Journal of Iranian Medical Council

When Doctors Become Martyrs: From Gaza to Tehran

Shahin Akhondzadeh — Tue, 09 Sep 2025 03:38:45 +0000

The Article Abstract is not available.

The Efficacy of Posterior Tibial Nerve Stimulation in the Treatment of Lower Urinary Tract Disorders in Children: A Systematic Review

Tue, 09 Sep 2025 03:41:49 +0000

Background: Lower Urinary Tract Disorders (LUTDs) are frequently observed among the pediatric population. Posterior Tibial Nerve Stimulation (PTNS) is a form of neuromodulation that aims to alter the aberrant pattern of nerve stimulation that supplies innervation to the bladder and pelvic floor. The objective of this systematic review was to broaden the scope of investigation on PTNS and evaluate its efficacy in the management of LUTDs in children.

Methods: A systematic search was conducted across seven electronic databases (Scopus, Web of Science, PubMed/MEDLINE, ProQuest, EMBASE, CENTRAL, PEDro) from inception to March 31, 2024, without any language restrictions. The search aimed to identify publications that compared the efficacy of PTNS with anticholinergic medications, urotherapy, sham, placebo, or other interventions for the treatment of LUTDs in children. The primary outcome was symptom improvement, and the secondary outcomes were urodynamic parameters and Quality of Life (QoL). The risk of bias was assessed using the Cochrane Collaboration’s tool.

Results: This systematic review included a total of six clinical trial, comprising 203 children. Merely, single research exhibited an overall low risk of bias, while another one demonstrated an overall unclear risk of bias. The studies evaluated a range of symptoms using various assessment methods or tools and found that PTNS resulted in symptom improvement for different LUTDs. Both arms of the two studies evaluating QoL reported a noteworthy improvement. Moreover, a significant improvement in the majority of urodynamic parameters was reported with PTNS across the studies.

Conclusion: The results of the included studies were in favor of PTNS for the treatment of LUTDs in children. Unified symptom assessment tools, standardized response to treatment criteria, a larger sample size, a lower risk of bias, a minimum number of urodynamic parameters, longer follow-ups, and the occurrence of adverse events should be considered for future clinical trials.

An Approach to New Treatments for Osteoarthritis: Advancing Phenotype-Specific Treatments and the Promise of Nanotechnology in Drug Delivery

Tue, 09 Sep 2025 03:44:34 +0000

Osteoarthritis (OA) is a prevalent joint disease causing substantial physical disability among adults, with no available therapy effectively halting structural deterioration or reversing existing defects. To address this, efforts have focused on tailoring treatment options through subgroup classification based on common characteristics.

These subgroups encompass structural types primarily driven by degenerative events affecting cartilage and bone, alongside inflammatory, pain-driven, senescence, and metabolic syndrome phenotypes. While classifying individuals into specific subtypes may prove challenging, it could aid in identifying patient groups most likely to benefit from specific therapies. Current clinical trials predominantly aim to regenerate or repair defects in cartilage and bone or target inflammatory mediators through intra-articular injections. However, this approach faces limitations due to low retention time and reduced efficacy, mainly attributed to rapid clearance from the joint.

Nanotechnology-based drug delivery systems offer promising solutions to these limitations. Advanced delivery platforms, including liposomes, natural polymers and their derivatives, and inorganic nanoparticles, have demonstrated superior retention and targeted delivery capabilities within the joint, potentially improving therapeutic outcomes and demonstrated promise in enhancing drug retention within the joint area. They provide solutions to current intra-articular medication delivery problems. Intra-articular drug delivery systems offer a significant improvement in drug efficacy by targeting specific cells or components. However, research in this field is still in its early stages and requires further investigation. This review article investigates recent developments in treatment options tailored to specific phenotypes of OA. In the following section, nanotechnology and its application in drug delivery for OA are explained.

Quality of Life and Psychiatric Symptoms in Post-COVID-19 Patients Six Months after Discharge: A Prospective Study Six Months Post-Discharge

Tue, 09 Sep 2025 03:48:58 +0000

Background: The aim of this study is to prospectively assess the quality of life and psychiatric symptoms in individuals who have been discharged after COVID-19, with a specific focus on understanding the enduring effects six months post-discharge and contributing valuable information for comprehensive post-COVID-19 care strategies.

Methods: This prospective study enrolled 99 patients with COVID-19 who visited the university outpatient clinic and 92 healthy age and gender matched individuals without COVID-19. The Depression Anxiety Stress Scale-59 (DASS-59) assessed stress, anxiety, and depression severity. For evaluating the Quality of life (QOL), the World Health Organization Quality-of-Life Scale (WHO QOL-BREF) questionnaire was employed. Multiple linear regression model addressed confounding factors including case group, age, gender, education, employment status, and marital status.

