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Background Depression is one of the most common psychological disorders that can affect a person’s mood and change his/her perception of the self and environment. Melilotus officinalis L. plant contains effective substances and antioxidant compounds. Objective The present study aims to investigate the antidepressant effects of alcoholic extract of Melilotus officinalis L. in male rats. Methods In this experimental research, 42 male rats were divided into six groups of 7 including control (normal saline), negative control (reserpine), positive control (reserpine+fluoxetine) and three reserpine groups treated by intraperitoneal injection of 100, 200, 400 mg/kg doses of alcoholic extract of Melilotus officinalis L. Behavioral tests including forced swim test (FST) and tail suspension test (TST) were used to evaluate depression, and the antioxidant capacity and malondialdehyde level were also measured. The data were analyzed in SPSS software, version 20 using one-way analysis of variance. The significance level was set at P<0.05. Results The 200 mg/kg and 400 mg/kg doses of alcoholic extract significantly reduced the duration of immobility in the FST compared to the negative control. In the TST, the doses of 200 and 400 mg/kg showed a significant increase compared to the negative control. The doses of 200 and 400 mg/kg significantly increased the antioxidant capacity of the brain compared to the negative control. The doses of 200 and 400 mg/kg significantly reduced the antioxidant capacity of the brain compared to the negative control. Conclusion The alcoholic extract of Melilotus officinalis L has antidepressant effects similar to fluoxetine probably due to its antioxidant compounds. [ABSTRACT FROM AUTHOR]

Background Herb shops are important for preparing medicinal plants. Improper packaging can lead to contamination of these plants by various types of microorganisms, fungi and yeasts. Objective This study aims to investigate the prevalence of microbial and fungal contamination in four plants from the Lamiaceae family in herb shops in Rasht, Iran. Methods In this study, 15 samples from mint, rosemary, and wild mint plants, and 16 samples from lemon balm were collected. The samples were diluted and incubated for one hour, then transferred onto Tryptic soy agar culture medium for bacterial enumeration. The sabouraud dextrose agar culture medium was used to count total mold and yeast, while McConkey Broth culture medium was used for specific identification of Escherichia coli. Data analysis was conducted in SPSS software, version 16. For comparing the bacterial and fungal contamination levels in the plant samples with the Pharmacopeial quality standard values, the non-parametric Wilcoxon signed rank test was used. Results Out of 61 plant samples, 59 (73.7%) were contaminated with bacteria, and 60 samples (86.6%) were contaminated with fungi. The number of samples contaminated with Escherichia coli was 27 (44.2%). The mean counts of bacteria and fungi in the plant samples were 3.39×105 and 6.3×105, respectively. Conclusion The microbial contamination in most of the plant samples examined in this study is significantly higher than the permissible limit. It is necessary for health authorities to implement stricter policies for monitoring the quality of natural products in herb shops of Rasht, Iran. [ABSTRACT FROM AUTHOR]

Background Nasal septal abscess, which is the collection of purulent materials between the cartilaginous or bony septum and the mucoperichondrium or mucoperiosteum, often occurs after septal hematoma caused by trauma. Other common factors include surgery, foreign bodies, and sinusitis. In addition to the risk of nasal deformity, septal abscess can cause life-threatening complications such as osteomyelitis, orbital or intracerebral abscess. Objective This study aims to investigate the frequency of nasal septal abscess and its related factors in patients in north of Iran. Methods In this descriptive cross-sectional study on the patients referred to a hospital in north of Iran in 2022. Their demographic and disease-related information were recorded and the risk factors were finally identified. Results In this study, 37 patients had septal abscess. The most common risk factor identified was a history of septoplasty or septorhinoplasty (35.1%), followed by diabetes mellitus (21.6%). Surprisingly, one of the factors in these patients was cauterization for epistaxis treatment (n=6). All patients were treated with broad-spectrum antibiotics and surgical drainage. In five patients, abscess resulted in saddle nose deformity. Positive culture results were reported in five samples. Conclusion Early identification of nasal septal abscess and its risk factors can help control the disease and prevent its serious complications. [ABSTRACT FROM AUTHOR]

Background It is necessary to provide safe care for patients with acute and life-threatening conditions by nurses working in the emergency departments (EDs). These nurses need higher levels of independent performance. Therefore, the competency to provide safe care and having professional nursing autonomy in novice nurses working in the EDs are very important. Objective The purpose of this study was to determine the relationship between professional nursing autonomy and safe nursing care in newly graduated nurses working in the EDs. Methods In this analytical cross-sectional study, the study population consists of all newly graduated nurses working in EDs of hospitals in Guilan, Iran. They all were included in the study using a census sampling method. The tools for collecting information were a demographic form, the assessment of safe nursing care questionnaire, and the professional nursing autonomy scale. Descriptive and inferential statistics (independent t-test, Spearman or Pearson correlation test, and linear regression analysis) were used to analyze the collected data. Results There was a significant relationship between professional nursing autonomy and safe nursing care; for every one unit increase in professional autonomy, the chance of providing safe nursing care increases by 0.133 (P=0.009). Conclusion The significant relationship of professional nursing autonomy with safe nursing care among the EDS nurses shows that if nurses have a greater control over their performance, decision-making ability, and autonomy to act based on patient safety, they can provide better quality care to patients. Therefore, empowering nurses by providing conditions to perform based on professional autonomy, can ultimately lead to better results for the patients and cause overall safety in the EDs. [ABSTRACT FROM AUTHOR]

