Journal of Shahid Sadoughi University of Medical Sciences

Disaster epidemiology: analyzing health risks and consequences

Ameneh Marzban — 2026-02-18

Introduction: In recent decades, the world has faced a dramatic increase in the number of critical events, from devastating earthquakes and widespread floods to global pandemics such as COVID-19 and humanitarian crises caused by war, forced migration, and climate change. These events not only destroy physical infrastructure, but also severely affect public health. In such circumstances, disaster epidemiology, as a new and applied branch of epidemiology, plays a key role in analyzing, predicting, and managing health consequences.

Effect of Play Therapy on the Communication Skills of Children with Autism

Shirin Aali — 2026-02-18

Introduction: Autism spectrum disorder is characterized by impairments in social and communication interactions. Play serves as a natural means for children's development, significantly enhancing communication abilities in this group. This study aimed to investigate the effect of play therapy on the communication skills of children with autism and analyze the supportive role of parents in this process. This research utilized a qualitative approach and a systematic content analysis of available scientific sources. Data were collected via a comprehensive review of relevant studies between 2010 and 2024. An initial search was conducted in domestic (Normegs, Irandoc, Jahad Daneshgahi) and international (Google Scholar, PubMed, Scopus) databases with combined keywords such as "play therapy", "autism", and "communication skills". Out of the 142 identified articles, 29 eligible studies were finally selected through a three-stage screening process that involved eliminating irrelevant studies, assessing quality, , and ensuring alignment with the research objectives. Data analysis utilized a three-stage coding process (open, axial, selective) along with theme identification in MAXQDA software version 2024.

Conclusion: Data analysis led to the extraction of 6 main themes: 1) Understanding the communication structure of autistic children (sensory-motor problems, difficulty in emotion sharing), 2) The role of play therapy in the development of cognitive, personality, and self-awareness skills, 3) Communication convergence via intentional group and altruistic games, 4) The importance of parental participation in emotional and educational support, 5) cognitive empowerment and reduction of stereotyped behaviors, and 6) management of behavioral disorders. Results indicated that play therapy improved eye contact, reduced anxiety, strengthened language skills, and increased social participation. Play-based interventions reduced anxiety by 29%.

Response of Serum Retinol Binding Protein 4 (RBP4) Levels and Insulin Resistance to Aerobic Exercise in Adults with Metabolic Disorders: A Systematic Review of Studies Conducted in Iran

Abbas Saremi — 2026-02-18

Introduction: Retinoic acid-binding protein-4 (RBP4) is an adipokine released from both visceral and subcutaneous adipose tissues into the bloodstream, playing a crucial role in regulating systemic blood glucose metabolism through hepatic gluconeogenesis. This study was conducted to review and analyze existing studies on the effectiveness of various aerobic exercise protocols on changes in serum RBP4 levels and insulin resistance in adults suffering from metabolic disorders.

Methods: In this systematic review, relevant information was systematically extracted by searching for keywords associated with the effects of aerobic exercise on RBP4 and insulin resistance in adults with metabolic disorders across several databases, including PubMed, Web of Science, Scopus, Magiran, Irandon, Noor Mags, and Sid. All studies published domestically in Persian and English from March 21, 2001 to February 7, 2025, by Iranian researchers in this field were systematically extracted.

Results: The analysis of 8 studies involving 221 adults participants with metabolic disorders in this systematic review indicated that aerobic exercise improved RBP4 levels and reduced insulin resistance in adults with metabolic disorders through various physiological mechanisms.

Conclusion: The findings of the present study demonstrated that aerobic exercise led to changes in serum RBP4 levels and insulin resistance in adults with metabolic disorders, suggesting it could serve as a vital strategy for the prevention and control of this metabolic disorder in adults.

