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Background: While home is frequently expressed as the favorite place of death (PoD) among terminally ill cancer patients, various factors affect the fulfillment of this wish. The determinants of the PoD of cancer patients in countries without healthcare system-integrated palliative and supportive care have not been studied before. This study aimed at identifying the predictors of the PoD of patients who suffer from advanced cancer by developing a reliable predictive model among who received home-based palliative care in Iran as a representative of the countries with isolated provision of palliative care services. Methods: In a cross-sectional study, electronic records of 4083 advanced cancer patients enrolled in the Iranian Cancer Control Center (MACSA) palliative homecare program, who died between February 2018 and February 2020 were retrieved. Multivariable binary logistic regression analysis as well as subgroup analyses (location, sex, marital status, and tumor topography) was performed to identify the predictors of PoD. Results: Of the 2398 cases included (mean age (SD) = 64.17 (14.45) year, 1269 (%52.9) male), 1216 (50.7%) patients died at home. Older age, presence and intensity of medical homecare in the last two weeks and registration in the Tehran site of the program were associated with dying at home (P < 0.05). Gynecological or hematological cancers, presence and intensity of the calls received from the remote palliative care unit in the last two weeks were predictors of death at the hospital (p < 0.05). The model was internally and externally validated (AUC = 0.723 (95% CI = 0.702–0.745; P < 0.001) and AUC = 0.697 (95% CI = 0.631–0.763; P < 0.001) respectively). Conclusion: Our model highlights the demographic, illness-related and environmental determinants of the PoD in communities with patchy provision of palliative care. It also urges policymakers and service providers to identify and take the local determinant of the place of death into account to match the goals of palliative and supportive services with the patient preferences. [ABSTRACT FROM AUTHOR]

Background: Sexual offenses encompass a diverse array of behaviors across various contexts, affecting numerous individuals. Despite the prevalence of sexual offending among adolescents, there is still a limited understanding of this population. To contribute further to the literature in this field, the present study was conducted to compare a group of male adolescents convicted of sexual offenses with a control group in terms of reflective functioning (RF), emotion regulation (ER) strategies, and emotion dysregulation (ED). Methods: 60 male adolescents aged 12 to 18 years (M = 16.90; SD = 0.97) who had been convicted of at least one serious sexual offense were recruited from male adolescents referred by juvenile courts to the Legal Medicine Organization in Mashhad, Iran, and compared with a control group of non-offending adolescents consisting of 60 male adolescents aged 12 to 18 years (M = 16.97; SD = 0.82) who were attending school. The groups were matched on age and education level. Results: A comparison between these two groups revealed that adolescents with a history of sexual offending exhibited poorer RF capacity, greater use of suppression as an ER strategy, and higher scores in all ED domains (p's < 0.001) except non-acceptance of emotional responses compared with the control group. Conclusions: Results suggest that RF, ER strategies, and ED need to be considered as important psychological factors in understanding and treating adolescents with a history of sexual offending. [ABSTRACT FROM AUTHOR]

Objective: Diabetes is an important risk factor for cardiovascular disease. The purpose of this study was to explore the role of diabetes and prediabetes in the risk of cardiovascular disease. Methods: This prospective study was performed on three groups of non-diabetic (n = 7291), prediabetic (n = 438), and diabetic (n = 1713) in the age range of 40–70 years in Kharameh (Iran) in 2014–2021. The participants were followed for 4 years. Demographic information, chronic disease history, behavioral habits, and laboratory parameters were examined. Initially, the incidence density was calculated and the difference between the risk of cardiovascular disease in the three groups was examined using the log-rank test. The Cox regression model was performed to investigate the association between prediabetes and diabetes with the risk of cardiovascular disease. Results: The mean age of the participants was 51.47 years. The density incidence in the three groups of non-diabetic, prediabetic, and diabetic individuals was estimated to be 1.5, 1.5, and 3.9 cases per 100,000 person-days, respectively. There was no statistically significant relationship between prediabetes and the incidence of cardiovascular disease. However, the incidence of cardiovascular disease in diabetics was 2.55, 2.16, and 2 times higher than in non-diabetics in the simple, adjusted for age and sex, and in multiple Cox regression, respectively. Conclusion: Due to the independent role of diabetes in the incidence of cardiovascular disease, diabetic individuals should be screened periodically for cardiovascular conditions. Furthermore, it is very important for these individuals to control the important risk factors that contribute to the incidence of cardiovascular disease. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Determination of remaining growth potential of patients is the most important factor in orthodontic treatment. Purpose: This study aimed to assess the correlation of clivus length and angle with age, gender, sagittal growth pattern of the jaws, and skeletal maturation using lateral cephalometry. Materials and Method: This cross-sectional study was conducted on 390 lateral cephalograms (Vatech, paX-i3D Green, South Korea) of patients aged 6 to 25 years. The patients were assigned to three groups of skeletal class I, II, III (n=130) with equal gender distribution. The clivus length and angle, Welcher angle, maxillary and mandibular effective length, sella turcica to Nasion (SN), and the angles between SN and point A (SNA), between SN and point B (SNB), and between NA and NB (ANB )were measured. Correlations of variables with age and gender, and cervical vertebral maturation stage (CVMS) were analyzed using the Pearson and Spearman’s correlation tests, independent t-test, and one-way ANOVA at 0.05 level of significance. Results: Clivus length had a significant correlation with SNA (r= 0.103, p= 0.042), SNB (r= 0.108, p= 0.033), maxillary (r= 0.547, p< 0.001) and mandibular (r= 0.589, p< 0.001) effective lengths, SN length (r= 0.586, p< 0.001), and CVMS (r= 0.697, p< 0.001). Clivus angle had a significant correlation with SNA (r= 0.105, p= 0.039), SNB (r= 0.155, p= 0.002), maxillary (r= 0.507, p< 0.001) and mandibular (r= 0.596, p= 0.001) effective lengths, SN length (r= 0.566, p< 0.001), and CVMS (r= 0.699, p< 0.001). The mean clivus length (p= 0.006) and angle (p= 0.002) were significantly higher in males, and had a significant correlation with age (r= 0.636 and r= 0.718, p< 0.001). The mean clivus length and angle were not significantly different in class I, II, III (p> 0.05). Conclusion: All parameters were greater in males, and increased with age (except Welcher angle). Clivus length and angle had significant correlations with position of both jaws but not with sagittal relationship. [ABSTRACT FROM AUTHOR]

Background: Considering that few studies have investigated the differences in clinical, laboratory, and imaging symptoms of patients with coronavirus disease 2019 (COVID-19) during different peaks of the disease in Iran, the present study compares the patients who were admitted to the COVID-19 departments of Imam Reza Hospital during the first, second, and third peaks of the disease. Methods: In this cross-sectional study, data were collected by reviewing the files of patients with a definite diagnosis of COVID- 19 based on the RT-PCR test in Imam Reza Hospital in Mashhad. The patients were divided into three groups based on the time of admission: The first peak from March 2020 to June 2020, the second peak from July to September 2020, and the third peak from October to December 2020. The variables evaluated in this study included demographic information, clinical signs and symptoms, and laboratory and radiological findings. Descriptive qualitative data were reported using frequency tables, while quantitative descriptive data were reported using measures of central tendency and dispersion. A comparison of qualitative data among the three peaks was conducted using the chi-square test, while for quantitative data, the ANOVA test was used followed by appropriate post-hoc tests. Results: A total of 561 patients with an average age of 58.90 ± 16.80 years were included in the study, of which 336 (59.9%) were male. Regarding underlying diseases, significant differences were found in age (P < 0.001), smoking (P < 0.001), diabetes (P = 0.003), high blood pressure (P < 0.001), asthma (P = 0.025), and ischemic heart disease (P < 0.001). For vital signs, significant differences were observed in heart rate (P < 0.001), respiration rate (P < 0.001), diastolic blood pressure (P = 0.010), and SPO2 (P < 0.001). In clinical characteristics, significant differences were found in fever (P < 0.001), nausea (P = 0.011), vomiting (P = 0.031), headache (P < 0.001), weakness (P < 0.001), and sore throat (P < 0.001). In laboratory characteristics, significant differences were observed in white blood cell (WBC) count (P = 0.024), neutrophil percentage (P < 0.001), lymphocyte percentage (P < 0.001), and C-reactive protein (CRP) (P = 0.001). The CT score values of the patients were significantly different between the three peaks. Patient mortality was significantly different across the three peaks. Less than 15% of hospitalized patients died in the first peak, while over 24% died in the second peak and nearly 40% of inpatients died in the third peak. In our study, the first and third surges and the second and third surges had different mortalities. Conclusions: The third and first peaks had the highest and lowest mortality rates, respectively. Underlying diseases and unstable vital signs were more common in the second and third peaks. Patients in the second peak had significantly higher CT scores compared to the other peaks. [ABSTRACT FROM AUTHOR]