Background Temporomandibular disorders (TMDs) are a group of conditions that cause dysfunction in the jaw joint, masticatory muscle pain and mouth opening limitations, and affects patients’ ability to eat, practice oral health, and perform other activities of daily living. The etiology of TMDs is not well-known. These disorders have a higher prevalence in women and younger people. Although the benefits of lowlevel laser therapy (LLLT) in treating TMD have been reported, the results vary from study to study. Objective The purpose of this study is to investigate the effectiveness of LLLT in the treatment of TMDs Methods In this narrative review study, a search was conducted in Google Scholar, PubMed, and Scopus databases for randomized clinical trials, case-control studies, and systematic reviews published from 1976 to 2023 using the keywords (Mesh terms) temporomandibular disorder, low-level laser therapy, LLLT, and myofascial pain. Results Of 271 found articles, only 8 were included in the study, of which 6 confirmed that the LLLT was effective in the treatment of TMDs. One article concluded that superluminous devices are more effective than LLLT and one article concluded that LLLT is not effective in treating TMDs. Conclusion The LLLT is effective in the treatment of TMDs and its related disorders, such as masticatory muscle disorder, temporal joint pain, and difficulty in jaw opening. The nuber of studies are limited and definite conclusions cannot be drawn. Therefore, further studies are needed in this field. [ABSTRACT FROM AUTHOR]

Background The human immunodeficiency virus (HIV) infection is important because it can cause stigma and psychological, family, and social problems in affected people. Objective This study aims to investigate the effect of schema therapy on adaptive and maladaptive strategies of cognitive-emotion regulation in people with HIV. Methods This is an interventional study with a pretest-posttest design. Thirty people with HIV were selected by a convenience sampling method and randomly divided into two groups of intervention and control. Garnefski et al.’s cognitive-emotion regulation questionnaire - short form (CERQ-SF) was used to collect data. The intervention group received 10 two-hour sessions of group treatment based on Young’s schema therapy model. The data analysis was performed in SPSS software, version 26 using descriptive statistics (frequency, percentage, mean, standard deviation) and analysis of covariance (ANCOVA). The significance level was set at 0.05. Results The results ANCOVA showed that group schema therapy affected the use of adaptive strategies (acceptance, positive refocusing, refocusing on planning, positive reappraisal, and putting into perspective) and maladaptive strategies (self-blame and catastrophizing), (P<0.001). However, it had no significant effect on other-blame (P=0.033) and rumination (P=0.102). Conclusion Schema therapy can increase the use of adaptive strategies and reduce the use of maladaptive strategies (self-blame and catastrophizing) of cognitive-emotion regulation in people with HIV. [ABSTRACT FROM AUTHOR]

Background Research theses can have a significant impact on the development of applied sciences, especially when their results are published. Objective This study aims to determine publication rate of papers extracted from the medical residency and master’s degree theses of Guilan University of Medical Sciences (GUMS) during 2008-2018. Methods This is a descriptive cross-sectional study. The data were collected from the medical residency and master’s degree theses of GUMS from 2008 to 2018. Then, they were searched in international and national databases according to the title, keywords, and names of supervisors, advisors, and students. Results Of 774 theses, 449 (58 %) papers had been extracted and published in journals indexed by ISI/ PubMed (41.2%), Scopus (11.8%), BIOSIS, Chemical Abstract, and Embase (0.44%) and others (46.56%). Most of them (98.66%) were original research. Moreover, in 383(85.3%) of the theses, there was no statistician or data advisor. The median time from defending theses to the publication of a paper from them was two years. Conclusion The publication of papers extracted from the theses of GUMS has increased, and more than 50% of them have been published in journals indexed by ISI, PubMed, and Scopus. However, the factors associated with the publication of papers need to be surveyed. [ABSTRACT FROM AUTHOR]

Background Cleft lip and cleft palate are the most common congenital anomalies in the head and neck region, which are affected by environmental and genetic factors. These anomalies can cause serious problems such as physical deformity, nutritional problems, respiratory problems, and problems in social interactions for affected people. Objective The current study aims to investigate the prevalence of lip and palate clefts and the related factors in infants born from 2014 to 2019 in Karaj, Iran. Methods This descriptive-analytical study was conducted on the data of 91,563 babes born from 2014 to 2019 in Kamali, Imam Ali, Maryam, and Ghaem hospitals in Karaj, Iran. The data were collected and analyzed in SPSS software, version 24. Results Of 91,563 cases, 46 were identified with various types of clefts. The overall prevalence was 0.5 per 1000 live births; 26.08 had cleft lip, 52.17% had cleft palate, and 21.73% had cleft lip and palate (P=0.024). Also, 56.52% of babies were male (P=0.37), 76.08% had mothers aged 20-30 years with a mean age of 24.4 years, 58.69% had first-time pregnancy mothers, 13.03% had parents with cousin marriage (P<0.001), and 37% had mothers with blood type A (P=0.11). Conclusion The prevalence of lip and palate clefts in babies born in Karaj is lower than the global prevalence and the prevalence in other cities of Iran. [ABSTRACT FROM AUTHOR]