Results: This study included 92 COVID-19 patients and 92 age and sex-matched healthy individuals. For the COVID-19 patient group, significant positive associations were found across all the psychiatric symptoms, with β values of 8.52 for depression, 11.62 for stress, and 8.15 for anxiety, all with p-values less than 0.001, indicating strong statistical significance. Conversely, quality of life was negatively impacted (β= -9.57, p<0.0001) that post-COVID-19 patients exhibited significantly higher levels of depression, stress, and anxiety, with notable declines in quality of life, particularly among older individuals and the unemployed.

Conclusion: The results of this study highlight the multifaceted impact of COVID-19 on mental health and quality of life, emphasizing the need for comprehensive care that addresses both physical and psychological recovery.

Psychological Factors Influencing Pain Intensity Perception: A Qualitative Study on Canadian Patient Insights

Tue, 09 Sep 2025 03:53:58 +0000

Background: Chronic pain is a pervasive condition that significantly impacts the quality of life and involves complex interactions between physical sensations and psychological factors. This study aimed to explore the psychological factors influencing pain intensity perception, offering insights into how emotional responses, cognitive perceptions, social influences, and physical experiences shaping the experience of pain.

Methods: This qualitative study involved semi-structured interviews with 28 participants aged 18-65 from Richmond Hill, Ontario, who experience chronic pain within September to December 2023. The interviews aimed to achieve theoretical saturation and were analyzed using NVivo software to identify themes and sub-themes within the data.

Results: Four main themes were identified: emotional responses, cognitive perceptions, social influences, and physical experience. Each theme comprised several categories with distinct concepts such as anxiety, depression, coping mechanisms, pain significance, personal control, family dynamics, healthcare interactions, sensory details, and activity levels. These themes collectively depicted a comprehensive view of the multifaceted psychological impact on pain perception.

Conclusion: The study underscores the importance of addressing the psychological aspects of pain perception in chronic pain management. By integrating emotional, cognitive, and social factors, healthcare providers can enhance therapeutic approaches and improve quality of life for individuals suffering from chronic pain.

Effect of an Intervention Package on the Medical Students’ Stigma towards Patients with Psychiatric Disorders

Tue, 09 Sep 2025 03:58:49 +0000

Background: The present study aimed at investigating the effect of a stigma reduction intervention package on improving the attitude of medical students towards patients with patients with psychiatric disorders.

Methods: The authors included medical students at the Iran Psychiatric Hospital in the study and divided them into two intervention and control groups using cluster randomization method. In addition to regular psychiatric training, the intervention group was trained with a package that included watching a film, stigma awareness workshop, and direct social contact with patients with psychiatric disorders; each followed by group discussions. The outcome measures were assessed three times; before, immediately after, and three months after the intervention, using the Social Distance Scale (SDS), Dangerousness Scale (DS), and the short form of Opening Minds Scale for Health Care (OMS-HC).

Results: 74 filled all the questionnaires in all three times; the intervention group included 39 and the control group included 35 students. In one-month follow-up, stigma among the participants decreased according to OMS-HC and DS questionnaires as the difference between stigma scores were significant (p-value<0.001); however, based on SDS questionnaire, the decrease in stigma was not significant (p-value=0.074). In the three-month follow-up, stigma score decreased only based on the differences of OMS-HC scores which were significant between two groups (p-value=0.020).

Conclusion: Attending psychiatry clinical rotation could improve the students’ attitudes towards patients with psychiatric disorders and based on OMS-HC questionnaire if combined with intervention package, could improve this attitude even further.

Exploring Laboratory Predictors of Early Mortality in Patients with Stroke Referred to the Emergency Department: A Case-Control Study

Mofid Hosseinzadeh, Khorsand Besharati, Mahmoud Latifi, Mandana Pouladzadeh — Tue, 09 Sep 2025 04:02:29 +0000

Background: Considering high mortality and morbidity in patients with stroke, identification of predictors of poor prognostic outcomes after stroke is vital for stroke management strategies. This study aimed to evaluate the clinical and laboratory characteristics of patients with stroke to determine the prognostic factors of early mortality within 72 hrs of admission.

Methods: This case-control study included patients with stroke attending the emergency department from March-June 2023. The patients were divided into two groups, who died early within 72 hr of admission (case group=135) and those who survived and/or expired lately after three days (control group=138).

Results: The mean age of the case group was significantly higher than the control group (68.53 vs. 64.78, p=0.04). No significant correlations were found between early death and gender distribution, marital status, and type of stroke (p>0.05). The overall rate of underlying diseases in case group (85.9%) was higher (71.74%, p=0.005, OR [95%CI]:2.4[1.3_4.428]). The mean levels of WBCs, ESR, RDW-SD, triglycerides, and blood sugar in case group were significantly higher (p<0.05). Moreover, adjusted models showed that underlying disease (p=0.035, OR[95%CI]:2.034[1.052-3.934]) and high levels of WBCs (p=0.025, OR[95%CI]:1.067 (1.008-1.129)]), RDW-SD (p=0.018, OR[95%CI]:1.11[1.018-1.21]) and triglycerides (p=0.045, OR[95%CI]:1.005 [1-1.01]) were independently associated with high risk of early lethal within 72 hr.

