Journal of Shahid Sadoughi University of Medical Sciences

Disaster Risk Management: the Missing Link to Health Systems Resilience

2026-05-03T09:55:57+00:00

Introduction: In recent decades, global health systems have faced a series of complex and unpredictable disasters and crises, revealing their fragility even in developed countries. Events such as the COVID-19 pandemic, the escalation of natural disasters due to climate change, and humanitarian crises arising from conflicts and widespread migration have shown that the response capacity of health systems is more limited than previously thought. Under these circumstances, the concept of ‘health system resilience’ has emerged as a key policy approach, emphasizing the ability to predict, absorb, adapt, and recover from shocks. However, an examination of existing policies and programs indicates that ‘disaster risk management’ still lacks adequate standing in the operationalization of health system resilience and is often considered marginally or purely reactively.

Effects of the Immediate and Long-term Water and Thera Band Exercises on Ground Reaction Forces in People with Pronate Foot During Walking: A Systematic Review and Meta-analysis

2026-05-03T09:55:56+00:00

Introduction: The ankle joint, due to its role in bearing the body’s weight, is one of the most vulnerable joints of the lower extremity. Therefore, the aim of the present study was to investigate the effects of immediate and long-term water and TheraBand exercises on ground reaction forces in individuals with pronate feet during walking.

Methods: The present study was a systematic review and meta-analysis. A search for Persian and English articles was conducted from the beginning of 2021 to the beginning of June 2024 in the citation databases WOS, SID, Magiran, Scopus, PubMed, ISC and Google Scholar search engine. Four articles were selected based on the inclusion and exclusion criteria. The short-term and long-term effects of ground reaction forces, impulse, free torque and loading rate of the studies were collected and meta-analyzed. The Downs and Black questionnaire was used to evaluate the quality of the articles. Quantitative data synthesis was conducted using the Cochrane Review Manager (Version 5.1).

Results: The findings indicated that an 8-week regimen of aquatic exercises significantly enhances anterior-posterior force during the heel strike phase (P=0.002; I=84%). Additionally, the results suggested a meaningful reduction in medial-lateral impulse (P=0.03; Z=2.16) and positive peak free torque in individuals with pronated feet during walking (P=0.02; Z=2.33). Furthermore, the data showed that eight weeks of aquatic training can significantly increase the negative peak free moment (P=0.0001; Z=3.81). The results of meta-analysis demonstrated that both short-term and long-term (eight weeks) effects of aquatic and Theraband exercises had no significant impact on vertical and internal-external forces (during both the heel contact and push-off phases), as well as on anterior-posterior force during the push-off phase (P>0.05).

Conclusion: According to the results of the present meta-analysis, it seems that the exercises in the water have long-term clinical and therapeutic effects on people with pronate and can be useful for correcting the walking pattern.

Evaluating the Impact of Vitamins C and E Treatment on Paraquat-Induced Acute Toxicity in Animal: A Systematic Review and Meta-Analysis

2026-05-03T09:55:55+00:00

Introduction: Paraquat is a widely used but extremely toxic herbicide that can cause severe health complications or even death if ingested or absorbed. Managing paraquat poisoning remains a great challenge since, despite the availability of treatment such as gastric lavage and antioxidantherapy, the mortality rate remains high. This meta-analysis study aimed to investigate the effect of vitamin C and E treatment on paraquat poisoning in animal studies.t

Methods: A comprehensive systematic search was conducted among electronic databases, including the Cochrane Library, PubMed, Scopus, ISI web of science, and Google Scholar, to identify relevant studies published from inception to December 2024 for animal studies. The meta-analysis was performed using a random-effects model based on data extracted from these animal studies.

Results: Finally, nine animal studies were included in the meta-analysis. The most frequently examined parameters included blood factors, liver enzyme levels, and creatinine levels, which therefore became the focus of the analysis. The meta-analysis showed a significant relationship between vitamin E administration, creatinine parameters (P < 0.001) and ALP levels (P = 0.026) after paraquat poisoning.

Conclusion: Although some parameters changed due to the small number of samples, a meta-analysis of all parameters was impossible. Creatinine and the ALP enzyme significantly changed in rat receiving vitamins. However, the two indices, SGPT and SGOT, did not change significantly. Further research with a larger number of samples is needed to draw a definitive conclusion.