Background The COVID-19 pandemic caused changes in daily life and disrupted hospital performance and the provision of medical services, especially in the organ transplant departments. Objective This study aims to compare the frequency of organ donation and transplantation before and after the COVID-19 outbreak in the transplant centers of northern Iran. Methods This cross-sectional study was conducted on 75 donors with brain death from 2018 to 2021 in Rasht. Demographic data, underlying diseases, history of smoking and drug use, causes of brain death, type of donated organ, number of donated organs per patient, type of transplanted organ, and the location of transplantation (in or out of the province) were recorded. Then, these factors were compared between two time periods: Before the pandemic (from July 2018 to February 2020) and during the pandemic (from February 2020 to August 2021). The recorded data was analyzed in SPSS software, version 21. The significance level was set at 0.05. Results The mean age of donors during the pandemic was significantly higher than that of patients before the pandemic (P<0.001). The most common cause of brain death in donors before the pandemic was trauma; after the pandemic, cerebrovascular causes were more common (P=0.01). The frequency of organ donation and the mean number of donated organs per donor during the pandemic were significantly lower than before the pandemic (P<0.001). Conclusion The COVID-19 pandemic has significant impact on the process of organ donation and transplantation in northern Iran. [ABSTRACT FROM AUTHOR]

Background Infertility is a major crisis for couples, causing anxiety in them. Infertile couples experience more psychological, marital, family, and social problems. Objective This study aims to compare psychological well-being, moral foundations, and sense of humor between fertile and infertile couples in Rasht, Iran. Methods In this causal-comparative study, 212 couples (106 infertile and 106 fertile) referred to AlZahra Hospital in Rasht in 2022 participated. Ryff’s psychological well-being scale, moral foundations questionnaire, and multidimensional sense of humor scale were used to collect data. For data analysis, the analysis of covariance was used in SPSS software, version 28. Results There was a significant difference between infertile and fertile couples regarding self-acceptance, positive relations with others, autonomy, and personal growth dimensions of psychological well-being and its total score, and also in the sanctity/purity dimension of moral foundations and the humor creativity and uses of humor for social purposes dimension of sense of humor. Conclusion Fertile couples in Rasht have significantly higher scores in some dimensions of psychological well-being, moral foundations, and sense of humor than infertile couples. [ABSTRACT FROM AUTHOR]

Background One of the applications of honey is in wound healing. A stapler normally connects the skin graft to the underlying bed. Due to its high cost and lack of production in Iran, and causing physical damage to the tissue, an alternative method is needed. Objective This study aims to compare the effects of using medical honey and staplers for skin graft fixation in patients with burn wounds in the north of Iran. Methods In this clinical trial, 80 patients with deep second-degree and third-degree burns less than 40% of total body surface area were included and were randomly divided into two groups of honey (n=40) and stapler (n=40). Demographic information and the percentage of burns were extracted from patients’ medical files. The graft rejection, number of hospitalization days, grafted skin displacement, graft contracture, pain severity, existence of edema or hematoma, itching severity, and infection after grafting were investigated and recorded. Results Of 80 patients, 34 were male (42.5%) and 46 were female (57.5%). The mean age of the patients was 39.29±15.42 years. A significant difference was observed in the mean number of hospitalization days after grafting (P<0.001), incidence of infection, hematoma, edema, and severity of pain and itching (P<0.001), which were lower in the honey group. The graft contracture rate was lower in the stapler group (P<0.001). Graft rejection was not observed in any groups. Conclusion The use of medical honey for skin graft fixation reduces the duration of hospitalization and adverse effects such as pain, itching, edema, hematoma, and infection compared to staplers. This method is as efficient as the routine treatment. [ABSTRACT FROM AUTHOR]

Background In the treatment process of hospitalized patients with COVID-19, one of the threatening complications is pulmonary complications such as barotrauma. Objective This study aims to investigate the prevalence of barotrauma in COVID-19 patients admitted to intensive care units (ICU) of two hospitals in Rasht, Iran. Methods This retrospective study was conducted on COVID-19 patients admitted to the ICUs of Razi and Poursina hospitals in Rasht in 2020. Their files were studied, and their demographic/clinical data and pulmonary complications were extracted using a checklist by an anesthesia resident. Results Out of 140 patients, 81(57.9%) received non-invasive mechanical ventilation and 59(42.1%) had invasive ventilation. Barotrauma was observed in 9 cases (6.4%), 8(88.9%) in the form of pneumothorax and one (11.1%) in the form of both pneumothorax and subcutaneous emphysema. The results showed that the incidence of barotrauma was significantly higher among patients who received invasive mechanical ventilation (P=0.003). No significant difference was observed among patients received noninvasive ventilation (P>0.05). Conclusion The prevalence of barotrauma among COVID-19 patients in the study hospitals is low, which indicates the proper performance of the attending physicians and compliance with the standard guidelines. [ABSTRACT FROM AUTHOR]