Conclusion: Older age and underlying diseases can be risk factors for stroke-related early death within 72 hr. Moreover, underlying disease and high levels of WBCs, RDW-SD, and triglycerides may independently be predictive of early in-hospital death in patients with stroke.

The Effect of Surgical Masks on Blood Oxygen Saturation Level, Heart Rate and Respiration Rate

Ali Cheraghi, Tooraj Zandbaf, Malihe Abedi, Seyed Mohammad Ali Raisolsadat — Tue, 09 Sep 2025 04:05:37 +0000

Background: Using surgical masks during surgical procedures is imperative to mitigate the spread of infections. Nevertheless, extended use of these masks can potentially impact vital signs. This study aims to examine the impact of surgical masks on oxygen saturation, respiratory rate, and heart rate among surgeons and operating room personnel.

Methods: This before-after study involved 51 participants, consisting of operating room technicians and surgeons. The participants were required to wear a surgical mask continuously for at least 30 min, with strict guidelines against removing or adjusting the mask. The study assessed various metrics, including heart rate, oxygen saturation, respiratory rate, and well-being scale before and after mask usage. Data analysis was conducted using SPSS 23.

Results: The study found that the average age of the participants was 44 years old, with a standard deviation of 11.58 years. Of the participants, 58.8% were male and 41.2% were female. Wearing a surgical mask was shown to have a significant impact on oxygen saturation (p=0.003), respiratory rate (p<0.001), and heart rate per min (p<0.001). These physiological changes were not significantly correlated with age, gender, body mass index, or duration of surgery (p>0.05).

Conclusion: Overall, the results indicate that wearing a surgical mask can lead to changes in oxygen saturation and respiratory and cardiovascular parameters, regardless of individual characteristics or surgical factors.

Presystolic Wave Evaluation in Patients with Coronary Slow Flow

Tue, 09 Sep 2025 04:11:17 +0000

Background: Noninvasive assessment of arterial stiffness in patients with Coronary Slow Flow Phenomenon (CSFP) could be valuable for evaluating cardiovascular risk. Presystolic Wave (PSW) velocity is considered a predictor of cardiovascular disease and a marker of arterial stiffness. This study aimed to evaluate PSW velocity in patients with CSFP

Methods: This cross-sectional study investigated patients with acute coronary syndrome, dividing them into two groups: Cerebrospinal Fluid (CSF) and Coronary Normal Flow (CNF), with 30 patients in each group. Both groups underwent echocardiography, and PSW velocity was compared between them. Data analysis was performed using SPSS version 24 software.

Results: A total of 60 patients were included in the study. The mean ages in the CSF and CNF groups were 49.8±9.6 and 49.6±10.7 yrs, respectively. In the CSF group, 63.33% were female, compared to 43.33% in the CNF group. There were statistically significant differences in Em and aortic aortic Velocity Time Integral (VTI) among echocardiographic variables (p<0.05). However, PSW velocity did not significantly differ between the CNF and CSF groups (33.6±17.4 vs. 37.8±10.4, p=0.26), though it was slightly higher in slow flow patients.

Conclusion: In this study, no significant difference was found in PSW velocity between patients with slow coronary flow and those with normal coronary flow, and it is not associated with arterial stiffness. Therefore, PSW velocity cannot be used as a predictor of arterial stiffness in CSF patients. Further research is recommended to validate or refute these findings.

Predictors Indicating the Need for Packed Red Cell Transfusion in Trauma Patients in a Referral Hospital in Tehran Iran

Tue, 09 Sep 2025 04:18:26 +0000

Background: Injury is one of the leading causes of death worldwide. Additionally, acute traumatic hemorrhage is one of the leading reasons for mortality in traumatic patients. This study aims to determine factors indicating Packed Red Cell (PRC) transfusion in traumatic patients.

Methods: This case-control study was conducted at Sina Hospital in Tehran, Iran, from July 24, 2016, to April 8, 2023. The case group included all trauma patients aged 18 yrs and older who received PRC transfusions within 72 hr after admission. The control group comprised trauma patients aged 18 yrs and older who received no blood transfusion during their hospitalization.

Results: Patients with PRC transfusion had lower Hemoglobin (Hb) levels, bicarbonate levels, Diastolic Blood Pressure (DBP), higher tachycardia rate, lower Mean Arterial Pressure (MAP), lower Base Excess (BE), higher positive Focused Assessment with Sonography in Trauma (FAST) results, and penetrating injuries than the control group. Multivariate logistic regression revealed Hb≤10 g/dl had 5.449 times more odds for PRC transfusion [OR: 5.449, p<0.001]. Also, DBP≤70 mm/Hg increased 1.563 times PRC transfusion’s chance [OR: 1.563, p=0.036]. Patients with penetrating injury had 2.035 times more odds for PRC transfusion compared to the blunt victims [OR: 2.035, p=0.01]. Other predictors were MAP less than 65 and tachycardia [Pulse Rate (PR)>100] with 4.574 and 4.056 odds of ratio, respectively [OR: 4.574, 4.056, p=0.02, <0.001].