Investigating the Association Between Demographic Characteristics of Pregnant Mothers and Fetal Intracardiac Echogenic Foci: A Retrospective Study

Soodeh Hooshmandi — 2026-02-18

Introduction: Echogenic intracardiac focus (EIF) is defined as a small, bright structure within the fetal heart exhibiting echogenicity equal to or greater than that of the surrounding bone. It is considered a second-trimester soft marker associated with aneuploidy in high-risk populations. This study aimed to investigate the relationship between nuchal translucency (NT) thickness and maternal demographic characteristics in fetuses presenting with echogenic intracardiac focus.

Methods: In this retrospective cross-sectional study, 100 clinical records of pregnant women whose fetuses had echogenic intracardiac focus confirmed by fetal echocardiography were reviewed. Maternal demographic characteristics, underlying maternal diseases, and NT measurements were recorded. Pearson correlation analysis was used to evaluate the associations between variables, and statistical analyses were performed using SPSS software version 16.

Results: Based on the findings, the mean ± standard deviation of maternal and paternal ages were 29.90 ± 6.449 years and 34.19 ± 7.056 years, respectively. The mean maternal weight was 75.81 ± 10.037 kg. Additionally, 18% of the pregnant women had diabetes and 6% had lupus. The mean NT measurement among the evaluated fetuses was 2.349 ± 0.584 mm. No statistically significant association was observed between parental age or maternal weight and NT values (P > 0.05).

Conclusion: The results of this study demonstrated that maternal demographic characteristics were not significantly associated with the risk of aneuploidy in fetuses with echogenic intracardiac focus. Therefore, echogenic intracardiac focus, as an isolated marker, may serve as a tool for identifying rather than excluding pregnancies at high risk for aneuploidy.

Evaluation of Urine Analysis in Children with covid-19 Hospitalized in Akbar Mashhad Hospital during the Period of 2021-2023

Zhila Sheikhi — 2026-02-18

Introduction: The aim of this study was to evaluate the urinary test results in children under 18 years old hospitalized with COVID-19 at Akbar Hospital in Mashhad City. The main focus was on identifying microbial infections, kidney complications, and changes in urinary indicators in these patients.

Methods: This cross-sectional study was conducted on 199 children hospitalized with a positive PCR test for COVID-19 at Akbar Hospital in Mashhad City March 2021 to February 2023. Demographic information and urinary test results were collected from medical records and the hospital HIS system. Urine tests included checking for protein, glucose, ketones, bilirubin, pH, nitrite, and blood cells. Statistical analysis utilized SPSS software for execution.

Results: This study assessed 199 hospitalized pediatric patients with COVID-19. In the majority of instances, protein and glucose tested negative (79.9% and 84.9%, respectively), although varying levels were observed in certain cases. Both nitrite and white blood cells in the urine tested negative. Hemoglobin was positive in 1.5% of cases, blood in 23.5%, and epithelial cells were positive in some samples. Urine cultures in some cases indicated the presence of bacteria like Klebsiella pneumoniae, Staphylococcus aureus, and coagulase-negative Staphylococcus species, displaying varying patterns of antibiotic resistance. Statistical analysis showed that parameters such as color, appearance, protein, blood, pH, epithelial cells, mucus, and bacteria were significantly associated with either normal or abnormal urine test results (p<0.05). However, no significant association was detected between urine test results and gender or age.

Conclusion: This study showed that kidney complications and abnormal urinary test results were infrequent in hospitalized children with COVID-19, with the majority of patients were remaining in a normal state.

Explanation of Elementary School Health Educators' Experiences of Orthodontics on Students' Oral Health: A Qualitative Study

Mohaddese Sharifi — 2026-02-18

Introduction: Childhood orthodontics can prevent or reduce the severity of various facial abnormalities, thereby improving the quality of life for individuals in adulthood. Elementary schools serve as one of the most effective environments for assessing children's oral health, with health educators playing a key role in this field. This study was conducted with the aim of explaining the experiences of elementary school health educators on orthodontic treatments on severe maxillofacial disorders of students in the future.

Methods: This was a qualitative study using content analysis. The participants were 20 school health educators from primary schools in Yazd who were purposively selected. Data collection was conducted using semi-structured interviews and continued until data saturation. Data analysis was performed according to the Granheim and Landman model.