Background Today, the consumption of nutritional supplements is increasing dramatically in the world. Objective This study aims to survey the knowledge and attitudes of people in Rasht, Iran, towards nutritional supplements and determine their consumption rate. Methods This descriptive-analytical study with a cross-sectional design was conducted over 6 months on 1220 people referred to pharmacies in Rasht city. They completed a self-report questionnaire surveying demographic data, knowledge, and attitude towards nutritional supplements. Results The majority of people had poor knowledge (mean score: 5.14±2.36 out of 9). The knowledge scores were significantly different in terms of educational level, occupation, use/non-use of supplements, number of used supplements, and the reason for taking drug supplements, such that people with a master’s degree or higher, healthcare providers, and supplement users had higher scores. The attitude score was 16.14±4.64 (out of 40), and 76.33% had a negative attitude towards nutritional supplements. The knowledge score had a significant negative relationship with the attitude score. Conclusion Given the poor knowledge of people in Rasht city and their negative attitude towards nutritional supplements, it is recommended to develop public education programs to improve their knowledge of nutritional supplements. [ABSTRACT FROM AUTHOR]

Background Technology-based interventions, such as electrical brain stimulation may be effective in the cognitive and personality processes of substance abusers, including nicotine dependents. Objective We conducted this study to investigate the effectiveness of transcranial alternating current stimulation (tACS) using alpha frequency on inhibitory control and impulsivity in nicotine-dependent individuals. Methods We used a pre-test/post-test/follow-up quasi-experimental design with control and sham groups. We selected 30 eligible nicotine addicts from Mashhad using the available sampling method and randomly divided the subjects into three groups. We applied the intervention in eight sessions for 20 minutes in the dorsolateral prefrontal cortex for the first group, fake interventions for the second group, and no intervention for the third group. The Fagerström questionnaire, Barrett impulsivity questionnaire, and go-no-go task were used to collect data. After eight sessions, people’s inhibitory control and impulsivity were evaluated and analyzed using multivariate analysis of covariance (MANCOVA). Also, after two months, we evaluated inhibitory control data with repeated-measures analysis of variance. Results The effectiveness of alpha-tACS intervention on short- and long-term inhibitory control was significantly different in the experimental group compared to other groups (P=0.001). There was no significant difference between these three groups in impulsivity (P=0.700). Conclusion Alpha-tACS intervention effectively increases inhibitory control in nicotine-dependent individuals but does not explicitly affect their impulsivity. [ABSTRACT FROM AUTHOR]

Background Emotional intelligence as the ability to understand emotions in self and others, is recognized as underlying success in various aspects. Objective This study aimed to investigate the relationship between emotional intelligence and sleep quality in female high school students. Methods This cross-sectional study was conducted on 284 female high school students in Rasht in 2019- 2020, selected by cluster sampling. Demographic, the Bar-On emotional intelligence, and the Pittsburgh sleep quality index (PSQI) questionnaires were completed online by the participants. Data were analyzed by IBM SPSS statistics software, version 22 using Spearman’s correlation coefficient and multiple logistic regression analysis. Results The Mean age of participants was 13.94±0.95 years, and the mean previous grade point average (GPA) of participants was 19.61±0.89. The Mean total score of students’ emotional intelligence and sleep quality were 334.95±42.82 and 4.71±3.20, respectively. There was a significant negative correlation between the total score of emotional intelligence and sleep quality (r=-0.427 and P<0.001). Also, 31% of the subjects had poor sleep quality (95% CI, 25.7%-36.6%), and the multiple logistic regression showed an inverse relationship between poor sleep quality and emotional intelligence score (OR=0.98, P<0.001). There was no association between demographic variables and sleep quality (P>0.05). Conclusion About a third of female students had poor sleep quality. There was a significant relationship between sleep quality and emotional intelligence. Therefore, poor sleep quality was associated with lower emotional intelligence. [ABSTRACT FROM AUTHOR]

Background Treatment measures for ankle sprains include care recommendations, symptomatic therapy, joint immobilization using bandages and plasters, and reconstructive surgery. Objective The purpose of this study is to compare the therapeutic effect of bandages and plastering in the treatment of ankle sprain. Methods This study was a randomized clinical trial that was conducted on 78 patients who were referred to the Poursina Hospital emergency room with ankle sprains. Patients who needed treatment after being diagnosed with ankle sprain were included in the study. The patients who met the inclusion criteria were divided into two groups A (plaster) and B (bandage) by a simple random method, and 3, 6, and 12 weeks after the start of the treatment, they were examined for the level of pain. Results The results showed that the amount of pain based on the visual analogue scale (VAS) after three and six weeks in the bandage group was lower than in the plaster group and this difference was statistically significant (P<0.001). Ankle-hindfoot scale (AHS) after 3, 6, and 12 weeks had the same average in the two studied groups. The duration of activity restriction in the plaster group was significantly lower than in the bandage group. The treatment results were evaluated in terms of complete recovery, time to return to work and activity, and pain level. Conclusion Plastering treatment reduces the days of activity limitation and patients return to work and daily activities faster. However, plastering has limitations, such as more cost and limiting the movements of the limbs. For a logical conclusion, there is a need for more studies considering all aspects of applying bandage and plastering methods in ankle sprain. [ABSTRACT FROM AUTHOR]