Conclusion: This study revealed hemoglobin levels, penetrating trauma, and shock indexes included DBP, MAP, and tachycardia as predictors for PRC transfusion.

Comparing the Efficacy of Home-Based Versus Center-Based Cardiac Rehabilitation on the Risk Factors for Cardiovascular Disease, Quality of Life and Adherence to Treatment: Double-Blind Randomized Clinical Trial

Mohammad Reza Vafaei Nasab, Gisoo Ariafard, Amid Khatibi — Tue, 09 Sep 2025 04:22:19 +0000

Background: This study was conducted to investigate the efficacy of home-based versus center-based cardiac rehabilitation on the risk factors for cardiovascular disease, quality of life and adherence to treatment.

Methods: Sixty-five patients were randomly assigned into the home-based group or the clinic-based group. A 3-month rehabilitation course was designed for patient in each session based on the AACVPR guidelines. Cardiac biomarkers, quality of life (using the SF-36 questionnaire), and treatment adherence (through a questionnaire) were evaluated at the beginning and end of the study for each patient. In both groups, data were compared before and after the rehabilitation, and the data between the two groups were also compared.

Results: In this study, the home group achieved significantly higher scores in three aspects of treatment adherence compared to the clinic group (p<0.01). The clinic group scored significantly higher in the social functioning domain of the quality-of-life measure compared to the home group (p=0.03). Additionally, the clinic group exhibited a lower average serum cholesterol level than the home group after rehabilitation (p=0.001).

Conclusion: Although the clinic group demonstrated better results in some quality-of-life domains and lower serum cholesterol post-rehabilitation, the home-based rehabilitation may offer benefits in terms of treatment adherence. Therefore, it seems that home-based rehabilitation can be considered a viable alternative for patients unable to attend center-based programs, particularly for those who prioritize convenience and adherence, but further research is needed to explore its impact on cardiovascular risk factors like blood pressure.

Elevation of Uric Acid in Serum and Saliva of Patients with Bipolar Disorder

Tue, 09 Sep 2025 04:27:16 +0000

Background: Bipolar Disorder (BD) is a fairly common serious mental illness. A definitive and reliable biomarker remains elusive despite extensive exploration of various serum markers, brain scans, and genetic variants for diagnostic utility in BD. Reports indicate that serum uric acid levels are elevated in BD. This study aimed to determine whether salivary uric acid levels, as a non-invasive method, change in the same way as serum levels in these individuals.

Methods: In a cross-sectional study, 28 patients aged 18 to 65 with BD based on DSM-5 diagnostic criteria were referred to teaching hospitals of Aja University of Medical Sciences in Tehran, and a control group consisting of 28 healthy individuals of the same gender and age entered the study. The serum and salivary uric acid levels were measured photometrically, and the data were analyzed by Unpaired Student’s t-test using SPSS software.

Results: The mean concentration of serum and unstimulated saliva uric acid was significantly higher in patients than in healthy individuals, and the cut-off point for serum was 6.4 mg/dL with a sensitivity of 79% and a specificity of 68%, and for saliva, it was 3.3 mg/dL with 65% sensitivity and 61% specificity

Conclusion: It seems that the amount of salivary uric acid increases in patients with BD, which may be used as an auxiliary biomarker for monitoring and diagnosis of the disease.

Randomized Clinical Trial of the Comparison of Continuous Training vs. Interval Training as a Pulmonary Rehabilitation Program for Patients with Idiopathic Pulmonary Fibrosis (IPF): A Pilot Study

Tue, 09 Sep 2025 04:32:17 +0000

Background: This study aimed to compare the two methods of pulmonary rehabilitation including continuous and High-Intensity Interval Training (HIIT) on exercise capacity, and quality of life in inpatients with Interstitial Lung Disease (ILD).

Methods: In this clinical trial, 30 patients diagnosed with IPF, were admitted to the pulmonary rehabilitation department and were randomly divided into two groups. In one group, the patients performed continuous training while walking on the treadmill with 60% of the maximum exercise capacity. In the other group, the patients performed HIIT with walking on a treadmill, including 2 min of activity with an intensity of 80% of the maximum exercise capacity, and 2 min of recovery with an intensity of 50 %.

Results: The participants were all Idiopathic Pulmonary Fibrosis (IPF) with a mean age of 12.67±51.50. The mean variables of the six-Minute Walk Test (6MWT) distance, results of the sit-to-stand test, and quality of life (based on a 12-Item Short Form Survey) before and after rehabilitation were significantly different in intragroup analysis. The mean of oxygen saturation, dyspnea, and fatigue before and after rehabilitation in both groups had a significant difference (p<0.001). In the intergroup analysis, the 6MWT distance was significantly improved in favor of the continuous training group (p=0.02), and the quality of life was significantly improved in favor of the high-intensity interval training group (p=0.002).