Background & aims: Missed nursing care is a global challenge that can have many consequences and it's known as a common threat to the patient safety and quality of nursing care. The nurses' professional commitment plays the final role in the occurrence of this issue. This study aimed to investigate the relationship between nurses' professional commitment and missed nursing care in Iran. Materials & methods: This cross-sectional descriptive-analytical study was conducted on 270 nurses working in two hospitals affiliated to Tehran University of Medical Sciences (Sina & Shariati) from September to December 2023. The research community included all nurses working in medical-surgical wards in the designated hospitals. The research samples were included in a targeted and quota method after obtaining organizational permits, ethical approval and informed consent. Data collection was done using three questionnaires including demographic information form, Nursing Professional Commitment Scale, and MISSCARE Questionnaire. The collected data was analyzed in SPSS software, version 25. Results: The results of Pearson's correlation test showed that there is a significant negative relationship between nurses' professional commitment and missed nursing care scores (r=-0.23) (p < 0.001). The mean score of nurses' professional commitment was reported at a moderate to high level (83.72 ± 16.02) and the mean score of missed nursing care was reported at a low level (47.84 ± 16.48). Nurses over 40 years old, morning shift and employed nurses showed higher professional commitment. Also, nurses under 29 years old and male nurses had more missed nursing care other than their participants. No relationship was observed between other demographic variables with nurses' professional commitment and missed nursing care. Conclusion: The results of this study showed that higher nurses' professional commitment leads to higher quality of care and less missed nursing care. Based on findings of this research, it is recommended for health care providers and nursing managers to adopt programs to increase nurses' professional commitment and consequently reduce missed nursing care. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) is often linked to chronic inflammation, which can be influenced by both lifestyle and dietary choices. However, the relationship between the inflammatory potential of diet and lifestyle factors and the risk of developing T2DM remains unclear. The present study aimed to investigate the associations of the empirical dietary inflammatory index (EDII), dietary inflammatory score (DIS), and lifestyle inflammatory score (LIS) with the risk of T2DM among Iranian adults. Methods: The current study was conducted on 5714 individuals from Yazd Health Study (YaHS) who were followed up for a mean period of six years. YaHS is a prospective cohort study which has been conducted since 2014. Dietary intakes were collected at baseline using the food frequency questionnaire. The relative risk (RR) of T2DM was calculated by Cox regression analysis across tertiles of EDII, DIS, and LIS, adjusted for potential confounders. Results: The mean ± SD for the age and body mass index of the study population were 47.0 ± 9.2 years and 26.7 ± 5.1 Kg.m2, respectively. A significant association between LIS and the risk of T2DM was observed (RR: 4.05, 95% CI: 2.61–6.27 P-trend < 0.001). Individuals in the highest compared to the lowest tertile of EDII-LIS (RR: 3.07, 95%CI: 2.01–4.68; P for trend < 0.001) and DIS-LIS (RR: 2.42, 95%CI: 1.69–3.49; P for trend < 0.001) had a higher risk of T2DM. However, no significant association was found between EDII and DIS scores and the risk of T2DM. Conclusion: Greater adherence to LIS, EDII-LIS, and DIS-LIS scores was associated with a higher risk of T2DM, while no significant association was found between EDII and DIS with T2DM risk. [ABSTRACT FROM AUTHOR]

Background: The current study aims to assess cardiovascular risk factors (CVRFs) among diabetic versus nondiabetic nonalcoholic fatty liver disease (NAFLD) patients. NAFLD is the most common hepatic disorder worldwide which is directly associated with diverse CVRFs such as type 2 diabetes mellitus (T2DM) and metabolic syndrome (MS). Materials and Methods: The current cross-sectional population-based study has been conducted on 1031 NAFLD patients. After excluding 340 prediabetes patients, the NAFLD patients were divided into T2DM and normal blood glucose (NBG). Then, CVRFs were compared between the two groups. Results: Out of 691 NAFLD cases included in the study, 337 (48.8%) patients had T2DM. In the T2DM and NBG groups, the body mass index (BMI) was 31.2 ± 4.6 and 29.9 ± 4.3 kg/m2, respectively (P = 0.001). The waist circumference was 102.2 ± 10.2 and 97.6 ± 10.6 cm, respectively (P < 0.001). The systolic blood pressure was 123.3 ± 15.6 and 119.6 ± 13.6 mmHg, respectively (P = 0.043). The triglyceride levels were 191.9 ± 104.7 and 176.5 ± 89.6 mg/dL, respectively (P = 0.042). Generally, these factors were significantly higher among the diabetic patients. Besides, cardiovascular disease (CVD), hypertension, and MS were statistically more prevalent in NAFLD patients with T2DM (P < 0.001) than nondiabetic NAFLD patients. In multiple logistic regression models, the odds ratio of CVD, hypertension, and MS was 2.18, 2.12, and 6.63 for patients with T2DM compared with NBG, respectively. Adjustment was made for age, sex, BMI, smoking, and physical activity. Conclusion: CVRFs were higher in NAFLD patients with T2DM than NAFLD patients with NBG. [ABSTRACT FROM AUTHOR]

Background: Corneal abnormalities are one of the important reasons for visual impairment. There is little evidence of the prevalence of different types of corneal abnormalities. The aim of this study was to assess the prevalence of various corneal abnormalities and identify the key risk factors associated with these abnormalities in an elderly population residing in Tehran. Methods: The Tehran Geriatric Eye Study (TGES) was conducted as a cross-sectional study, utilizing a population-based approach and employing stratified cluster random sampling. The study focused on individuals aged 60 years and above residing in Tehran. An ophthalmologist performed a slit lamp examination to evaluate the eyelid, cornea, and crystalline lens. Results: The prevalence of posterior embryotoxon (PE), punctate epithelial defect (PED), pigment on endothelium (POE), corneal dystrophy (CDys), corneal vascularization (CV), and corneal degeneration (CDeg) were estimated to be 0.08% (95% confidence interval [CI]: 0.02 to 0.40), 8.77% (95% CI: 6.64 to 11.51), 0.57% (95% CI: 0.33 to 0.98), 0.53% (95% CI: 0.33 to 0.82), 0.95% (95% CI: 0.60 to 1.52), and 44.87% (95% CI: 41.80 to 47.98), respectively. Overall, approximately 49.08% of the participants exhibited some form of corneal abnormality in at least one eye. The multiple logistic regression model revealed that increasing age was significantly associated with PED, CV, and CD. Furthermore, illiterate participants had a significantly higher prevalence of PE. Conclusion: The findings of this study indicate that approximately half of the elderly population aged 60 years and above in Tehran have at least one corneal abnormality, with corneal degeneration being the most prevalent. Age was identified as the primary determinant of corneal abnormalities. [ABSTRACT FROM AUTHOR]

Background: Demographic characteristics apparently play a critical role in the incidence and prevalence of uveitis in different societies. Numerous studies have investigated the demographic-epidemiological factors and clinical patterns of uveitis in Iran; however, no study has been conducted in the west of the country yet. Objectives: To assessed epidemiologic pattern of uveitis in patients residing in the west of Iran. Methods: This study investigated 358 files of uveitis patients referring to the specialized retina-uveitis clinics in a referral hospital in the west of Iran from March 2016 to September 2022. The demographic characteristics, clinical patterns, and complications of uveitis were evaluated in this study. Results: The uveitis patients' mean age (± SD) at the diagnosis time was 48.14 (± 11.91) years (18 - 72 years), the patients with anterior uveitis had the lowest mean age (45.47 ± 11.54 years), and the patients with panuveitis had the highest mean age (52.90 ± 10.14 years) at the diagnosis time. The prevalence of the disease was equal in both genders; however, posterior uveitis and panuveitis significantly involved males more than females (P < 0.01 and 0.01 respectively). The most common anatomical pattern of involvement belonged to anterior uveitis (34%), followed by panuveitis (23.4%), posterior uveitis (22.9%), and intermediate uveitis (19.5%). The prevalent etiology in anterior, intermediate, and panuveitis were idiopathic and Toxoplasma chorioretinitis was the most common causes in posterior uveitis (34.14%). Moreover, acute clinical course and nongranulomatous pathology were also more prevalent. The most common complications of the disease were cataracts and cystoid macular edema (CME). Also, patients with panuveitis followed by posterior uveitis had the worse visual prognosis. Conclusions: The predominant pattern of involvement in patients referring to the referral center in the west of Iran was in the form of anterior uveitis, acute in terms of clinical course, and non-granulomatous in terms of pathology. This clinical view for evaluation in a referral center differs from the pattern expected to be observed in the general population and even in general ophthalmology centers. [ABSTRACT FROM AUTHOR]

Introduction: Occupation plays an important role in the spread of infectious diseases in humans. Toxoplasmosis and hydatidosis are world-wide diseases with different routes of transmission. This study aimed to investigate the prevalence of toxoplasmosis and hydatidosis and risk factors associated with these diseases among the butchers of Tabriz City, the northwest of Iran. Methods: In this case-control study conducted in Tabriz city in 2023, 250 serum samples were collected from butchers (n = 125) and outpatients referred to Imam Reza Hospital (n = 125) and. The ELISA test was used to identify IgG and IgM antibodies against toxoplasmosis and IgG antibodies against hydatidosis. The results were analyzed by statistics tests using SPSS v. 16 software. Risk factors' association was tested using Chi square or logistic regression analysis. Results: The results indicated that 66/125 (52.8%) cases and 40/125 controls (32%) were positive for toxoplasmosis IgG antibody. Also, 5/125 (4%) and 1/125 (0.8%) were positive for toxoplasmosis IgM antibody in the case and control groups, respectively. In addition, 10/125 people (8%) were positive for anti-hydatidosis IgG antibody in the case group, while no positive cases were found in the control group. The main risk factors for toxoplasmosis were age (OR: 1.014), education level (OR: 0.638), and work experience(OR: 1.695), these factors for hydatidosis included age and education level (OR: 1.765 and 0.271) respectivily. Conclusions: Our results suggest the high prevalence of toxoplasmosis and in butchers of Tabriz, which required special attention and basic measures. Moreover, the prevalence of hydatidosis IgG antibodies also requires more attention to be focused on breaking the transmission and reducing the infection. [ABSTRACT FROM AUTHOR]