Evaluation of Neurological Symptoms in Children and Adolescents under 18 Hospitalized with COVID-19 at Shahid Sadoughi Hospital

2026-05-03T09:55:53+00:00

Introduction: SARS-CoV-2 virus also affects children by causing a wide range of symptoms, including neurological involvement. This study investigated the frequency and pattern of neurological manifestations in pediatric patients with COVID-19.

Methods: This descriptive–analytical study was conducted on children under 18 years of age with COVID-19 who were referred to the pediatric emergency department of Shahid Sadoughi Hospital or referred from other centers. Demographic information, clinical symptoms with emphasis on neurological manifestations, complications, and diagnostic results including RT-PCR and lung CT scans were recorded. Followed-up after discharge was conducted by interviewing parents. After coding and checking the accuracy, the data were analyzed with SPSS version 16 software.

Results: A total of 191 children (49.7% boys and 50.3% girls) were studied. The most common neurological manifestation was motor disorders such as imbalance, weakness, tremor, and limb pain (14.9%). This was followed by seizures (12.2%), headache and impaired consciousness (8.8%). Symptoms such as dizziness, anorexia, fatigue, and lethargy were reported in 22.1% of cases. In total, 48.2% of patients had at least one neurological symptom. There was no significant association between the occurrence of neurological symptoms and gender, underlying disease, or length of hospitalization; however, headache was more prevalent with increasing age (p<0.01) and movement disorders were more common in the 5–13-year age group (p<0.001). The presence of ground glass appearance on lung CT scan was also associated with impaired consciousness (p=0.01).

Conclusion: Neurological symptoms, especially movement disorders and headache, are relatively common among children with COVID-19, and some of them are related to age and lung imaging findings; while gender, underlying disease, and length of hospitalization do not play a role in the occurrence of these symptoms.

Evaluating the Effectiveness of Flipped Classroom Instruction on Cardiopulmonary Resuscitation Competency Among Undergraduate Emergency Medical Students: A Randomized Controlled Trial

2026-05-03T09:55:52+00:00

Introduction: Considering the essential role of cardiopulmonary resuscitation (CPR) training in enhancing the clinical competence of emergency medical students, along with the limitations of traditional teaching methods, the adoption of innovative approaches such as the flipped classroom has gained increasing attention. The aim of this study was to determine the effectiveness of flipped classroom instruction on CPR competence among undergraduate emergency medical students.

Methods: This study was designed and conducted as a randomized controlled trial. A total of 102 undergraduate emergency medical students were randomly assigned to either the intervention group or the control group. The intervention group underwent CPR training through the flipped classroom approach, whereas the control group received CPR training through traditional instruction. In the control group, traditional education included in-person lectures, classroom discussions, and practical exercises. To assess students’ performance and clinical competence, the Mini-CEX form was applied to evaluate individual clinical skills, and the OSCE was employed to assess practical competence in performing CPR. These evaluations were conducted at three time points: baseline (pre-test), week eight, and week twelve.

Results: Findings indicated that the intervention group, compared to the control group, achieved higher scores both in the assessment of clinical skills using the Mini-CEX and the practical competence assessment (OSCE) related to CPR performance. The differences in mean scores at post-test time points were statistically significant (p < 0.001). Specifically, the mean OSCE scores in the intervention group increased by approximately 8.8 points from baseline to week eight, by 11.8 points from baseline to week twelve, and by 3 points between week eight and week twelve. These results demonstrated a significant upward trend in clinical competence among participants in the intervention group over time.

Conclusion: Based on the findings, flipped classroom instruction may be regarded as an effective and student-centered approach for CPR training and may serve as a foundation for curriculum reforms in emergency medical education.

Investigating the Effect of the Injection Speed of the Combination of Neostigmine and Atropine on the Heart Rate of Patients under General Anesthesia in Shahid Rahnamoun Hospital, in Yazd City in 2021

2026-05-03T09:55:50+00:00

Introduction: A large number of surgical procedures are performed worldwide each year, and it is essential to take precautions to ensure maximum patient safety. The combination of atropine and neostigmine, commonly known as reversal, is administered at the end of surgery to counteract the effects of muscle relaxants; however, it may influence cardiovascular stability. The aim of this study was to find a way to minimize this impact.