Conclusion: HIIT was associated with a significant improvement in exercise capacity and quality of life in ILD patients. However, there was no evidence that it was superior to continuous training.

The Assessment of Adherence to the Treatment Regimen in Patients with Percutaneous Coronary Intervention

Shahab Ziba Sokhan, Jamalodin Begjani, Saeideh Mazloomzadeh, Ali Zahed Mehr — Tue, 09 Sep 2025 04:37:00 +0000

Background: Cardiovascular diseases are one of the world’s most important causes of mortality. Despite the reduction in mortality, these patients are forced to adherence is a particular therapeutic regimen to prevent further complications. This cross-sectional study was conducted on 110 patients four to six weeks following Percutaneous Coronary Intervention (PCI).

Methods: The questionnaire involved seven areas: attention in treatment, willingness to participate in treatment, ability to adapt, treatment integration with life, adherence to treatment, commitment to treatment, and doubt in implementing treatment.

Results: Findings showed that the standardized mean score of total treatment adherence was 91.39. According to the results, gender, age, marital status, place of residence, underlying disease, smoking, use of cardiac drugs, patient condition and the number of vessels involved did not affect the score of treatment adherence (p>0.05). Further analysis revealed that with increasing hospitalization days, treatment adherence increases (p<0.05).

Conclusion: The present survey indicated that patients’ treatment adherence was favorable. Based on the findings, treatment adherence, one of the fundamental factors for reducing the mortality rate of patients undergoing PCI, is satisfaction level. Further investigations are highly recommended to consider other risk factors for reducing the mortality rates in these patients.

Effect of Virtual Reality Therapy on Balance and Walking Speed in Children with Spastic Cerebral Palsy: A Randomized Controlled Trial

Tue, 09 Sep 2025 04:40:27 +0000

Background: Children with spastic cerebral palsy have some limitations in their functional mobility and also problems with their balance and postural control. The purpose of this study was to examine the effect of virtual reality training on balance and walking speed in children with spastic Cerebral Palsy (CP).

Methods: This is a single blinded randomized controlled trial. According to the preliminary data obtained from the pilot study, the total sample size was determined, and 30 children with spastic CP (5–12 years) were randomly allocated into the intervention (n: 15) and control groups (n: 15). Both groups received the treatment with conventional occupational therapy for 30-min sessions three times per week. The intervention group also received supervised therapy using Xbox Kinect games in each session for 6 weeks. Balance by TUG test and Pediatric Balance Scale (PBS), and walking speed by 10-meter walking test were measured in pretest, post-test, and follow-up. Additionally, repeated measures analysis of variance (ANOVA) was used to examine the interaction effects of time and group.

Results: Thirty children with spastic CP (mean age: 8.5 years; Gross Motor Function Classification System: level I, 23.3%, level II,) were analyzed. The results showed that there was a statistically significant difference between the two groups only in the PBS score (p=0.013). Additionally, the interaction effect of time and group was significant for both TUG and PBS scores (p<0.001).

Conclusion: Using V.R therapy along with routine occupational therapy can be effective for improving balance and walking speed in children with spastic CP.

Variations of Frontal Sinus and Sphenoid Sinus Pneumatization in Patients with Cleft Lip and Palate: A CBCT Study

Maryam Paknahad, Mahya Agharokh — Tue, 09 Sep 2025 04:42:39 +0000

Background: This study aimed to evaluate the frontal sinus and sphenoid sinus pneumatization and variations in patients with Cleft Lip and Palate (CLP) on Cone Beam Computed Tomography (CBCT) images and to compare them with a control group.

Methods: In order to evaluate the sphenoid sinus types, CBCT images of 59 patients with CLP and 59 non-cleft individuals and for evaluation of the frontal sinus types, CBCT images of 31 subjects with CLP and 31 non-cleft individuals were obtained. The main types of frontal sinus pneumatization (types 1, 2, and 3) and the main types of sphenoid sinus pneumatization (conchal, presellar, sellar and post-sellar) were analyzed in CLP and control groups. The two groups were compared using chi-square test.

Results: For sphenoid sinus, the sellar and post-sellar types were the most common types in the CLP group and the control group, respectively. The results revealed no significant difference between the CLP group and the control group regarding all types of sphenoid sinus pneumatization. Type 2 was the most common type of frontal sinus pneumatization in both CLP and control groups. The results demonstrated no significant difference between the CLP and control groups regarding all types of frontal sinus pneumatization.

Conclusion: The results showed no significant difference between the CLP and control groups regarding the types of frontal sinus and sphenoid sinus pneumatization, proposing a similar risk of consequences in the CLP group and non-cleft individuals.

Investigating the Effectiveness of Using Surgical Clips to Mark Biopsied Breast Masses

Tue, 09 Sep 2025 04:47:04 +0000

Background: The present study was designed with the aim of investigating the effectiveness of using surgical clips to mark biopsied breast masses.