Background: The stage of tooth formation is one of the most reliable indicators for predicting a patient's developmental age by radiographs. This study compared the accuracy of three distinct dental age estimation methods (Demirjian, Nolla, and Willems) in children aged 3–17 in the northern Iranian population. Methods: This cross‐sectional study examined panoramic radiographs of 434 children aged 3–17 from Mazandaran Province, Iran, who had teeth 31–37 present on the left mandible. This study employed the Demirjian, Nolla, and Willems methods to estimate the dental age of the sample and compare it with the chronological age. The data were analyzed using SPSS v16. A paired t‐test was used to compare chronological and dental ages. The Pearson correlation was used to correlate the chronological and dental ages. The errors of different methods were compared using the Wilcoxon test. P values < 0.05 were considered significant for all tests except Wilcoxon. For Wilcoxon, a P value < 0.017 was considered significant. Results: The three methods presented differing mean estimated ages. The Demirjian method delivered the highest mean, and all three methods differed significantly when compared in pairs. The results showed that the Demirjian method overestimated chronological age by 0.25 years (P < 0.001) in girls and 0.09 years (P = 0.28) in boys. The Willems method underestimated chronological age by 0.05 years (P = 0.47) in girls and 0.12 years (P = 0.13) in boys. The Nolla method underestimated chronological age by 0.41 years (P < 0.001) in girls and 0.40 years (P < 0.001) in boys. The accuracy of each method varied with the patient's age. Conclusion: According to the findings, the Willems method outperformed the Demirjian method, and the Demirjian method exceeded the Nolla method for estimating dental age in Iranian children aged 3–17. Overall, the Demirjian method overestimated the age of the study population, whereas the other two underestimated it. [ABSTRACT FROM AUTHOR]

Background: In this study, we decided to investigate the state of depression, anxiety, and quality of life and its relationship with some demographic characteristics of lung neoplasm patients who were candidates for surgery. Materials and Methods: In a cross-sectional study, all patients with lung neoplasm who were referred to medical centers affiliated to Isfahan University of Medical Sciences and were candidate for lung surgery in 2020--2021. Based on the inclusion and exclusion criteria, 52 people were assigned to the study consecutively. Then, the patients completed the demographic information questionnaire, the Hospital Anxiety and Depression Scale, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30) (EORTC QLQ-C30). Results: The score of depression and anxiety was normal (range 7-0) and the score of quality of life was in the relatively good range (50-175). As the patient's age increases (P = 0.014) and the duration of the disease increases (P = 0.041), the level of depression increases significantly. People with higher education had lower depression (P = 0.001) and anxiety (P = 0.003). People living in the city had a significantly better quality of life (P = 0.039). The higher the depression (P < 0.0001) and anxiety (P = 0.037) of the people, the lower the quality of life of the patients. Conclusion: As anxiety and depression increase, the quality of life of lung neoplasm patients decreases. Some demographic characteristics such as old age, insufficient education, rurality, and increased duration of the disease can be the risk factors for depression, anxiety, and reduced quality of life of patients with lung neoplasm. [ABSTRACT FROM AUTHOR]

Introduction: Gastric Cancer ranks as the fourth most common cancer globally, with the second highest mortality rate. Given its significance, this study aims to ascertain and explore the 1-5-year survival rales of patients diagnosed with Gastric Cancer. Material & Methods: This descriptive analytical study examines data from patients diagnosed with Gastric Cancer in Sagheze city, Ku rd is Lan province, spanning from 2010 to 2018. Data from 236 patients with confirmed Gastric Cancer diagnoses, including demographic information, date of diagnosis, tumor morphology, tumor site, and tumor stage, were collected from the Cancer Registry Center at Kurdistan University of Medical Sciences and the Digestion and Liver Research Center at Tohid Hospital in Sanandaj. The data were then analyzed using SPSS 22 software, employing survival analysis based on the Kaplan-Meier method, Lhc Log-rank Lest statistic, and Cox regression. Results: Of the patients, 159 (67.4%) were male, with a mean age at diagnosis of68.46±15*50 years. Tumor morphology varied, with 132 (55.9%) categorized as unspecified neoplasms, 39 (16.5%) as invasive types, 35 (14.8%) as adenocarcinomas, 22 (9.3%) as intestinal types, and 8 (3.4%) as diffuse types. Gender (p=0.190), tumor site (p=0.084), and tumor stage (p=0.739) showed no significant relationship with the 1-5-year survival rate. However, age at diagnosis (p>0.001) and tumor morphology (p>0.001) were found to influence survival rates, which were estimated al 43%, 40%, 39%, 39%, and 36% for years I to 5, respectively. Conclusion: Age at diagnosis, tumor site, tumor morphology, tumor differentiation, and treatment type emerge as crucial factors influencing disease prognosis and patient survival. [ABSTRACT FROM AUTHOR]

Background: Limited studies have investigated the relationship between Anti-Müllerian hormone (AMH) and metabolic syndrome (MetS), yielding inconclusive results. This study aimed to examine the relationship between AMH levels and MetS and its components in women from a general population. Methods: This prospective study recruited 769 women. Generalized Estimating Equation (GEE) models analyzed longitudinal trends of MetS components. Cox proportional hazard models evaluated effect of age-specific AMH tertiles on MetS occurrence, adjusting for confounders. Results: The GEE analysis indicated that women in the third tertile exhibited higher mean FPG compared to those in the first tertile of age-specific AMH (3 mg/dL; 95% CI: 0.40, 5.60; P = 0.024); however, this association became non-significant after adjustment. Notably, the second tertile showed a significant decrease in FPG mean changes over time (-0.69 mg/dL; 95% CI: -1.31, -0.07; P Interaction = 0.030). Women in the second and third tertiles of age-specific AMH demonstrated lower mean HDL-C compared to the first tertile (-2.96 mg/dL; 95% CI: -4.67, -1.26; P < 0.001 and -2.63 mg/dL; 95% CI: -4.31, -0.96; P = 0.002, respectively). The association between HDL-C changes and the second tertile remained significant after adjustment (-1.91 mg/dL; 95% CI: -3.68, -0.14; P = 0.034). No significant associations were observed between age-specific AMH tertiles and TG and SBP/DBP. Cox models revealed no significant differences in the hazard ratio of MetS between AMH tertiles after adjusting for confounders. Conclusion: Despite minor variations in MetS components, AMH levels did not affect MetS risk in women from a general population. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) is a cluster of risk factors and the Framingham risk score (FRS) is a useful metric for measuring the 10-year cardiovascular disease (CVD) risk of the population. The present study aimed to determine the 10-year risk of cardiovascular disease using the Framingham risk score in people with and without MetS in a large Iranian cohort study. Methods: This cross-sectional study was done using the Fasa cohort. Participants aged ≥ 35 years old were recruited to the study from 2015 to 2016. The FRS was calculated using age, sex, current smoking, diabetes, systolic blood pressure (SBP), total cholesterol, and high-density lipoprotein (HDL) cholesterol. MetS was defined as the presence of three or more of the MetS risk factors including triglyceride (TG) level ≥ 150 mg dl− 1, HDL level < 40 mg dl− 1 in men and < 50 mg dl− 1 in women, systolic/diastolic blood pressure ≥ 130/≥85 mmHg or using medicine for hypertension, fasting blood sugar (FBS) level ≥ 100 mg dl− 1 or using diabetes medication and abdominal obesity considered as waist circumference (WC) ≥ 88 cm for women and ≥ 102 cm for men. Multiple logistic regressions were applied to estimate the 10- year CVD risk among people with and without MetS. Results: Of 8949 participants, 1928 people (21.6%) had MetS. The mean age of the participants with and without Mets was 50.4 ± 9.2 years and 46.9 ± 9.1 years respectively. In total 15.3% of participants with MetS and 8.0% of participants without MetS were in the high-risk category of 10-year CVD risk. Among participants with MetS gender, TG, SBP, FBS and in people without MetS gender, TG, SBP, FBS, and HDL showed strong associations with the predicted 10-year CVD risk. Conclusion: Male sex and increased SBP, TG, and FBS parameters were strongly associated with increased 10-year risk of CVD in people with and without MetS. In people without MetS, reduced HDL-cholestrol was strongly associated with increased 10-year risk of CVD. The recognition of participant's TG, blood pressure (BP), FBS and planning appropriate lifestyle interventions related to these characteristics is an important step towards prevention of CVD. [ABSTRACT FROM AUTHOR]

Background: The word-in-noise discrimination test evaluates the phonological aspect of speech based on the detection of the vowels. While word-in-noise perception (WINP) test is one of the speech perception exams and evaluates the ability to understand the meaning of words by discovering the consonants. Until now, all word-in-noise tests have assessed speech discrimination performance, and for the first time, the normal values of the WINP test for adults have been determined. Since the normal values of WINP scores in children have not been reported, our research aimed to determine the normal values of the WINP test in children aged 5 to 13 years. In this cross-sectional study, 120 Persian speaking Iranain children with normal hearing thresholds were evaluated from the beginning to the end of spring 2023. We divided them into 4 age groups (A = 5–7 < years, B = 7–9 < years, C = 9–11 < years, D = 11–13 < years). The evaluations included general audiology tests and WINP tests using homtonic-monosyllabic words (HMWs) at a signal-to-noise ratio of 5 dB. Results: Significant difference was observed between the mean scores of the WINP test in age group A (54%) compared to age group B (66%), (Pv = 0.04). Also, the differences between the mean scores of age group A compared to age groups C (70%) and D (69%) were significant (Pv = 0.01, Pv = 0.03). Conclusions: This article presented the norm values of WINP test scores for Persian speaking Iranian children aged 5 to 13 years. The norm values of WINP test scores in the age group of 5–7 years were lower than in the age groups of 7–13 years. The biggest change in the performance of speech perception in noise was observed in the age range of 7–9 years. [ABSTRACT FROM AUTHOR]

