS 27, employing the Mann-Whitney U test and Generalized Estimating Equation (GEE) model, with a significance level of p<0.05. Results: The average age was 36.35 yr, mostly 30–39. The NAFLD patients were older, with higher overweight (20.6%) and smoking (47%) rates. They also had significantly higher carotid intima-media thickness. Conclusion: This study highlights a significant link between NAFLD and CIMT. Patients with NAFLD had higher CIMT values than healthy controls. Factors like Body Mass Index (BMI), overweight status, smoking, and age also showed significant correlations with CIMT. These findings underscore the need for early detection and targeted interventions to reduce cardiovascular risks in NAFLD patients.
Evaluation of Various Morphology and Location of Lingula and Prevalence of Accessory Mandibular Foramina Using Cone Beam Computed Tomography: A Retrospective Study
Background: The Mandibular Lingula (ML) is a tongue-shaped bony prominence that overlies the Mandibular Foramen (MF). Due to its association with important structures, it is used as an important anatomical landmark. The Accessory Mandibular Foramen (AMF) is an anatomical variation occasionally found on the ramus. The purpose of current study was to evaluate and standardize the various morphologies and precise locations of the lingula and the prevalence of accessory mandibular foramina using Cone-Beam Computed Tomography (CBCT). To observe the age and sex differences in ML. Methods: This was a retrospective institution- based study conducted using 400 samples of CBCT images acquired from the dental archives of the Radiology Department. All the data samples were assessed using RadiAnt DICOM viewer software. The data were subjected to statistical analysis using the chi-square test, and an independent sample t-test was used to assess the height and position of ML between males and females. A One-way ANOVA were used to compare the age-wise difference in height and position of the ML. Results: The most commonly observed morphology of mandibular l ingula in the study was nodular (41.8%). Based on sex, nodular shape was most common in males ( 55.1%), and triangular shape was more common in females (47.3%). The overall incidence of AMF is 1.5% in this study. Conclusion: Hence, these imaging findings will be helpful to oro -dental surgeons to avoid complications and anthropologists in forensic aspects.
Association between Serum Uric Acid and Mortality Rate among Admitted Patients in Intensive Care Unit
Background: Patients admitted to the Intensive Care Unit (ICU) generally exhibit high mortality rates, of which identifying associated factors can lead to better clinical management. The current study investigated the association between serum uric acid levels and mortality rates in patients admitted to ICU. Methods: In this cross-sectional study, demographical, clinical, and laboratory data of 126 patients admitted into the ICU of Razi Hospital, Rasht, Iran, were recorded. Also, the serum levels of creatinine and uric acid were evaluated. The severity score and mortality estimation was assessed using the Acute-Physiology-and-Chronic-Health-Evaluation-II (APACHE II) score. Data was analyzed using SPSS software, version 21, and the significant level was set at 0.05. Results: About 57.9% of the patients were male and 42.1% were female. The mean age of the patients was 56.46±17.02 years. The mean level of uric acid was 4.13±1.94 mg/d. Among different cause of ICU admission, surgery was the leading cause (38.89%), of which 69.05% were discharged, and the average ICU stay was 10.87±8.75 days. Patients requiring ventilators or vasopressors had significantly higher mortality rates (p<0.001). Higher APACHE II scores, longer ICU stays, and elevated uric acid levels were strongly associated with increased prevalence of mortality (p<0.05). Logistic regression analysis confirmed that the need for ventilators, vasopressors, and elevated uric acid levels significantly raised the death outcome among ICU patients with hyperuricemia (p<0.05). Conclusion: The findings demonstrated that elevated serum uric acid levels are significantly associated with increased mortality rates among patients admitted to the ICU, which suggests that monitoring and managing hyperuricemia may help improve patient outcomes in critical care settings.
Neutrophil to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, and Systemic Immune-Inflammation Index Association with Nutritional Markers in Maintenance Hemodialysis Patients
Background: Cardiovascular Disease (CVD) is the leading cause of death in patients with End-Stage Renal Disease (ESRD) undergoing Hemodialysis (HD). Recent studies have demonstrated that the Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Immune-Inflammation Index (SII) may help identify individuals at high risk of CVD. Malnutrition and inflammation have also been identified as significant risk factors for CVD in HD patients. Methods: Eighty-nine patients undergoing maintenance hemodialysis were included in the study. Nutritional parameters—including albumin, uric acid, Blood Urea Nitrogen (BUN), creatinine, triglycerides, cholesterol, Low-Density Lipoprotein (LDL), High-Density Lipo-protein (HDL), Fasting Blood Sugar (FBS), and Hemoglobin A1c (HbA1c)—were measured. The relationship between these parameters and NLR, PLR, and SII, was analyzed. Results: BUN, creatinine, uric acid, ferritin, FBS, HbA1c, LDL, and triglycerides were positively correlated with PLR, NLR, and SII (p<0.05). Conversely, albumin was negatively correlated with NLR and SII; as albumin levels increased, NLR and SII decreased (p<0.05). The correlation between albumin and PLR was not statistically significant (p>0.05). HDL was significantly negatively associated with NLR, PLR, and SII. Additionally, age had a significant effect on the variation of SII, NLR, and PLR (p<0.05). Conclusion: The three novel inflammatory composite indices—SII, NLR, and PLR—were closely associated with common nutritional biomarkers and may serve as cost-effective and convenient markers for predicting clinical prognosis in ESRD patients with CVD risk.