Methods: This study was a semi-experimental study in which the statistical population included all the breast cancer patients who referred to Golestan Hospital for marker testing. A checklist including the variables examined and patient information (such as age, location of lesion, size of lesion, ultrasound findings, mammography findings, history of snake bites, received or not received chemotherapy, response rate to treatment, type of marker used, number of markers used, cabling requirements, operation results) was collected and finally analyzed.

Results: In this study, 42 women with a mean age of 48.29±9.56 years were examined. 22 cases of masses were in the left breast. According to the size results, 35.7% (15) of the masses in the first dimension were between 11 and 20 mm and 31.0% (13) were between 21 and 30 mm and in the second dimension 45.2% (19) of the masses were between 21-30 mm and 28.6% (12) were between 11 and 20 mm. In the present study, the results of mammography after surgery showed that all the markers were placed in the correct location, 100% (42) and 71.8% (30) of the markers used were metal and 28.6% (12) were made of titanium metal. One marker was used in 59.5% (25) of the patients and two markers were used in 21.4% (9) of the patients.

Conclusion: This success and effectiveness is due to the innovations used in this study in the shape of the marker and its entry, and it is hoped that the results of this study will be used for better localization of the tumor.

Anticonvulsant Effects of Matricaria chamomilla Extract and Rosa damascena Oil in a Pentylenetetrazol-Induced Seizure Model: A Comparative Study

Mahdi Mashhadi Akbar Boojar, Seyed Mohammad Hoseini, Mehdi Saberi — Tue, 09 Sep 2025 04:50:26 +0000

Background: Seizures are paroxysmal events that cause abnormal brain activity. They manifest as convulsions and loss of consciousness. Pharmaceutical treatments have many severe side effects, thus people are investigating alternative therapies involving essential oils. This research project has investigated the anticonvulsant effects of Matricaria chamomilla extract (MCE) and Rosa damascena oil (RDO) on mice with induced seizures.

Methods: In this study, 64 male mice in 8 groups were examined independently for the behavioral responses to Pentylenetetrazole (PTZ) after receiving saline, diazepam (4 mg/kg), MCE, and RDO (100, 200, or 400 mg/kg). The efficacy of the treatments was assessed by evaluating the occurrence of the first facial or forelimb movements, Minimal Clonic Seizure (MCS), first Generalized Tonic-Clonic Seizure (GTCS), the number of leg stretches, and the mortality rate. The data was separately evaluated using one-way ANOVA, and significance was determined at p<0.05.

Results: Seizure symptoms were absent in mice treated with diazepam, MCE, and RDO until one hour after PTZ administration, while all mice in the PTZ and normal saline group died. MCE and RDO at 200 and 400 mg/kg increased the latency of MCS and first facial or forelimb movements and reduced leg stretching in PTZ-treated mice. Both compounds delayed the onset of GTCS.

Conclusion: Consequently, MCE and RDO demonstrate promising anticonvulsant effects in a preclinical model, warranting further investigation into their therapeutic potential and mechanisms of action in seizure disorders. They also offer potential alternatives to traditional antiseizure agents.

Quality of Life After Sleeve Gastrectomy

Tue, 09 Sep 2025 04:54:13 +0000

Background: Sleeve Gastrectomy (SG) is a popular and effective surgical procedure for Metabolic and Bariatric Surgery (MBS) worldwide. As MBS gains popularity across different social classes, evaluating Quality of Life (QoL) post-surgery in various regions is crucial. Social and economic factors significantly influence QoL and can help surgeons identify the best candidates for MBS.

Methods: This pre-post study was conducted on 57 patients between 18 and 60 years old with a Body Mass Index (BMI) over 40 kg/m² or over 35 kg/m² with at least one obesity-related comorbidity who were candidates for SG. QOL was measured using the WHOQOL-BREF questionnaire. The questionnaire contains 26 items, grouped into 4 domains: physical health, psychological health, social relationships, and environmental health; it also contains QOL and general health items. Each item of the WHOQOL-BREF is scored from 1 to 5 on a response scale, which is stipulated as a five-point ordinal scale. The scores are then transformed linearly to a 0–100 scale. IBM SPSS version 20 was utilized for the analysis

Results: A total of 57 patients underwent SG, with 40 females and 17 males. The patients had a mean age of 37.6±9.58 years and a mean BMI of 42.8±5.20 kg/m². The results showed that the scores of all domains of the WHOQOL-BREF questionnaire before and 6 months after SG have a statistically significant difference (p<0.05).

Conclusion: The QoL improves after sleeve gastrectomy.

Effects of Chitosan on Micro-Shear Bond Strength of Self-Adhesive Cements

Tue, 09 Sep 2025 05:09:04 +0000

Background: The long-term success of bonding of self-adhesive cement to the tooth is questionable. Different conditioning methods were suggested to improve the bonding durability of these cements. This study aimed to investigate the effect of 1% chitosan solution on micro-shear bond strength of self-adhesive resin cements to dentin.