Background: There is a lack of quantitative studies that specifically measure the association between the experience of pregnancy and unintended pregnancy. The present study aims to address the prevalence of unintended pregnancy and identify its predictors. Additionally, the study explores whether unintended pregnancy is associated with pregnancy uplifts and hassles. Methods: This cross-sectional study was conducted on 488 pregnant women between 20 to 40 weeks' gestation at the comprehensive health center in Tabriz City from February 2022 to January 2023. A cluster sampling method was used for sampling, and data were collected using socio-demographic questionnaires and the Pregnancy Experience Scale (PES). Descriptive statistics were used to describe the socio-demographic characteristics and the prevalence of unintended pregnancy. Binary logistic regression was employed to identify the predictors of pregnancy desirability. To examine the relationship between unintended pregnancy and pregnancy experience, an independent t-test was used for bivariate analysis, and a general linear model (GLM) was utilized for multivariate analysis, with control for potential confounding variables. Results: The prevalence of unintended pregnancies was 30.7% (24.3% unwanted pregnancies, and 6.4% mistimed pregnancies). The results of the binary logistic regression indicated that the lower age of both the woman and her spouse were significant predictors for unintended pregnancy (P < 0.05). Based on an independent t-test, the mean score for uplifts in women with unintended pregnancy was significantly lower than in women with intended pregnancy (mean difference (MD): -4.99; 95% confidence interval (CI): -5.96 to -4.02; p < 0.001), While the mean score of hassles in women with unintended pregnancy was significantly higher than women with intended pregnancy (MD: 2.92; 95% CI: 2.03 to 3.80; p < 0.001). The results of GLM showed that women who had unintended pregnancies had significantly lower scores for uplifts (B = -4.99; 95% CI: -5.96 to -4.03; P < 0.001) and higher scores for hassles (B = 2.92; 95% CI: 2.06 to 3.78; P < 0.001). Conclusions: The high prevalence of unintended pregnancies in Tabriz highlights the importance of targeted interventions to address this issue, considering the policy framework and unique challenges faced by women. Future studies should focus on developing context-specific interventions that effectively meet the needs of women with unintended pregnancies. Plain Language Summary: An unintended pregnancy is a pregnancy that occurs either when the woman did not intend to get pregnant at all or when she intended to get pregnant but became pregnant at an inappropriate time. This type of pregnancy can have negative effects on the physical and mental health of women during pregnancy and after delivery. So far, no study has investigated the relationship between the experience of pregnancy and unintended pregnancy, and the existing studies, which are qualitative and based on interviews, have examined women's experiences of unintended pregnancy. For the first time, our study examined the relationship between pregnancy experience and unintended pregnancy in 488 women using a valid questionnaire, the Pregnancy Experience Scale, which includes two parts: uplifts and hassles specific to pregnancy. Our findings showed that women who have an unintended pregnancy have a worse pregnancy experience in both uplifts and hassles specific to pregnancy. Also, limited studies have investigated the prevalence of unintended pregnancy in Iran, especially in the city of Tabriz in recent years. Our study, found this prevalence to be 30.7% in Tabriz, with 24.3% of women having no intention of getting pregnant and 6.4% of women experiencing pregnancy at an inappropriate time. The recommendation is to implement strategies to reduce unintended pregnancy rates and improve women's knowledge of fertility, sexuality, and contraception. [ABSTRACT FROM AUTHOR]

Background. Granulomatous dermatoses, particularly on facial skin, pose a diagnostic challenge, as similar histologic patterns can be produced by different causes. Aim. To evaluate the correlation between clinical suspicion and histopathological findings in various facial granulomatous dermatoses. Materials and Methods. This retrospective, cross-sectional study included all patients with the histopathological diagnosis of facial granulomatous dermatoses from the years 2016 to 2021 in an academic hospital. Demographic, clinical, and histopathologic features were reviewed and analyzed. Results. In this study, 150 histopathological records with the diagnosis of facial granulomatous dermatoses from the years 2016 to 2021 were reviewed. The most common clinical diagnosis was rosacea 34 (23.6%), followed by sarcoidosis 27 (18.8%), leishmaniasis 15 (10.4%), and granulomatous rosacea 10 (6.9%). The frequency of clinical diagnosis of rosacea (70.6), sarcoidosis (66.7), foreign body G (62.5), TB (75), pseudolymphoma (75), acne agminata (66.7), and granulomatous rosacea (70) in female patients was higher than that in males (P value = 0.03). The effect of age on the type of both clinical and histopathological diagnosis was statistically significant (P value = 0.0001 and 0.004, respectively). Conclusion. Our study contributed significantly to the understanding of the clinicopathological aspects of facial granulomatous dermatoses and advocated for a multidisciplinary approach to the diagnosis and management of these complex skin conditions. [ABSTRACT FROM AUTHOR]

Background: Given the high prevalence of hypertension in older adults, this study was conducted to identify the factors affecting the 5-year survival of older people with hypertension. Materials and Methods: In this cohort study, individuals aged 60 and over living in Amirkola, north of Iran who were diagnosed with hypertension were followed up for 5 years, and the effect of various factors on their survival was analyzed. Results: Among 1439 older people, 892 individuals (61.99%) had hypertension. Age (adjusted hazard ratio [aHR] = 1.052, 95% confidence interval [CI] = 1.019-1.086, P = 0.002), diabetes mellitus (aHR = 2.166, 95% CI = 1.398-3.354, P = 0.001), serum creatinine (aHR = 2.163, 95% CI = 1.391-3.363, P = 0.001), female gender (aHR = 0.460, 95% CI = 0.276-0.766, P = 0.003), body mass index ≥30 kg/m2 (aHR = 0.386, 95% CI = 0.212-0.701, P = 0.002), physical activity score >150 (aHR = 0.382, 95% CI = 0.162-0.898, P = 0.027), each one unit increase of social support score (aHR = 0.914, 95% CI = 0.861-0.970, P = 0.003), and instrumental functional ability score (aHR = 0.907, 95% CI = 0.843-0.974, P = 0.009) showed a significant effect on 5-year survival of older people. Conclusion: Multiple factors (such as age, gender, social support, lifestyle behaviors, and comorbidities including diabetes mellitus and renal function) might predict the 5-year survival of the elderly with hypertension. They should be considered in health-care package of these patients. [ABSTRACT FROM AUTHOR]

Objectives: Since December 2019, COVID-19 spread worldwide. Patients with COVID-19 are at high hazard for dysphagia. This study investigates the incidence of dysphagia in COVID-19 patients admitted to the intensive care unit (ICU) and identifies predictors of dysphagia in COVID-19 patients. Methods: This prospective study analyzed 100 COVID-19 patients admitted to the ICU of Firoozgar Hospital in Tehran City, Iran. The demographic and clinical features of the eligible patients were collected. Dysphagia and cognition were evaluated according to the Persian version of functional oral intake (FOIS-P) status and the Rancho Los Amigos scale (RLAS). The qualitative variables are described in frequency and percentages and the quantitative variables are illustrated by Mean±SD. Also, univariate and multivariate cox regression was performed to predict possible relations between demographic and clinical variables with dysphagia. Results: A total of 100 COVID-19 patients (43.3±13.3 years, 55% were men) who were admitted to the ICUs were appraised by speech and language pathologists. Meanwhile, 70% of the subjects had at least one comorbidity, with the most common ones being diabetes, hypertension, and obesity. Also, 74% of patients were on invasive mechanical ventilation (60% through endotracheal tube and 40% through tracheostomy). In addition, 57% of patients presented dysphagia. Age (odd ratio (OR)=1.127; 95% confidence interval (CI), 1.019%, 1.247%; P=0.02) and level of consciousness (OR=0.393; 95% CI, 0.178%, 0.868%; P=0.021) were predictors of dysphagia. Discussion: Dysphagia was prevalent among COVID-19 patients predicted by age and level of consciousness. Early evaluation of suspected patients is required for timely and efficient interventions to avoid further problematic issues and progress their quality of life. [ABSTRACT FROM AUTHOR]

Objectives: Cerebral palsy (CP) can cause motor, sensory, cognitive, and communicative problems and poor feeding performances in children. Feeding problems could be lifethreatening and negatively affect cognitive and physical growth. This study investigates the frequency of response to oral motor skills, the frequency and severity of feeding problems, and the relationship between age and oral motor skills with feeding problems in children with CP aged 2 to 7 years. Methods: This was an observational and cross-sectional study. The participants were 60 children (26 girls and 34 boys) with CP with a mean age of 4.76±1.71 years. The screening tool for eating problems and oral motor assessment scale assessed participants' feeding and oral motor skills. The Spearman test determined the correlation between age and oral motor dysfunctions with feeding problems. Results: The present study revealed that 80% of participants indicated feeding problems in the screening tool of the eating problems test. Problems with feeding skills (51.5%) were the most frequent. Furthermore, the most frequent response of participants to "closing the lips while feeding with a spoon" was 46.7%, and "sucking with straw," equaled 55.0%," which was passive. For other items, the most frequent response of the examinees was "functional." Finally, the results showed no significant correlation (P<0.05) between age and mean scores of frequency and severity of feeding problems. A significant negative correlation was found between mean scores of oral motor skill with frequency (P<0.001, r=-0.476) and severity (P=0.001, r=-0.424) of feeding problems. Discussion: The majority of children with CP have problems with feeding and oral motor skills. Some skills in the fields of feeding and oral motor should be noticed more by speechlanguage pathologists and included in their therapeutic program, especially "feeding skills," "closing the lips while feeding with a spoon," and "sucking with straw." [ABSTRACT FROM AUTHOR]