Background The proper diagnosis and treatment of neonatal sepsis is done depends on the understanding of its causative organisms. Objective The present study aimed to investigate the types of microorganisms in definitive neonatal sepsis. Methods Neonatal sepsis is a serious infectious disease with high mortality. And its diagnosed by blood culture. It includes early (appearance of clinical symptoms from birth to the third-seventh day) and late (from the third day to the twenty-eighth day) types with specific and sometimes common clinical symptoms. This cross-sectional study was performed on 266 neonates hospitalized with definitive sepsis in Ghaem Hospital in Mashhad from 2010 to 2020 using available sampling method. Infants suspected of bacterial infection who had positive blood cultures were included in the study. Type of bacterial organism, time of sepsis, main causes of death and need for mechanical ventilation were evaluated. Results Eighty eight neonates had early sepsis and 197 neonates had late sepsis. The bacterial organism of early sepsis was gram negative as 70.1% and in late sepsis was gram negative as 77.1%. The most common causes of early sepsis were Klebsiella pneumonia 21 cases (23.9%), Staphylococcus epidermis 16 cases (18.2%) and 10 cases (11.4%) E. coli . And the most common causes of late sepsis were K. pneumonia 35 cases (25.4%), Enterobacter aeroginosa 25(18.1%), S. epidermis 12(8.7%) and E. coli 11(8%). Conclusion K. pneumonia, S. epidermis and E. coli were three most common organisms in early neonatal sepsis and K. pneumonia, S. epidermis and Enterobacter were the most common organisms in late neonatal sepsis. [ABSTRACT FROM AUTHOR]

Background Various drugs are used as adjuvants to improve the quality of supraclavicular block method. Objective This study aims to investigate the effect of adding dexmedetomidine to lidocaine in the supraclavicular block method in patients candidate for upper extremity surgery. Methods This double-blind randomized controlled clinical trial was conducted on 61 patients candidate for upper extremity fracture surgery receiving the supraclavicular block method from 2017 to 2018. They were randomly divided into two groups of lidocaine-normal saline (30 mL of 1.5% lidocaine plus normal saline) and lidocaine-dexmedetomidine (30 mL of 1.5% lidocaine plus 1 μg/kg of dexmedetomidine). The supraclavicular block characteristics and intraoperative hemodynamic changes were measured. Results There was no statistically significant difference between the two groups regarding the demographic factors. The mean age of patients was 43.09±10.92 years, and most of them were male. The mean onset time of sensory-motor blockade was faster and the duration of sensory-motor blockade and analgesia were longer in the lidocaine-dexmedetomidine group than in the other group. These differences were statistically significant. There was significant differences in hemodynamic parameters among nine assessment times in each group and between the two groups. Conclusion Adding dexmedetomidine to lidocaine in the supraclavicular block method accelerates the blockade onset and increases the duration of blockade and analgesia after surgery without causing any considerable side effects. [ABSTRACT FROM AUTHOR]

Background Oral lesions can affect people’s quality of life by interfering with chewing, swallowing, and speech. These lesions may originate from epithelial or mesenchymal tissues. Malignant oral lesions can be life-threatening. Epidemiological data of oral lesions in Iran is limited. Objective This study aims to investigate the frequency of oral lesions in Rasht, Iran. Methods In this cross-sectional study, histopathologic data of oral lesions reported by Razi laboratory in Rasht from 2015 to 2019 were evaluated. The data collected: Patients’ age and sex, histopathologic findings, and location, type and origin of lesions. Non-specific diagnoses and dental and bone lesions were excluded. Results A total of 259 pathologic reports were included. The mean age patients was 52.09±19 years, and 40.2% were male. Oral lesions in patients aged <40 years were mainly benign (64.2%), whereas half of lesions in patients ≥70 years were mostly malignant. Tongue was the most common location of the lesions (34.7%) and the main location for malignant lesions (46.7%). Benign lesions were significantly higher in females whereas malignant lesions were significantly higher in males (P=0.011). Epithelial tissues were the most common site of origin (49%) and salivary glands were the least common site of origin (11.6%) for oral lesions. Conclusion Malignant oral lesions are more common in Iranian men aged >70 years, where the tongue is the most common site of involvement and epithelial tissue is the main site of origin. [ABSTRACT FROM AUTHOR]