Methods: 28 human sound premolar teeth were divided into 4 groups. The occlusal surfaces of the teeth were ground to expose the dentine surface. In control groups, BF (Bifix) and EB (Embrace) dual-cure self-adhesive cements were applied to the dentin surface using a microtube and were light cured. In the EB+Ch and BF+Ch test groups, dentin surfaces were conditioned with 1% chitosan solution before using resin cements. The specimens were thermocycled for 2000 times between 5-55°C and their bond strength was measured by a mechanical testing machine at strain rate of 0.5 mm. Failure modes were determined using a stereo-microscope at 40X magnification. Data were analyzed using Two-Way ANOVA and Tukey’s tests (α=0.05).

Results: The results have revealed maximum bond strength in the EB+Ch test group (13.73±0.42 Mpa) and the minimum strength in the BF control group (8.01±0.42 Mpa). Data analysis showed the maximum bond strength in groups where dentin had been pretreated with chitosan solution (p<0.001). The failure mode was mainly adhesive type in all groups.

Conclusion: Dentin surface treated with 1% chitosan solution prior to application of self-adhesive cements increases the cement-dentin bond strength.

Delayed Surgical Treatment and Survival Outcome in Breast Cancer

Shaghayegh Kamian, Melika Golmohammadi, Fargol Farahmandi, Parynaz Parhizgar — Tue, 09 Sep 2025 05:18:48 +0000

Background: For decades, there was inconsistency regarding the association between delay in treatment initiation (surgery) and survival outcomes in breast cancer patients. Therefore, this study aimed to evaluate the impact of the interval between diagnosis and curative surgery on survival outcomes in patients diagnosed with breast cancer.

Methods: This retrospective study was conducted on patients with stage I-III breast cancer referred to Imam Hossein Hospital in Tehran between 2011 and 2013. The Kaplan-Meier survival analysis and Cox proportional hazard model were performed to investigate the effect of delay in time from diagnosis to surgery and its effect on patients’ overall survival.

Results: analysis of 93 patients who were treated with surgery at Imam Hossein Hospital showed the interval between diagnosis and surgery using various subgroup (cut-off value: 15, 30, and 45) had no effect on overall survival. However, surgery over 60 days after biopsy may be associated with worse overall survival (p=0.017). Cox proportional hazard model for comorbidities (HR and 95% CI: 0.2; 0.05-0.8, p<0.05) and distant metastasis (HR and 95%CI: 0.06; 0.01-0.23/p<0.0001) indicated a significant association with worse survival outcomes.

Conclusion: The findings demonstrated that time intervals of 60 days or longer between biopsy and surgery adversely impact overall patient survival. The presence of comorbidities and metastasis is likely to reduce the overall survival during the specified intervals.

Effect of Repetitive Transcranial Magnetic Stimulation (rTMS) on Nicotine Use Disorder in Patients with Schizophrenia: A Randomized Double-Blind Clinical Trial

Tue, 09 Sep 2025 05:22:20 +0000

Background: Schizophrenia is a chronic mental disorder with high nicotine use rates. Despite available interventions, smoking cessation remains challenging due to unique neurobiological and behavioral factors. This study evaluates the efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) using Theta Burst Stimulation (TBS) in reducing nicotine cravings and consumption in schizophrenia.

Methods: A randomized, double-blind controlled trial was conducted with 44 patients with schizophrenia and nicotine use disorder between summer 2022 and summer 2023. The main objective was to assess rTMS effectiveness in reducing cravings and consumption. Secondary objectives included evaluating changes in cravings via the Visual Analog Scale (VAS), comparing cigarette use before, immediately after, and one month post-intervention, and assessing effects on positive and negative symptoms (PANSS scale). Participants were randomized to rTMS or sham. Inclusion criteria were DSM-5 schizophrenia and nicotine use disorder. The rTMS group received 10 sessions using the TBS protocol (20 Hz, 90% RMT, 20 trains, 30 pulses/train, 1.5 s on, 30 s off, 750 pulses/hemisphere) over two weeks, targeting the left Dorsolateral Prefrontal Cortex (DLPFC). Key outcomes were measured pre- and post-intervention.

Results: Nicotine cravings and cigarette consumption decreased significantly in the rTMS group versus sham. No significant differences in schizophrenia symptom severity were observed. The intervention was well tolerated with minimal side effects.

Conclusion: rTMS with TBS effectively reduces nicotine cravings and consumption in schizophrenia, representing a promising adjunctive therapy for smoking cessation.

Epidemiology of Lower Limb Injuries and Dysfunctions in Athletes of Mountain Sports

Sara Lotfian, Ehsan Saadat, Haleh Dadgostar — Tue, 09 Sep 2025 05:26:06 +0000

Background: Lower limbs have been reported as the most common site of acute injury in mountain sports, however, the long-term effect of participating in sports that are practiced in steep terrain is not clear. This study aimed to investigate specifically the frequency of lower limb injuries and functional disorders of athletes in different disciplines of mountain sports including mountaineering, skiing, and sky running.