Introduction: Headache is one of the essential symptoms of pituitary adenoma associated with the tumor and the patient’s characteristics. The pattern of adenoma-related headaches varies widely and can significantly impact the patient’s quality of life. Objectives: We aimed to investigate the severity and pattern of headaches in patients with pituitary adenoma in Iran. Patients and Methods: In this cross-sectional study, we investigated 109 patients with an initial complement of headaches. The diagnosis of pituitary adenoma was confirmed. Patients’ demographic characteristics [e.g., gender, body mass index (BMI), and age] and tumor characteristics (e.g., subtype of tumor and size of tumor) were collected by interview, clinical examination, and imaging. We measured the severity of the headache using Headache Impact Test-6 (HIT-6) questionnaire version 1.1. Results: In our study, the most common subtype of pituitary adenoma was prolactinoma, followed by nonfunctional growth hormone (GH)-releasing and adrenocorticotropic hormone (ACTH)-releasing adenomas. Functional adenoma was significantly more common in women; however, the incidence of non-functional adenoma was more in men (61%), indicating the correlation between gender and subtype of adenoma (P = 0.008). Most tumors were functional microadenomas (69%), while macroadenomas were primarily non-functional (50%). The HIT-6 scores demonstrated that functional microadenomas had higher HIT-6 scores and patients with prolactinoma experienced more severe headaches than other subtypes (P = 0.003). Conclusion: Our study revealed significant effects of the type of adenoma on the severity of headaches, as patients with functional microadenomas had more muscular headaches. Additionally, the hormonereleasing function of tumors plays a vital part in the advent and severity of adenoma-related headaches. [ABSTRACT FROM AUTHOR]

Introduction: Hospital-acquired infections pose a significant risk to patients who are hospitalized and have become a major global concern. These infections are associated with an increasing number of complications, morbidity, and mortality rates, and result in considerable costs for patients during their hospital stay. Objectives: This study aimed to investigate the knowledge, attitude, and practice of the staff of Shahid Sayad Shirazi Hospital in Gorgan regarding the factors related to hand hygiene based on the PRECEDE model, 2020. To improve the observance of hand hygiene in personnel, it is necessary to study the factors related to their behaviors. Patients and Methods: This was a cross-sectional study with a descriptive-analytical approach. The statistical population was the administrative and medical personnel working in Shahid Sayad Shirazi Hospital, who were selected by random sampling. An author-made questionnaire was used, which included questions on knowledge, attitude, and performance. The questionnaire was based on Najafi Ghezeljeh et al’s study questionnaire and had 6 sections: demographic, knowledge, attitude, and enabling, where content validity was confirmed by determining CVR = 0.78 and CVI = 0.84. The questionnaire’s reliability was Cronbach’s alpha=0.84. The data collected were analyzed using SPSS version 16, and descriptive statistics and inferential statistics parametric tests ANOVA, t test, and Pearson’s correlation coefficient were used at the error level (0.05). Results: The results showed that the score of all areas was above average. The domain of enabling factors was affected by four variables: gender, degree of education, grade of education, and type of employment. The knowledge was affected by three demographic variables: age, work experience, and marital status. The performance is affected by the variable of work experience. Conclusion: To observe hand hygiene according to the instructions, it is required to create resources on a proper basis and provide basic knowledge, attitude, and practice training to the staff based on the PRECEDE model. [ABSTRACT FROM AUTHOR]

Introduction: Brucellosis, a globally prevalent disease, affects both humans and animals, with notable significance in Iran. While the severity and mortality of this disease are rare, it poses a substantial economic burden due to reduced productivity and livestock abortion. Torbat Jam city has a high prevalence of brucellosis in the region, necessitating an investigation into its epidemiological aspects. Objectives: The present study aimed to investigate the epidemiology of brucellosis in Torbat Jam city. Materials and Methods: This study examined 5366 cases of brucellosis in the city of Torbat Jam from 2017 to 2022. A comprehensive checklist encompassing variables, such as age, gender, place of residence, occupation, season, history of contact with infected animals, consumption of unpasteurized dairy products, and vaccination history was used for data collection. The t-test was used to compare the means of two groups, while the chi-square test was employed to assess the relationship between categorical variables and grouped numerical variables. A significance level of 0.05 was considered in this study. Results: A total of 5366 cases of Malta fever were analyzed in this study, with male patients comprising 50.40% and female patients accounting for 49.60% of the cases. The mean age of the patients during the study period was 33.18±18.81 years. Brucellosis onset occurred at an average age of 35.39±18.03 years in males and 30.96±19.01 years in females, with a statistically significant difference (P value <0.01). The youngest reported case of brucellosis was 1 year old, while the oldest was 101 years old. The highest disease occurrence (60.8%) was observed in the age group of 15-50 years, with a higher prevalence observed in both genders within this age group. Conclusion: The city of Torbat Jam is considered a high-risk area in terms of brucellosis prevalence. Factors such as rural living, contact with animals and consumption of unpasteurized dairy products significantly contribute to the disease’s spread in these regions. The results underscore the insufficient public awareness regarding brucellosis transmission and prevention, highlighting the urgent need for educational programs to enhance knowledge and awareness among individuals in these areas. [ABSTRACT FROM AUTHOR]

Background: Celiac disease (CD) is a multifactorial systemic disease that causes enteropathy and can lead to a wide spectrum of disorders related to infertility. Objectives: This case-control study aimed to evaluate the frequency of celiac disease (CD) and its association with infertility in women. Methods: This study was conducted on women referred to Ghadir Mother and Child Hospital in Shiraz. Women with infertility served as the case group, while fertile women comprised the control group. Blood samples were collected from participants, and tissue anti-transglutaminase (Anti-TTG Ab) levels were measured. Patients with elevated Anti-TTG Ab levels were referred for duodenal biopsy. Results: One hundred subjects were enrolled in the case group and 200 in the control group. Eight patients in the case group tested positive for serology, and four of these had duodenal biopsies confirming CD. In the control group, one individual tested positive for serology, but the duodenal biopsy was negative (P for between-group differences: 0.001 for serology and 0.012 for biopsy results). There was a significant association between high levels of Anti-TTG Ab and infertility (odds ratio = 17.30, 95 % CI: 2.13 - 140.39), which remained even after adjusting for age and body mass index (odds ratio = 9.92, 95 % CI: 1.17 - 84.21). Conclusions: The frequency of CD was higher among infertile women compared to fertile women. Increased levels of Anti-TTG Ab were independently associated with infertility. [ABSTRACT FROM AUTHOR]

Background: The incidence of gestational diabetes mellitus (GDM) has increased in recent decades. Established prevention methods for GDM include diet and exercise. Recent interest has focused on the roles of vitamin B12 and folate in the development of GDM. These micronutrients are essential for one-carbon metabolism, which is involved in many metabolic pathways. However, the study results were conflicting and varied by geographic area. Objectives: The aim of this study was to evaluate the relationship between GDM and vitamin B12 levels in our region. Methods: This case-control study enrolled 180 pregnant women at 24 - 28 weeks of gestation. Half of the participants had GDM, and the other half were healthy individuals. All participants attended outpatient pregnancy care clinics at Shiraz University of Medical Sciences from June 2020 to April 2021. Gestational age, age, and body mass index were matched between the two groups. Vitamin B12, folate, insulin, and homocysteine levels were measured in both groups and insulin resistance was calculated. The results were compared between the two groups, and the relationship between vitamin B12 levels and insulin resistance in each group was investigated. Results: Vitamin B12 deficiency was present in 15.6% of the women with GDM. There were no cases of vitamin B12 deficiency in the control group. The GDM group had lower vitamin B12 levels (365.22 ± 136.82 pg/mL vs. 496.08 ± 156.46 pg/mL, P = 0.001). There was a negative correlation between serum vitamin B12 level and insulin resistance index (P = 0.001, r = -0.62). Folate levels were higher in the GDM group (17.93 ± 3.66 ng/mL vs. 14.60 ± 5.32 ng/mL, P = 0.001), but these levels did not significantly relate to insulin resistance or GDM. Conclusions: In our region, there is a significant relationship between low levels of vitamin B12 and both insulin resistance and GDM, which suggests the need for larger studies and attention to the detection and treatment of vitamin B12 deficiency during pregnancy. [ABSTRACT FROM AUTHOR]

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Introduction: This study aimed to determine the frequency of CT scan involvement due to COVID-19 pneumonia in different age groups of patients. Methods: Patients with COVID-19 were referred to Amir al-Momenin Hospital in Arak City from May 2020 to June 2021. Age, sex, history of underlying disease, and CT scan results were recorded. CT scan Scores on the 5th to 8th day for patients were determined. The prepared CT scan was evaluated, and the pattern of pulmonary involvement and the prevalence of involvement in the lobes were assessed separately (upper, lower, peripheral, and bronchovascular fairytale). Results: Overall, 349 patients were included. The mean age was 50.89 years. The most common involvement of the right lower lobe was 92% and the left lower lobe was 89.1%. Most patients had peripheral lung involvement. The average number of lobes involved was 4.14. GGO and GGO and Consolidation were correlated with younger patients. Higher Consolidations were observed in the age groups of 30 to 50 and 50 to 70. Crazy Paving is more common in the elderly and Halo was more common in young patients. The severity of lung involvement and the number of lobes involved were associated with high age. Conclusion: Different age groups have specific features in CT scans to assess COVID-19 patients. Crazy Paving Appearance, Subplural bands, GGO, and Consolidation were seen in the elderly and severe/critical patients. Also, the amount of involvement and the number of lobes involved in the lungs of patients increases in patients of high age. [ABSTRACT FROM AUTHOR]