Methods: The present study was conducted as a double-blind clinical trial involving 69 patients who were candidates for various surgical procedures and met the inclusion criteria. Participants were selected purposively and randomly divided into three groups based on the reversal injection speed (10 seconds, 1 minute, and 3 minutes). Heart rate was measured and recorded using a data checklist- first at the end of the operation and before the reversal injection, and then at different intervals after the injection. Then, the data was entered into SPSS version 26 software and analyzed using descriptive statistical methods.

Results: The variables of gender and injection speed significantly affected changes in heart rate. Specifically, the mean heart rate variation was higher among female patients than male ones, and lower in the 3-minute injection group compared to the other groups.

Conclusion: Administrating the reversal drug over three minutes resulted in the smallest alternations in patients' heart rates following surgery.

Epidemiological Investigation of Types of Poisoning Referred to Shahid Beheshti Hospital in Taft, Yazd Province, in 2019

2026-05-03T09:55:49+00:00

Introduction: Poisoning cases represent a major category of medical emergencies and remain an important cause of mortality, as well as leading contributor to acute diseases in many developing countries. The aim of this study was to investigate the frequency distribution of poisonings and provide appropriate strategies to reduce poisoning cases.

Methods: This descriptive cross-sectional study was conducted on 609 poisoned patients who were referred to Shahid Beheshti Hospital in Taft, Yazd Province, Iran, during the year 2019. Sampling was performed using the census method. Data were collected using a researcher-made checklist by reviewing medical records and the Medical Care Monitoring System (MCMC). Statistical analyses were conducted using SPSS version 20. Descriptive statistics, - including frequency, percentage, mean, standard deviation-were calculated, and the chi-square test was used to compare qualitative variables. A p-value of less than 0.05 was considered statistically significant.

Results: Out of 609 patients admitted to Shahid Beheshti Hospital in Taft, 49.6% were male and 50.4% were female. The average age of the participants was 27.49 (±14.64) years, with the highest percentage (39.9%) in the 19-30 age groups. The most common poisoning agent was drugs, accounting for 66.2%, of which 19.7% were psychiatric medications. The average hospital stay was 2.34 (±1.33) days. The highest and lowest rates of poisoning occurred in spring and summer, with 35.1% and 16.4%, respectively.

Conclusion: The highest rate of intentional poisoning and suicide attempts was observed among young female individuals. As psychiatric drugs constitute the most common agents involved in drug-related poisonings, it is recommended that access to these medications be restricted and regulated, preventing their purchase without a physician’s prescription. Overall, given the number of hospitalization days due to poisoning and the high cost of treatment, measures should be taken to prevent poisoning cases.

Investigating the Relationship between Anthropometric Indices and Blood Pressure in Adults: Results of the First Phase of Shahdieh Cohort in Yazd Province

2026-05-03T09:55:48+00:00

Introduction: Obesity and overweight are important risk factors for a wide range of diseases, including high blood pressure. In addition, anthropometric indicators are considered independent predictors of blood pressure. The purpose of this study was to investigate the relationship between blood pressure and anthropometric indices and to determine the best determinant of hypertension in the Yazd Shahdieh cohort population.

Methods: The present study was a descriptive study conducted during the first phase of Shahdieh Cohort Study on, involving 10194 residents of Shahdieh, Ashkazar and Zarch Cities. eligible individuals were enrolled, and the data were analyzed using STATA 16 through Chi-square, T-test, ANOVA, logistic regression, and ROC Curve analyses.

Results: Among the participants, 36.7% of adults were found to have high blood pressure. Adjusted logistic regression results showed that the variables of gender, BMI, age, education level, triglyceride levels, diabetes, and family history of hypertension in first-degree relatives as significant predictors of hypertension. Of all anthropometric indices, the waist-to-hip ratio demonstrated the highest diagnostic value and accuracy for determining blood pressure, with an area under the ROC curve (AUC) of 0.67.

Conclusion: Considering the observed relationship between anthropometric indicators and elevated high blood pressure, it is evident that promoting education on obesity prevention, along with lifestyle modification, healthy nutrition, and regular physical activity, is essential to reduce the risk and prevalence of hypertension.