Background People who take statins respond differently to them due to genetic differences. One of the most significant enzymes involved in drug metabolism is cytochrome P450 2D6 (CYP2D6) enzyme, coded by the CYP2D6 gene. Individuals who carry two non-functional alleles in this gene are considered as poor metabolizers. Recognizing poor metabolizers may help prevent adverse effects of drugs. Objective This study aims to assess the association of CYP2D6*4, as the most frequent non-functional allele of CYP2D6 gene, and response to atorvastatin in patients with high low-density lipoprotein (LDL) level in northern Iran. Methods A total of 180 patients with high LDL level underwent treatment with atorvastatin for 8 weeks to assess their response. They were assessed in terms of CYP2D6*4 polymorphism using the amplification-refractory mutation system/polymerase chain reaction method and the results were validated by the sanger sequencing method. At the end, the association between CYP2D6*4 allele and response to atorvastatin was assessed. Results In patients, the percentage of the CYP2D6*4 variant was 7%. This allele was not observed in homozygous patients. There was no significant association between CYP2D6*4 polymorphism and response to atorvastatin, which might be due to low frequency of CYP2D6*4 in patients. The observed allelic frequency was close to the frequency reported in previous studies for healthy Iranian people. Conclusion It seems that CYP2D6*4 polymorphism is not the cause of poor metabolism in poor metabolizers in northern Iran. Therefore, to diagnose poor metabolizers in this region, further studies on other genes are recommended. [ABSTRACT FROM AUTHOR]

Background The coronavirus disease 2019 (COVID-19) pandemic led to depression, stress and mental health problems in medical students working in hospitals. Objective The present study aims to evaluate the professional quality of life (QoL) of medical interns in Rasht, Iran during the COVID-19 pandemic. Methods This cross-sectional study was conducted on 152 medical interns working in hospitals affiliated to Guilan University of Medical Sciences in 2020. The professional QoL was assessed using the professional quality of life scale (ProQOL). Results The mean scores of compassion satisfaction, burnout, and secondary traumatic stress were 38.4±8.3, 30.9±5.4, and 25.3±7.5, respectively. Compassion satisfaction had a significant relationship with marital status, history of underlying diseases, being resident of the city, and work shift duration. Conclusion The professional QoL of medical interns in Rasht is low. Considering the differences in the spread of COVID-19 in Iran, it is necessary to conduct more study in other cities and on other medical trainees. [ABSTRACT FROM AUTHOR]

Background According to the possible role of vascular endothelial growth factor (VEGF) in the incidence of oral lichen planus (OLP) lesions, it seems necessary to evaluate this factor in patients with OLP. Objective The present study aims to investigate the level of VEGF in patients with OLP. Methods In this systematic review and meta-analysis, the search was conducted in online databases, including PubMed, Web of Science, and Scopus. The data were analyzed in the Stata v. 14 software at a 95% confidence interval (CI) and using a random effect model. The standardized mean difference was used to measure the difference in VEGF level between the two groups of control and OLP. The data heterogeneity was quantified by the I2 index. Results There was no significant difference between the two groups in terms of VEGF (SD=0.46, 95% CI: -2.13, -3.05, P=0.730) and the I2 index showed significant heterogeneity among the results of the studies (I2=97.9%). Based on the results of the immunohistochemistry, there was a significant difference in the VEGF level between the two groups (SD=3.30, 95% CI: 6.25, -0.36); however, the difference between the two groups was not statistically significant via the ELISA method (P=0.530). Conclusion The VEGF level in patients with OLP is higher compared to healthy people. Therefore, the serum factors which indicate VEGF should be considered an effective risk factor for OLP. [ABSTRACT FROM AUTHOR]

Background Electroconvulsive therapy (ECT) is a safe and practical treatment method for patients with severe, refractory, or emergency psychiatric disorders. However, ECT is often associated with hemodynamic fluctuations. Objective This study aims to investigate the patterns of hemodynamic changes in patients undergoing ECT. Methods This longitudinal study was conducted in Shafa Hospital, a referral and academic center in Rasht City, Iran, in 2020. The hemodynamic parameters, including heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded before the induction of anesthesia (T0), 1 min after the induction of anesthesia (T1), 1 min after the seizure (T2), and 15 min after the wakefulness (T3). The trend of changes of these parameters was compared in the above-mentioned time intervals. Results The data from 126 patients were analyzed. Most of the cases were diagnosed with a psychotic disorder of schizophrenia (59.5%) and a minority had major depression (14.3%). Meanwhile, 15.9% of the patients suffered from comorbidities. In terms of SBP, DBP, and MAP, the trend of changes was significant (P=0.0001) at four measurement point times, but this was not true for HR (P=0.74). However, all changes in the hemodynamic parameters were kept in the normal range. Conclusion Our study showed that despite the fluctuations in the hemodynamic parameters during ECT, patient management was acceptable as a result of the teamwork and appropriate interaction of psychiatric and anesthesia teams. [ABSTRACT FROM AUTHOR]