Introduction: Acute pain caused by kidney stones is considered one of the most prevalent reasons for referring to treatment centers or hospitals. One of the essential issues in this field, which still has many questions, is the probability of an increase in kidney stone formation during fasting. This study assessed the relationship between kidney stone pain and fasting during Ramadan. Methods: This study conducted a descriptive cross-sectional check on the patients who referred to 3 central urgencies named Imam Khomeini-Shahid Labafi Nejad and Baghiatallah due to Colic pain generated from kidney stones during three periods of time, including before, in, and after Ramadan. Results: The study indicates ureteral stones are more prevalent than kidney stones in patients with Kidney Colic Pain during three periods. Also, it was released that the most amount of Colic pain was experienced by males under 40 years during three periods of time, so there is a significant relevance between the male gender and Renal Colic (P<0.05). A noticeable change in diet and more usage of carbohydrate compounds in addition to high-protein diets was reported here, so there is a significant difference between more carbohydrates and Renal Colic before and after Ramadan (P=0.022). Conclusion: It is specified that factors such as male gender, age under 40, being overweight, high-calorie diet, and low physical activity are the risk factors associated with Renal Colic. Also, this study found that the reception of renal colic patients in Ramadan had no significant difference in another two months. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to assess the impact of coronavirus-related stress coping styles and nurse-physician relationships on the mental health of nurses. Methods: This cross-sectional study included 516 nurses in Tehran-affiliated hospitals from 24 February 2021 to 12 February 2023. Patient Health, the Generalized Anxiety Disorder-7, Coronavirus-Related Stress Coping Styles, and Professional Relationship between Physician and Nurse Questionnaire were used. Results: Depression (mean = 9.03, SD = 5.87) and anxiety (mean = 8.73, SD = 4.52) and were mild. The distancing coefficient was the significant interpreter for anxiety (P<0.001, ß =-0.379). Also, there were significant relationships between anxiety and escape avoidance, confronting coping, self-controlling, and planful problem-solving. Escape-avoidance coping was the strongest predictor of depression (P<0.001, ß = 0.311). Also, significant relationships existed between depression and distancing, confronting coping, positive reappraisal, and planful problem-solving. The Nurse-Physician relationship coefficient was a negative significant predictor of depression (P=0.023 and ß =-0.091). Age coefficient was a significant predictor for anxiety and depression (P=0.005 and P<0.001, respectively). Educational level was a negative significant predictor for anxiety and depression (P<0.001 and P<0.001, respectively). Conclusion: The results indicated that age, educational level, coping styles, and nurse-physician relationship correlated to nurses' anxiety and depression during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Rabies remains a public health problem in middle-income countries like Iran, despite being preventable. This study aimed to evaluate the six-year incidence of animal bites in the southern Caspian Sea region from 2016 to 2022, and focus on estimating the direct costs of animal bite cases using the incidence-based method. Methods: A multicenter, registry-based study was conducted using surveillance data of animal bites. Results: Of the 40 922 cases reported during the study period, 65.9% were male and 34.1% were female. Animal bites were most frequent among individuals over 50 years of age (23.5%), while children under 10 years of age had the lowest frequency of animal bites (2.3%). Animal bites were most common in June. Dogs were responsible for 33 277 (81%) cases, cats for 5,624 (13.7%) cases, cows for 1054 (2.5%) cases, and other animals for the remaining cases. During the six-year study period, four deaths due to rabies were reported in the study area. The annual bite incidence rate was 386.3 per 100 000 people in northern Iran. The males-to-female ratio was highest in 2019 (M/F ratio = 2.4, 95% CI = 1.2-3.4). Conclusion: The elderly are at higher risk of animal bites, especially in rural areas. It is important to emphasize the use of protective clothing, washing wounds with soap water and rabies vaccination as initial treatment. Targeted vaccination efforts for eligible animals should be prioritized to minimize unnecessary financial burden. Educating farmers about rabies prevention programs, especially in cases of cow bites, is also important. [ABSTRACT FROM AUTHOR]

This study was designed to assess the relationship between dietary insulin index (DII) and dietary insulin load (DIL) and rheumatoid arthritis (RA) risk in a case–control study. This study enrolled ninety-five newly diagnosed RA patients and 200 age- and sex-matched healthy controls. Dietary intakes were assessed using a validated 168-item semi-quantitative FFQ. DII and DIL were calculated using food insulin index values from previously published data. In the unadjusted model, individuals in the highest DIL tertile had the significantly higher odds of RA than those in the lowest tertile of the DIL scores (OR = 1·32, 95 % CI (1·15, 1·78), P for trend = 0·009). After adjusting for confounders, the risk of RA was 2·73 times higher for participants in the highest tertile of DIL than for those in the lowest tertile (OR = 2·73, 95 % CI (1·22, 3·95), P for trend < 0·001). In addition, patients in the highest DII tertile had higher risk of RA than those in the first tertile (OR = 2·22, 95 % CI (1·48, 3·95), P for trend = 0·008). This association persisted after adjusting for potential confounders (OR = 3·75, 95 % CI (3·18, 6·78), P for trend = 0·002). Our findings suggest that diets high in DII and DIL may increase the risk of developing RA, independent of other potential confounders. These findings can be verified by more research, particularly with a prospective design. [ABSTRACT FROM AUTHOR]

Background: Predictive equations have been considered as a practical approach for estimating resting energy expenditure (REE) across multiple populations, but their accuracy for each community remains to be determined. Thus, the purposes of this study were to determine the validity of REE predictive equations and to develop a new REE predictive equation in adults living in Tehran. Methods: The study included 284 subjects (158 females) aged 18-60 years old from two cross-sectional studies conducted in Tehrani populations. Anthropometric measurements were assessed using standard protocols. REE was measured using indirect calorimetry (IC) and was estimated using preexisting equations. A new equation was also developed based on the REE from IC and variables such as age, sex, height, and weight. Measured REE was compared to new equation and preexisting predictive equations via correlation, linear regression, and Bland-Altman tests. Results: The new equation and the equations by Mifflin—St. Jeor, Livingston, Frankenfield, Nichols, Müller, and Ganpule demonstrated the best predictive value at a group level (mean percentage error=-2.2 to 2.4 %). At an individual level, the new equation and the equations by Mara, Frankenfield, Roza, Nikooyeh, and Harris & Benedict showed the greatest accuracies compared to measured REE (accuracy prediction=50-53%). Conclusion: This study highlights the importance of considering race when predicting REE. It also demonstrates that the newly developed equation is more appropriate in a clinical setting at group but not individual level. Thus, further research is needed to examine the new equation in an independent sample. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this retrospective single-center study was to determine the frequency of sarcopenia and its association with mortality and other morbidities in children with chronic liver disease who had undergone liver transplantation. Background: Sarcopenia, a muscle-wasting syndrome, is common in patients with advanced liver disease and is associated with increased morbidity and mortality. While sarcopenia in adults has been extensively studied, there is little information in this regard about children and adolescents with chronic liver diseases. Methods: The study included 108 children and adolescents who had undergone liver transplantation. Sarcopenia was measured using skeletal muscle index at the third lumbar vertebral level and assessed using abdominal computed tomography imaging. Results: The frequency of sarcopenia in the studied population was found to be 45.7%. Patients with sarcopenia were more likely to be male (P<0.0001), older (P<0.0001), and had lower height-for-age z-scores (P=0.012). Genetic/metabolic diseases were the most common underlying cause of sarcopenia in children. Except for a higher rate of transplant rejection in the sarcopenia group (P=0.035), there was no significant difference in mortality rates (P=0.688) or post-LT complications between the two groups. One year after LT, computed tomography-derived body composition parameters revealed no significant differences between children who survived and those who did not. Conclusion: Our findings indicated a high frequency of sarcopenia in children with chronic liver disease, implying that more research is needed to better understand its impact on clinical outcomes in this population. [ABSTRACT FROM AUTHOR]

Background: The concurrence of acute myocardial infarction (AMI) with COVID-19 can complicate the clinical conditions of patients and affect the patterns of hospital resource utilization. This study aimed to investigate and analyze the direct treatment costs of AMI patients with concurrent COVID-19. Methods: This cross-sectional study collected and analyzed clinical data, including symptoms, readmission, and interventions, and treatment cost data for all patients at Tehran Heart Center using SPSS26 software. The mean medical costs of patients from January through May 2022 were also calculated. Results: The COVID-19 group was composed of 72.9% male and 27.1% female patients, whereas the non-COVID-19 group consisted of 67.3% male and 32.7% female patients. Most of the patients in the COVID-19 group (60%) were in the elderly age group (>65 y). The length of stay was 8.70±5.84 days for the COVID-19 group and 6.31±4.42 days for the non-COVID-19 group. The mortality rate in the COVID-19 group was 24%, higher than the 5% rate in the other group. Additionally, the average total treatment costs were $6384.54±$6760.13 in the COVID-19 group and $6362.49±$4343.07 in the non-COVID-19 group (P>0.78 and P>0.050). Conclusion: The study found that the COVID-19 group had a significantly higher in-hospital mortality rate than the non-COVID-19 group. During the follow-up period, the incidence of complications (chest pain and heart failure) was higher in the non-COVID-19 group. It also showed that longer hospital stays resulted in higher treatment costs. [ABSTRACT FROM AUTHOR]