Methods: In this cross-sectional study, 114 athletes registered in the Mountaineering and Skiing Federations of Iran, completed an online survey. The link sent to volunteers included a checklist for demographic profile, history of acute injury, and the Persian version of the Lower Extremity Functional Scale (LEFS).

Results: The overall prevalence of lower limb injury was 27.4%, and the median score of LEFS was 78, which was in the normal range. However, 44.2% of the athletes had an LEFS score that indicated a lower-than-normal lower extremity function. No correlation was found between a history of acute injury and reduced LEFS score.

Conclusion: The high prevalence of lower limb dysfunction in mountain athletes and the lack of correlation between the history of acute injury and lower limb dysfunction in this study indicates the possible role of other risk factors in the development of overuse injuries.

Epidemiological Study of Aluminum Phosphide Poisoning Mortality in Tohid Hospital, Sanandaj, from 2010 to 2018

Tue, 09 Sep 2025 05:45:40 +0000

Background: Aluminum Phosphide (ALP) is a highly toxic inorganic compound, widely used as a rodenticide and insecticide during grain storage and transportation in developing countries. The present study investigated the aluminum phosphide poisoning mortality in Tohid Sanandaj Hospital from 2010 to 2018.

Methods: In this cross-sectional descriptive-analytical study, the medical records of 76 aluminum phosphide-poisoned patients admitted to Tohid Hospital in Sanandaj between 2010 and 2018 were studied. The data were analyzed through SPSS-20 software, using frequency, percentage, the mean and standard deviation for descriptive variables, and t-test and chi-squared for analytical variables. Using the relative risk index, the strength of the relationship was assessed.

Results: This study showed that 21.1% of the patients died of poisoning, and 76.9% were discharged. The highest mortality rate was associated with the oral administration and intact tablet form. In this study, 56.6% of participants were men, and the mortality rate due to pill poisoning was the same in both sexes (p=0.55). The results also demonstrated that majority of the individuals studied had a diploma (56.6%; p=0.566), and in terms of occupation, the highest frequency was related to self-employment (56.6%; p=0.472), but the highest mortality rate was observed in the unemployed groups (43.8). In this study, 59.2% of the participants were single, and the highest mortality rate was related to the single group (p=0.763).

Conclusion: Considering that administration to the treatment time interval and the number of pills consumed is associated with higher patient mortality, these components can be studied as an estimate of prognosis more thoroughly and accurately in ALP poisoning.

Comparison of the Diagnostic Performance of Shear Wave Elastography and Strain Elastography in Differentiating Benign and Malignant Breast Masses: A Prospective Study in Iran

Tue, 09 Sep 2025 05:49:37 +0000

Background: Elastography is a non-invasive diagnostic imaging technique that assesses the elasticity or stiffness of tissues. This study aimed to compare the diagnostic performance of Shear Wave Elastography (SWE) and Strain Elastography (SE) in distinguishing benign from malignant breast masses.

Methods: In a prospective study, 447 women with breast masses were evaluated divided into two groups: 223 underwent SE, and 224 underwent SWE. Histopathological findings served as the gold standard. Sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), and Receiver Operating Characteristic (ROC) curves were calculated for both techniques. Data analysis was performed using R software (version 4.3), with t-tests and chi-square tests for group comparisons.

Results: The mean age of participants was 46.1±9.8 years. Significant differences were observed between the benign and malignant groups in terms of age, mass size, and family history of breast cancer (p<0.05). For SWE, sensitivity, specificity, PPV, and NPV were 92, 93, 89, and 95%, respectively, compared to 85, 87, 82, and 89%, respectively for SE. The diagnostic accuracy of SWE was higher than SE (93 vs. 86%). The area under the ROC curve was 0.94 for SWE and 0.88 for SE.

Conclusion: SWE demonstrated superior diagnostic performance compared to SE in differentiating benign and malignant breast masses. This non-invasive technique can serve as a valuable clinical tool to improve diagnostic accuracy for malignancies and reduce unnecessary biopsies. However, multicenter studies with larger, more diverse samples are needed to validate these findings.

They are Tongue Papillae, Not HPV-Related Lesions: More Attention, Please!

Hamed Mortazavi — Tue, 09 Sep 2025 05:52:04 +0000

The Article Abstract is not available.

Nursing Care for Cancer Patients in the End Stages of Life: Navigating the Challenges and Ambiguities

Reza Abdollahi, Somayeh Khezerloo — Tue, 09 Sep 2025 05:54:29 +0000

The Article Abstract is not available.

The Reform Process of Mental Health Services Within Iran’s Primary Health Care (PHC) System: What has been Accomplished and What Remains to be Done

Hadi Zarafshan, Mohammadreza Shalbafan — Tue, 09 Sep 2025 05:57:00 +0000

The Article Abstract is not available.