Results: Three main categories were identified, which include "the necessity to enhance school awareness,” "the appropriate attitude of school health educators towards orthodontics,” and "the need to improve the performance of school health educators in oral hygiene".

Conclusion: The findings indicate that while educators' attitudes towards early orthodontic treatment are appropriate, there is a need for improvement in their knowledge and performance. This necessitates greater involvement from educational and healthcare organizations in this field. Additionally, it is also recommended to implement measures such as periodical oral and dental examinations for students by health staff as well as providing general and specialized courses for health educators in the field of oral and dental health, along with covering medical service costs.

Survey on the Knowledge and Practices of General Physicians and Dentists in Yazd City Regarding the Causes and Treatment of Halitosis in 2020

Fatemeh Neshati — 2026-02-18

Introduction: Currently, the widespread occurrence of halitosis has led to its classification as a distinct medical condition. Conducting local studies on this matter will facilitate the development of appropriate educational and intervention programs. These measures will help us to manage halitosis at the community level. Therefore, the present study aimed to investigate the knowledge and practice of general practitioners and dentists working in Yazd city regarding the causes of halitosis and its treatment.

Methods: In this cross-sectional descriptive study involved the systematic selection of 110 general practitioners and dentists from Yazd City, who completed a questionnaire regarding their knowledge of halitosis causes, diagnosis and treatment. Data were analyzed using SPSS software, employing T-test, one-way ANOVA, Post Hoc test, and Pearson correlation coefficient for analysis. A significance level of 0.05 was established.

Results: The findings revealed that 59.1% of the participating physicians and dentists were male, while 40.9% were female. The average work experience among them was 15.02±8 years. The average knowledge score for physicians and dentists was 13.03±2.99 out of possible 20, with scores ranging from 5 to 19. No statistically significant relationship was found between the average knowledge score and the gender or workplace of the doctors and dentists; however, a direct statistical relationship was identified between the knowledge of physicians and dentists and their clinical work experience (P=0.008).

Conclusion: The results indicated that general practitioners and dentists in the city had a moderate level of knowledge regarding halitosis, its diagnosis, and treatment, with those having more extensive work experience demonstrating a higher level of knowledge. It is recommended to include this topic in retraining programs.

Evaluation the influence of Spirulina platensis extract on cell viability and change the expression of apoptotic BAD gene in the AGS human gastric adenocarcinoma cells

Seyed Jahanbakhsh Daniyali — 2026-02-18

Introduction: In this study, the influence of Spirulina platensis extract with anti-inflammatory, cancer prevention and immune system strengthening properties on cell viability and changes in BAD apoptotic gene expression in human gastric adenocarcinoma cells of the AGS line was investigated.

Conclusion: The results indicate that Spirulina platensis algae extract is able to reduce the cell survival of gastric adenocarcinoma cells by inducing BAD gene expression and preventing proliferation.

Methods: In the present experimental study, by culturing the AGS cell line in DMEM-12 medium with 10% fetal bovine serum and treating the cells at concentrations of 10, 20 and 40 μg/ml of Spirulina platensis algae extract and incubating for 24 and 48 hours, cytotoxicity was examined using the MTT colorimetric method according to the kit instructions at both incubation times. The AGS line cells were then incubated with a concentration of Spirulina platensis extract at IC50 point (40 µg /mL) for 48 hours to assess the expression level of the BAD gene via real-time RT-PCR. Statistical analysis was accomplished using Mann-Whitney test using SPSS 16 software.

Results: The results of this study indicated that the cell viability of AGS gastric Adenocarcinoma cell line significantly decreased at concentration of 20 (P<0.001) and 40 (P<0.0001) µg/mL compared to the control group. In addition, AGS cell line treatment with Spirulina platensis extract at a dose of 40 µg/mL and 48 incubation time, showed a significant increased expression of BAD gene (P<0.001).

Conclusion: The results indicate that Spirulina platensis extract can reduce the viability of gastric adenocarcinoma cells by inducing expression of BAD gene that preventing proliferation