bodily health of people. Objective This study aims to evaluate the effectiveness of emotion-focused therapy (EFT) on perceived stress and alexithymia in patients with coronary heart disease. Methods This was a quasi-experimental study with a pre-test-post-test design with a control group in 2019 on 30 patients diagnosed with coronary heart disease who were referred to Dr. Heshmat Hospital in Rasht City, Iran. The patients were selected by simple random sampling and assigned to 2 groups of 15, including an experimental group and a control group. The assessment tools included the 14-item perceived stress scale (PSS-14) and the 20-item Toronto alexithymia scale (TAS-20), which were completed before and after the intervention. The experimental group received EFT in eight 90-min sessions for two months. The data were analyzed using descriptive statistics, multivariate analysis of covariance and the Bonferroni post hoc test. Results There was a significant difference between the experimental group that underwent EFT and the control group that did not receive any treatment (F2, 25= 170.5, P<0.001, η² P =0.932). Meanwhile, according to the adjusted means, this difference indicates the effectiveness of EFT. Conclusion EFT training can play an important role as an adjunctive and psychological treatment along with drug intervention in reducing the perceived stress and alexithymia. [ABSTRACT FROM AUTHOR]

Background Optical coherence tomography (OCT) is one of the most valuable imaging techniques in the evaluation of macula. The repeatability and reproducibility of OCT are of crucial importance in reassuring this tool’s efficacy in evaluating the structure of the retina. Objective This study aims to investigate the repeatability and reproducibility of OCT in measuring the macular thickness in normal eyes before and after pupil dilation. Methods A total of 44 eyes of healthy individuals in the age range of 20 to 50 years were employed for the measurement of macular thickness in the central 6 mm using the Cirrus SD-OCT tool. Results According to ICC, the repeatability of macular thickness was 0.95 (95% CI, 0.95 - 0.96). The mean macular thickness before and after pupil dilation was statistically significant in the nasal quadrant of the outer 6 mm ring (N2 ) and the inferior quadrant of the outer 6 mm ring (I2 ) (P=0.0001). The highest repeatability before and after pupil dilation was seen in the nasal quadrant of the inner 3 mm ring (N1 ) and the central ring (C), respectively. Conclusion This study shows that measuring the macular thickness using the Spectral domain cirrus OCT (SD-OCT) has acceptable repeatability and reproducibility. Since the absolute value of the mean difference between the three measurements in the N2 and I2 regions was statistically significant, using a single method (i.e., whether to apply the eye drop) is preferable for follow-ups in cases where the measurements are needed within 3 to 6 mm in center of the macula. [ABSTRACT FROM AUTHOR]

Background Keratoconus (KCN) is a bilateral, progressive, and non-inflammatory disorder in the cornea, which results in thinning and protrusion of the cornea. Objective This study aims to determine the effectiveness of using pachymetric progression indices (PPIs) in grading the severity of KCN disease. Methods In this study, 76 patients with different stages of KCN were enrolled. The severity of KCN was graded according to maximum keratometry, cornea thickness, and spherical equivalent. The PPIs measured by Pentacam and the demographic characteristics were recorded and their correlation with the severity of KCN was assessed. Results In terms of KCN severity, 18% of patients were at grade 1, 31% at grade 2, 42% at grade 3, and 7% at grade 4. The power of PPIs in predicting KCN grade 4, grade 3 and grade 2 based on the area under the curve ranged from 0.722 to 0.993. Conclusion The PPIs (Minimum, Maximum, Average) can predict the severity of KCN disease with good sensitivity and specificity. [ABSTRACT FROM AUTHOR]

Background Study on the effectiveness of new methods of low back pain treatment is very important due to its high prevalence. There is no consensus on the most effective treatment for low back pain, despite the existence of different treatments options. Objective This study aims to assess the effect of 8 weeks of dynamic neuromuscular stabilization (DNS) and core stability (CS) exercises on pain, hamstring flexibility, balance, abdominal muscle strength, and quality of life (QoL) in men with chronic low back pain. Methods Participants were 20 men with non-specific low back pain, randomly divided into two groups of DNS (Age=47.8±9.82 years, BMI=25.8±2.9 kg/m² ) and CS (Age=42.4±11.8 years, BMI=28.1±13.1 kg/ m² ). Subjects performed exercises for 8 weeks. Before and after exercises, their pain, hamstring flexibility, static and dynamic balances, abdominal muscle strength, and QoL were assessed. For data analysis, the paired t-test and analysis of covariance were used, considering a significance level of P<0.05. Results Both training methods improved pain, abdominal muscle strength and static balance. The CS exercise significantly improved hamstring muscle flexibility, and DNS exercise significantly improved QoL. The comparison between the two methods showed no significant difference in any study variables. Conclusion Both CS and DNS exercises can be used in designing the interventions for patients with chronic low back pain. [ABSTRACT FROM AUTHOR]