Prediction of Anxiety and Depression Based on Perceived Social Support and Socioeconomic Status in Cystic Fibrosis Patients: A Study in Tehran, Iran
Background: Cystic Fibrosis (CF) is a chronic disease frequently associated with psychological issues like anxiety and depression, often influenced by socioeconomic status (SES) and perceived social support (PSS). This study investigated the relationship between PSS, SES, and anxiety and depression levels in CF patients. Methods: A cross-sectional study involving 100 CF patients at the National Research Institute of Tuberculosis and Lung Disease (NRITLD) in Tehran, Iran (2024) utilized self-administered questionnaires for SES, Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), and Multidimensional Perceived Social Support Scale (MPSS). Data were collected in person or online. Statistical analyses included descriptive statistics, Pearson correlations, and simultaneous multiple regression (α=0.05). Results: Simultaneous regression revealed PSS as a positive predictor of anxiety (B=0.551, β=0.309, p=0.047), and SES as a negative predictor (B=–0.532, β=–0.570, p=0.001), explaining 23.2% of anxiety variance (R=0.482, R²=0.232; F(2,97)=7.11, p=0.002). The depression model was also significant (R=0.594, R²=0.301; F(2,97)=10.13, p<0.001), with SES being a significant negative predictor (B=–0.705, β=–0.496, p=0.001), while PSS had a non-significant negative effect (B=–0.242, β=–0.089, p=0.540). Durbin–Watson statistics were 1.457 for anxiety and 0.985 for depression. Both anxiety and depression scores negatively correlated with PSS (r=–0.496, p≤0.05). Conclusion: PSS and SES are significantly associated with anxiety and depression in CF patients. Enhancing social support and addressing socioeconomic disparities could improve psychological well-being. Early screening and targeted interventions are recommended for managing mental health in this population.
Effect of Blood Flow Restriction Training on Balance and Walking Speed in Children with Spastic Diplegic Cerebral Palsy: A Randomized Controlled Trial
Background: The neurodevelopmental condition known as cerebral palsy is characterized by a variety of motor dysfunctions, such as irregularities in posture and movement. Since these individuals are less tolerant of high-intensity exercises, a training program is required. This study aimed to assess how blood flow restriction training affected the balance and walking speed of children with spastic cerebral palsy. Methods: This randomised controlled trial was conducted at the ‘Cogniable, the child’, Physiotherapy clinic and SGT Hospital, Gurugram, India from November 2023 to May 2024. Thirty-two children with spastic diplegic cerebral palsy who were between the ages of 8 and 15 years and met the selection criteria were included in the study and randomly assigned into two groups. Study group (n=16) received blood flow restriction training along with rehabilitation program and control group (n=16) received only rehabilitation program. The data was collected at baseline and at end of 4th week of the study. The outcome measures used were Time Up and Go test (TUG) and 6-min walk test. Data was statistically analysed by using independent t-test and paired t-test. Results: After 4 weeks of intervention with blood flow restriction training combined with a rehabilitation program, the study group demonstrated significant improvements in both the TUG (p=0.042) and the 6-min walk test (p=0.003) compared to the control group. Within-group analysis showed significant improvements in the study group (p<0.001 for both tests) while control group revealed significant difference of p=0.001 for TUG and p<0.001 for 6-min walk test following four weeks of intervention. Conclusion: The results indicated that adding blood flow restriction training to children with spastic cerebral palsy improves balance and walking speed.
Evaluation of the Malpractice of General Surgeons in Complaints Referred to the Forensic Medicine Department of Tehran Center from 2016 to 2022
Background: Medical malpractice represents a growing concern in healthcare systems globally, with significant ethical, legal, and professional implications. General surgeons are among the most frequently implicated specialists in malpractice complaints reviewed by Iran’s Forensic Medicine Organization (FMO). Despite this, comprehensive analyses of complaints specifically involving general surgeons in Tehran remain limited. This study aimed to evaluate the characteristics, underlying causes, and outcomes of malpractice complaints against general surgeons referred to the Forensic Medicine Commission of Tehran from 2016 to 2022. Methods: In this descriptive cross-sectional study, all the malpractice cases related to general surgery submitted to the legal medical commissions of Tehran from 2016 to 2022 were reviewed. Data were extracted from the validated case files, including plaintiff demographics, characteristics of the complaints, and details of the malpractice findings. Cases with incomplete data were excluded from the analysis. Results: Of 965 total malpractice complaint cases, 196 (20.31%) involved general surgeons. Among these, 77 cases (39.28%) resulted in a confirmed malpractice verdict. The majority of cases originated from private medical centers (54.59%), which also had the highest malpractice rate (52.34%), followed by charity hospitals (36.36%) and university hospitals (20.93%). Mortality was reported in 9.10% of the confirmed malpractice cases, while the remaining cases involved organ failure or long-term functional impairment. Conclusion: Nearly 40% of the reviewed claims resulted in confirmed malpractice, with private centers presenting the highest conviction rate. The predominance of emergency surgeries, technical incompetence, and carelessness as leading causes of malpractice underscores the need for improvements in surgical education, clinical oversight, and procedural standards.