Iran is a developing country with low levels of economic development and globalization and is ruled by a theocratic government. To address the lack of national research on well-being in Iran, this retrospective observational study aims to examine life satisfaction and its main determinants among Iranian adults. Using World Gallup Poll data collected between 2006 and 2017, we examined life satisfaction as a cognitive aspect of subjective well-being in relation to various factors. Our results show that income is the strongest predictor of life satisfaction, followed by standard of living, gender, social support, age, negative affect, and education. In developing countries such as Iran, which face significant economic, political, and social challenges, individuals prioritize the satisfaction of basic needs by emphasizing factors such as the socioeconomic status. In contrast, developed countries with established welfare systems may emphasize other values such as social connections and healthy lifestyle behaviors as key factors in life satisfaction. This study contributes to a deeper understanding of the determinants of life satisfaction in Iran and provides insights for future research and policy making. [ABSTRACT FROM AUTHOR]

Background: Neoadjuvant chemotherapy (NCT) has become an increasingly popular approach in management of breast cancer (BC). This study was conducted to evaluate the pathologic response and 36-month recurrence and survival rates of patients with human epidermal growth factor receptor 2 (HER2)-negative BC treated with different NCT regimens. Methods: A total of 163 female patients with HER2-negative BC who received NCT during 2017-2020 were identified from the Clinical Breast Cancer Registry of Iran and entered the study. The prescribed NCT regimens included 4 cycles of doxorubicin plus cyclophosphamide, 4 cycles of doxorubicin plus cyclophosphamide followed by 4 cycles of paclitaxel, 4 cycles of doxorubicin plus cyclophosphamide followed by 4 cycles of docetaxel or 6 cycles of doxorubicin plus cyclophosphamide plus docetaxel (TAC). Results: Thirty-two patients (19.6%) experienced pathologic complete response (pCR). TAC regimen, triple negative-BC and ki67 > 10% were significantly associated with increased pCR. The recurrence, overall survival (OS) and disease-free survival (DFS) rate at 36 months for all patients were 16.6%, 84.7% and 79.8%, respectively. Type of neoadjuvant regimen as well as age, hormone receptor status, Ki67, grade, clinical stage, type of surgery and pathologic response to chemotherapy did not significantly influence the survival and recurrence; however, TAC results in improved recurrence, OS and DFS rates. Conclusion: This study provides further evidence that NCT is a viable treatment option for patients with HER2-negative BC. The TAC regimen resulted in a significantly higher pCR rate compared to other regimens, but did not result in a significant improvement in recurrence, OS and DFS rates. [ABSTRACT FROM AUTHOR]

Background: While there has been extensive research on colorectal cancer (CRC) incidence and its associated factors in Iran, a significant gap exists in studies predicting its future trends. Our study aimed to thoroughly report CRC incidence across Iran from 2014 to 2017, by sex, age, and geographical regions, and provide a projection for 2025. Methods: This retrospective study utilized data from the Iranian National Population-based Cancer Registry (INPCR). Patients with the International Classification of Diseases for Oncology, 3rd Edition (ICD-O-3) codes C18 to C21 were included. The age-standardized incidence rate (ASR), was calculated per 100 000 individuals annually, and crude incidence rates were retrieved for various demographic groups and years. Results: Between 2014 and 2017, a total of 43 580 new CRC cases (55.96% males) were registered. Men exhibited an ASR of 134.45, while women's ASR was 94.85. The highest ASRs were observed in Tehran, Qom, and Ilam (18.99, 18.26, and 18.06, respectively). Incidence rates surpassed 20 after age 50 for both genders, reaching their peak within the 80-84 age group. Adenocarcinoma was the most frequent histological type of CRC in nearly all provinces. Case numbers and ASRs are projected to continuously rise until 2025, with a predominance of male cases. Conclusion: The anticipated increase in CRC incidence in Iran emphasizes the need for additional studies to better identify risk factors. Furthermore, implementing screening programs is recommended for individuals at a higher risk of CRC, including men, the elderly population, and those residing in regions with a notable prevalence of CRC. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the risk factors of death caused by COVID-19 in Iran. Methods: This study was a retrospective cohort study from February 20, 2020, to August 22, 2022, in the hospitals in Isfahan, Iran. The data were collected through a researcher-made checklist. To determine the risk factors of the death, logistic regression and Cox regression models were used. For each variable, the odds ratio and 95% confidence interval were also reported. Results: 1 885 Patients were included. The age of deceased persons was significantly higher than that of the surviving persons. The risk of death for the age group above 60 years was about 14 times higher than that of people aged 19-35 years [95%CI: 14.41 (2.02-102.99), P<0.01]. Hypertension [95%CI: 1.92 (1.47-2.5), P<0.01], diabetes [95%CI: 1.62 (1.23-2.13), P<0.001], and chronic obstructive pulmonary disease [95%CI: 1.92 (1.47-2.50), P<0.01] were also risk factors of mortality. Conclusions: This study reveals that the mortality rate due to COVID-19 is associated with old age, longer hospitalization in the ICU, increased length of stay, and comorbidities of high blood pressure, diabetes, and chronic pulmonary disease. [ABSTRACT FROM AUTHOR]

Objective: To investigate the distribution pattern of animal bites in Mirjaveh, Iran from 2015 to 2020. Methods: The data on animal bites were collected from the Department of Infectious Diseases, the provincial health center. Monthly climatic data on precipitation and temperature during the study period were also collected. The correlation between incidence and temperature, precipitation rate, land type, and altitude was also analyzed. Results: The results showed that men were more affected by animal bites than women (76.4%, P<0.001), and the highest incidence rate occurred in the age group of 5-19 years. The incidence rate of animal bites was found to be correlated with temperature and altitude. An increase in temperature was associated with a rise in the incidence rate of animal bites. The number of animal bites increased until 2019, possibly due to an increase in the number of dogs in the area. Conclusions: Targeted interventions should be implemented to reduce the incidence of animal bites, particularly among children, housewives, and students. Improving access to appropriate treatments, increasing public awareness of the hazards of animal bites, and increasing the number of vaccinated dogs in the area are essential strategies to be considered. [ABSTRACT FROM AUTHOR]

Objective: Incidental findings (IFs) are newly discovered abnormal findings unrelated to the primary purpose of imaging. Brain computed tomography (CT) scan is one of the most essential and initial imaging evaluations for head trauma patients, which may also have nontraumatic IFs. We aim to investigate the prevalence and nature of IFs in brain CT scans of head trauma patients. Methods: We conducted a cross-sectional study to evaluate brain CT scans of 1006 head trauma patients over one year (April 2021 to March 2022), to identify incidental findings by consensus agreement of two radiologists. We categorized the incidental findings into four categories based on appropriate follow-up recommendations. Results: We included 1006 head trauma patients who underwent brain CT scan, of which 126 incidental findings were discovered in brain CT scan of 107 patients. The prevalence of incidental findings was 10.6% (107/1006). The most common incidental finding was brain atrophy (n=15, 11.9%). The mean age of patients with IFs was significantly higher than those without IFs, but there was no difference between the two groups regarding gender. Conclusion: The discovery rate of incidental findings of brain CT scans in head trauma patients was considerable. Serious medical findings that need immediate evaluation were found in 5.6% of patients, mostly over the age of 40. Therefore, patients who have clinically significant incidental findings need improved documentation and follow-up to evaluate the long-term outcomes and reliability of imaging results. [ABSTRACT FROM AUTHOR]

Background: Capillary blood glucose measurement is one of the most important diagnostic procedures in managing and treating patients, especially those with diabetes. Since the preparation method of the capillary sampling site affects the blood glucose (BG) level, it is essential to identify the best preparation method with the least error estimation. This study compares the capillary BG level with the venous BG level after preparing the sampling site with four different preparation methods. Methods: This quasi-experimental study has a single-group design. It was conducted on 85 nursing and midwifery students of Kashan University of Medical Sciences and Health Services, in 2022. The subjects who met the inclusion criteria were selected using convenience sampling. Capillary BG was measured from each finger using a glucometer while each finger was prepared with alcohol, water, soap and water, or no washing. Then, the venous blood sample of the same person was sent to the laboratory. The data were analyzed by SPSS software, version 22. The Friedman and Dunn post hoc tests were used to compare venous and capillary BG levels obtained using different methods. The significance level was set at P<0.05. Results: There were significant differences between venous BG levels and capillary BG levels in blood sampling site preparation with alcohol (P<0.05). Preparation with alcohol had the highest (7.34±27.03), and the soap and water had the lowest (-0.67±14.82) estimation errors. Conclusion: The use of alcohol to prepare the blood sampling site, which is a common practice in many healthcare facilities, may misrepresent BG levels and lead to misdiagnosis and treatment. Therefore, it is suggested that the soap and water cleaning method be used instead, which has the lowest error compared to venous BG. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the potential risk factors of lifetime urolithiasis occurrence on a nationwide scale in Iran. Methods: All data regarding urinary stone events were extracted from the cross-sectional Iran National Stone Survey (INSS) study, and the possible determinants of urolithiasis incidence were evaluated. Results: Our multivariable logistic regression suggested that while older age at presentation, male sex, and a positive family history of urolithiasis in either of the patient's parents or siblings were all significantly associated with an increased odds of lifetime urolithiasis occurrence (all P < .001), a positive family history in one's sister (odds ratio; OR = 5.56) or brother (OR = 4.70) were the most significant predictors. Moreover, belonging to Baluch ethnicity (i.e., an ethnical group indigenous to the south eastern regions of Iran) and residing in regions with higher water hardness (i.e., total concentration of dissolved minerals) were also associated with an increased odds of urolithiasis occurrence (P < .001 and P = .023, respectively). Conversely, living in regions with higher mean humidity decreased the chances of developing a urinary stone event during one's lifetime (OR = 0.62, P < .001). Conclusion: Our results indicated that a constellation of demographic, ecological, and familial risk factors are associated with an elevated risk of developing urinary stones during one's lifetime. These findings can assist in implementing novel regional healthcare policies, considering the specific demographic and ecological characteristics. They also support tailoring personalized preventive strategies, particularly for individuals with multiple nonmodifiable risk factors. [ABSTRACT FROM AUTHOR]