Comparative Analysis of Treadmill Walking with Different Occlusion Pressure on Aerobic Capacity and Muscle Strength among Sedentary Collegiates: A Pilot Study
Background: Blood Flow Restriction Training (BFRT) has demonstrated potential as a low-load training method to improve muscular strength and aerobic capacity, particularly in sedentary individuals. However, little is known about the effects of varying occlusion pressures on aerobic activity and knee muscle strength. This study aimed to investigate the effects of treadmill walking and two different occlusion pressures 40% and 60% of Artery Occlusion Pressure (AOP), on aerobic capacity and quadriceps muscle strength in sedentary young adults. Methods: This single-blind, randomized pilot study involved 40 sedentary college students, 18 of whom were women and 22 were men. The participants were randomly assigned to Group A (40% AOP) and Group B (60% AOP). Training was conducted three times a week for four weeks using a modified Balke protocol and H+ cuffs on the dominant leg. The Activforce 2 dynamometer and queen’s college step test was used to evaluate quadriceps force and VO₂ max before and throughout the intervention, respectively. Results: Both groups demonstrated significant improvements in aerobic capacity and knee extensor strength following the intervention (p<0.05). Two-way repeated measures ANOVA showed a significant main effect of time and a significant group×time interaction (p<0.05), indicating greater improvement in the 60% AOP group compared to the 40% AOP group. Percentage change analysis further supported these findings. Conclusion: Moderate-pressure BFRT (60% AOP) combined with treadmill walking resulted in greater increases in muscle strength and aerobic capacity than lower pressure BFRT. The findings suggest that pressure-specific programming can be used to optimize the advantages of BFRT in sedentary populations
A Comparative Analysis of the Short-Term Efficacy of Sleeve Gastrectomy and Roux-en-Y Gastric Bypass
Background: Given the growing global burden of obesity and the increasing number of bariatric procedures performed annually, it is crucial to compare the outcomes of different surgical techniques to guide clinical decision-making. This study aimed to evaluate the effectiveness of Roux-en-Y Gastric Bypass (RYGB) vs. Sleeve Gastrectomy (SG) in terms of weight loss and postoperative complications. Methods: A cross-study was conducted involving patients aged 18 years and older, with a Body Mass Index (BMI) of 40 kg/m² or higher, or a BMI between 35 and 40 kg/m² accompanied by obesity-related comorbidities. The participants underwent either SG or RYGB based on the medical assessments. The study analyzed the demographic data, surgical duration, length of hospital stays, and weight loss outcomes. Results: Eighty patients were included in the study, with 40 patients in each group, and there were no significant differences in their baseline characteristics. One year after surgery, SG resulted in a significantly greater reduction in BMI and Total Weight Loss percentage (TWL%) compared to RYGB, with a p-value of 0.021 for both measures. Additionally, SG had a shorter operative time, with a p-value of 0.004. The length of hospital stays and rates of anastomotic leaks were similar between the two groups. Conclusion: SG demonstrated superior short-term weight loss compared to RYGB, with greater BMI reduction and TWL. Both procedures had similar safety profiles.
Forecasting Lice Infestation Trends in Iran: Impact of COVID-19 and Future Projections
Background: Lice infestation is a global public health issue, particularly among children, with the COVID-19 pandemic potentially altering its trends. This study assessed the pandemic’s impact on lice-related search activity in Iran and forecasted future trends using Google Trends data. Methods: While Google Trends has been used for other health conditions, this is the first study to apply this methodology to lice-related searches in Iran, capturing unique regional pandemic impacts. Results: Analyzing Persian search terms (2014–2024), a time-series analysis compared unadjusted and seasonally adjusted models. The seasonally adjusted model outperformed the unadjusted one, with higher stationary R-squared (0.846 vs. 0.669), lower MAPE (1.624 vs. 9.189), and reduced BIC (0.032 vs. 3.676). It predicted a 7.7% increase in lice-related searches from November 2024 to November 2026. Conclusion: These findings support using digital data for lice surveillance and underscore the need for context-specific public health strategies.
A Future Without Human Error? A Critical Look at AI’s Growing Influence in Medical Education
The Double-Edged Sword of Defensive Nursing: Safety or Overcaution?
Cervical Effacement is More Prognostic than Cervical Dilation in Outcome of Pregnancy in Pregnant Women with Incompetent Cervix
Learning Cognitive-Behavioral Therapy through Peer-Assisted Learning: A Novel Experience
Promoting Responsible Portrayal of Mental Health in Iranian Cinema: Experience from the Second-Best Mental Health Movie Award at Iran’s 44th Fajr National Film Festival