Background: The transcendental society is characterized by cohesive, purpose-driven, and flourishing families. To achieve this,marital satisfaction (MS) plays a crucial role in the lives of married couples. Objectives: This study aimed to determineMS and its influencing factors among newlymarried women. Methods: A prospective cohort study was conducted in Shiraz, Iran, involving 495 young first-married women within the first 2 years of their marriage. The participants completed a valid questionnaire encompassing demographic information, socioeconomic characteristics, and mate-selection criteria at the onset and after 2 years of marriage. The questionnaire in the second stage consisted of updated demographic and socioeconomic data and assessments of MS. These questionnaires demonstrated reliability rates of 70.6% and 88.6% in the first and second stages, respectively. Marital satisfactionwasmeasured on a scale of 1 to 10,with scores ≥ 5 and> 5 indicating lowand high satisfaction levels, respectively. The data were analyzed using SPSS software version 25. Results: The mean age of the participants was 28.2 ± 5.3 years. Most women (70.7%) had an age difference of 1 - 7 years with their husbands; however, 78.4% had an academic education. Additionally, 73.5% reported no blood relation with their spouses, 74.5% did not have children, 62.8% were employed, and 87.3% did not live with their parents after marriage. The average follow-up period was 23.8 ± 8.3 months. Marital satisfaction was reported as high in 442 (89.3%) participants and low in 53 (10.7%). Multiple regression analysis revealed that the following factors significantly influenced MS among young married women: belief in the correctness of mate-selection criteria (OR = 21.4, P < 0.001), meeting husband's expectations (OR = 13.1, P < 0.001), sexual satisfaction within the marriage (OR = 11.5, P < 0.001), pre-existing acquaintance with the husband (OR = 9.4, P < 0.001), and abstaining from cigarette, alcohol, substances, or psychological drugs after marriage (OR = 8.5, P = 0.001). Furthermore, not living with the husband's family (OR = 6.4, P = 0.002), having a healthy husband (OR = 5.9, P = 0.002), receiving support fromthe husband's family (OR = 5.9, P = 0.001), husband's abstinence fromcigarette, alcohol, substances, or psychological drugs after marriage (OR = 3.6, P = 0.04), engaging in regular communication with the husband regarding mutual expectations (OR = 3.5, P = 0.03), and higher age of the husband (OR = 1.1, P = 0.03) were also correlated with MS. Conclusions: This study highlights the significance of various pre-marriage and post-marriage personal and familial factors in determining MS among young married women. These findings underscore the importance of providing guidance, education, and support to couples and their parents regarding these influential factors before and after marriage. [ABSTRACT FROM AUTHOR]

Background: The aggregation of clonal plasma cells causes plasma cell neoplasms, which vary in severity and clinical outcomes. The present research focused on the epidemiological, clinical, immunologic, and cytogenetic characteristics of plasma cell neoplasms. Methods: In this five-year retrospective cross-sectional study, demographic information such as age and sex, calcium elevation, renal insufficiency, anemia, and bone lesion (CRAB) characteristics, as well as laboratory data including bone marrow and peripheral blood film results, immunohistochemistry, flow cytometry, and cytogenetic study outcomes were collected at Shiraz University of Medical Sciences, Shiraz, Iran. The collected data were analyzed using SPSS Statistics software (version 20.0). Descriptive statistics were reported as numbers, percentages, and mean±SD. Results: 417 newly diagnosed plasma cell neoplasm patients were confirmed by bone marrow or other tissue biopsy tests. 279 patients were men (66.9%). The most prevalent age group was 60-64 years old (18.46%). Plasma cell myeloma (PCM) affected 355 (85.13%) patients, while monoclonal gammopathy of undetermined significance (MGUS) affected 6 (1.43%) patients. Solitary plasmacytoma was seen in 56 (13.42%) patients. At the time of diagnosis, 119 (33.52%) of 355 PCM patients were asymptomatic, whereas 236 (66.47%) patients had at least one CRAB symptom, 55 (15.49%) had two or more, and 14 (3.94%) had three or more. There were 7 (1.97%) cases of amyloidosis. Cytogenetic abnormalities were found in 51.28% (40/78) of the patients. Twenty-one individuals (52.5%) were hyperdiploid with multiple trisomy, while 19 (47.50%) were not. Conclusion: When diagnosed, Iranian PCM patients might have more advanced disease. PCM was more prevalent in young adults, and hyperdiploid was the most common cytogenetic finding in this investigation. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the quality of nursing care in critical care units (CCUs) for patients with COVID-19. Methods: A cross-sectional study was conducted on 100 nurses working in CCUs at a teaching hospital in Tehran from June to December 2021. Nurses' performance in caring for COVID-19 patients was evaluated through a nursing care quality measurement scale. Data were analyzed by SPSS 21 software, and using t-tests, ANOVAs, Pearson's correlation coefficients, and regressions. Results: The study revealed that 68.2% of nurses were female, and 67.2% of patients were male. The mean quality of care score ranged from medium to high (125.77±33.73), with better care provided to male patients compared to female patients (p<0.01). A significant negative correlation was observed between the quality of care and patients' age (r=-0.40; p<0.0001) as well as the number of monthly overtime hours worked (r=-0.206; p=0.03). Age and gender were identified as predictive variables for the quality of care (p<0.05). Conclusion: The quality of care in CCUs for COVID-19 patients was rated as medium to high. Increasing the number of nurses during pandemic such as COVID-19 is essential to enhance the quality of care. Furthermore, training programs should be implemented to improve nurses' attitudes in COVID-19 wards, particularly towards caring for the elderly. [ABSTRACT FROM AUTHOR]

(1) Background: Emotional regulation is a critical determinant of adaptive functioning during adolescence, exerting a profound influence on psychological well-being. This study seeks to deepen our understanding of the intricate interplay between emotional regulation and maladaptive psychological symptoms, examining these dynamics through a cross-country comparison. (2) Methods: A total of 224 adolescents, aged 13 to 21 years, from both Iran and Belgium, participated in a cross-sectional comparative study. The study aimed to elucidate the relationship between emotional regulation and mental health functioning, assessing internalizing symptoms, externalizing symptoms, and self-injury. A demographic questionnaire, the Emotion Regulation Inventory, the Strengths and Difficulties Questionnaire, and the Self-Harm Inventory, were administered. Data analysis incorporated correlation assessments, multivariate analysis of variance, and structured equation modeling. (3) Results: The findings revealed a positive association between emotional dysregulation and psychological symptoms across the entire sample. Conversely, emotional suppression, more prevalent in Iran, showed no significant link with maladaptive symptoms but was associated with self-harm in the Belgian sample. Cultural disparities were evident, with internalizing problems more prevalent in Iran and externalizing issues more common in Belgium. (4) Conclusions: Emotional dysregulation emerged as a common factor compromising mental health. It emphasizes the necessity of considering cultural nuances when developing interventional and preventative programs and calls for further research in this field. [ABSTRACT FROM AUTHOR]

Background: Since general practitioners manage acne-related referrals, there needs to be more information in Iran about how drugs such as Isotretinoin are prescribed and the treatment plan. Thus, this study aimed to evaluate general practitioners s' practices and attitudes in prescribing Isotretinoin for acne vulgaris in primary care. Methods: This web-based cross-sectional descriptive study was conducted using two questionnaires designed with the target population of GPs working in Fars province in 2021 regarding the prescription of Isotretinoin. Moreover, demographic information, questions about interest in dermatology, and participation in dermatology workshops were gathered. Results: A total of 308 complete questionnaires were obtained. According to our results, 85 (27.6%) GPs prescribed Isotretinoin in primary care. Based on our results, higher age (OR: 1.042; CI95%: 1.013–1.072; P-value:0.004) and attending dermatological courses (OR: 3.280; CI95%: 1.592–6.755; P-value:0.001) were significantly correlated with more frequent Isotretinoin administration. Among GPs who do not prescribe Isotretinoin, the most common causes are concerns about liver dysfunction (54.7%), teratogenic concerns (37.2%), and lack of familiarity with the drug (31.4%) respectively. Conclusion: The results of this study depicted the reluctance of most physicians to prescribe Isotretinoin and factors such as taking part in supplementary courses under the supervision of dermatologists and following national guidelines that could encourage them to prescribe Isotretinoin. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has limited hemodialysis patient's attendance in healthcare centers and receiving diet education. This study was conducted to investigate the effectiveness of distance learning on the nutrition quality of hemodialysis patients during the COVID-19 pandemic. Methods: In the single-blind randomized clinical trial, 60 patients undergoing hemodialysis were randomly divided into control (n = 30) and experimental (n = 30) groups. Before and after the intervention, Dialysis Malnutrition Score (DMS), Malnutrition-Inflammation Score (MIS) (primary outcome), albumin, the total iron-binding capacity of the blood (TIBC), and body mass index (BMI) (Secondary outcome) were investigated. The experimental group received educational content through social networks for three months, whereas the control group received routine care and training. Results: There was no significant difference between the two groups in terms of the mean of DMS, MIS, albumin, and TIBC before the intervention. Pre-test BMI had a confounding effect; therefore, an analysis of covariance was performed to eliminate that effect. This analysis showed significant differences in the post-test mean DMS, MIS, TIBC, and BMI between the two groups. In the control group, significant differences were observed in MIS and BMI toward deterioration. The results also indicated a significant relationship between education level and age with TIBC and between marital status and albumin index. Conclusion: Distance learning can be considered by healthcare managers and police makers as a suitable alternative to the classic face-to-face learning method to enhance hemodialysis patients' nutrition quality during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]