Background Students, as the first adopters of new technologies are more exposed to smartphone addiction than other groups in society, and consequently problems, such as biopsychological and academic conditions. Objective This study aimed to explore the relationship between smartphone addiction and stress and life satisfaction in the medical students of Guilan University of Medical Sciences. Methods The present cross-sectional study was performed on 331 medical students in the intern and trainee of the Faculty of Medicine of the University of Guilan province, Iran, in 2020. Web-Based questionnaires were used to collect the necessary data. The personal and social information (age, gender, academic performance; grade point average, the place of residence, marital status, & educational level) and Smartphone addiction scale (SAS), Perceived Stress Scale (PSS; Cohen et al, 1983), and the Satisfaction With Life Scale (SWLS) were completed by the study volunteers. The information was entered into SPSS. Descriptive statistics and inferential statistics (Pearson correlation coefficient, Independent Samples t-test, and multiple linear regression analysis) were used in statistical analysis. Results The present research results suggested that smartphone addiction was positively correlated with stress (P=0.01, r=0.65) and life satisfaction (P=0.01, r=-0.58). Smartphone addiction scores, stress, and life satisfaction were influenced by demographic variables. The results of multiple analyses indicated that stress (β=0.52) and life satisfaction (β=-0.34), respectively, significantly explained 57% of the variance of smartphone addiction (P<0.001). Conclusion The increase in smartphone addiction was associated with more perceived stress and lower life satisfaction among medical students. This finding can provide useful insights for policymakers about the psychological effects of smartphone addiction on students. [ABSTRACT FROM AUTHOR]

Background Marital infidelity is a crisis for couples and families. identifying an effective treatment approach at the lowest cost can be effective in preventing and intervening in injuries caused by infidelity. Objective The aim of this study was to compare the effectiveness of emotion-based couple therapy and self-compassion-based therapy on emotion regulation in women affected by infidelity. Methods This quasi-experimental study was designed as pre-test-post-test with follow-up. The study population included all couples involved in marital infidelity who referred to Iranmehr Counseling and Psychological Services Center in Rasht, Iran in 2020, from which 20 couples were selected as the sample by available sampling method. Granfsky emotion regulation questionnaire was used to collect data and emotion-focused couple therapy sessions and self-compassion-based therapy were performed for 16 sessions of 4 hours (one treatment every two hours) on a weekly basis. After three months of treatment sessions, couples also participated in a follow-up session in order to measure the duration of treatment. Data were analyzed using combined analysis of variance. Results The results showed that both therapies are effective in increasing the emotional regulation of couples, but there is no significant difference between emotion-oriented couples therapy and compassion- based therapy on emotion regulation (F = 1.57 and P = 0.218). Conclusion Both treatment approaches in counseling centers were very effective in helping incompatible couples to improve and reduce marital problems, increasing satisfaction, especially in couples affected by infidelity. [ABSTRACT FROM AUTHOR]

Background One of the essential factors affecting the conditions of primigravid women is fear of childbirth that may be influenced by factors such as experiential avoidance, cognitive fusion, and difficulty in emotional regulation. Objective The present study aimed to investigate the relationship between experiential avoidance, cognitive fusion, and emotional regulation difficulties with fear of childbirth among Iranian primigravid women. Methods This cross-sectional analytical study was conducted on 300 primigravid women. The data was collected from a government hospital in Rash, Alzahra hospital. The research tools included demographic information form, the questionnaire of experiential avoidance (AAQ-II), Difficulty in Emotional Regulation (DES), Cognitive Fusion (CFQ), and fear of childbirth (CAQ). SPSS v. 16 was used to analyze the data. Descriptive statistics, Pearson correlation coefficient, and multivariate regression were performed. The significance level was considered 0.05 Results The present study's findings showed a significant reverse relationship between income and fear of childbirth (R=-0.22, p<0.05). Experiential avoidance, cognitive fusion, and difficulty in emotional regulation generally had a positive and significant relationship with fear of childbirth and could also predict it. Conclusion The score of fear of childbirth in primigravid women was high, and women with lower income had a higher score in fear of childbirth. Further problems can be prevented by supporting women who are more likely to be affected by fear of birth, holding psychology courses, and controlling emotions. [ABSTRACT FROM AUTHOR]

Background Esophageal Squamous Cell Carcinoma (ESCC) is the seventh most common and lethal malignancy worldwide with a high incidence in Iran. Esophageal cancer has a poor prognosis and low 5-years survival rate. Despite several studies on esophageal cancer, its underlying mechanism remains unclear. Therefore, it is significant to analyze the molecular factors involved in disease for introducing effective diagnosis and therapeutic approaches. Accordingly, the aberrant expression of miRNA was demonstrated in the etiology of esophageal cancer, and applying them as detecting biomarkers was further considered by researchers. This study aimed to evaluate the expression level of miRNA-138 in the tumor tissues of ESCC and normal adjacent tissues. Objective In total, 35 samples of tumor and normal tissues of the esophagus were collected from ESCC patients. Methods Then, RNA extraction was conducted and the expression level of miRNA-138 was assessed in the collected tissue samples, applying real-time RT-PCR. Moreover, the relationship between the miRNA- 138 expression level and the patient’s clinical characteristics was assessed. Results According to the obtained results, the expression of miR-138 was significantly downregulated in the tumor tissues of ESCC, compared to normal adjacent tissues (P<0.05). Additionally, the level of miRNA-138 downregulation was significantly correlated with tumor differentiation degree and metastasis status (P<0.05). Conclusion The significant downregulation of miRNA-138 in the tumor samples of ESCC indicated the role of this epigenetic alteration in esophageal carcinogenesis. Therefore, applying the miRNA-138 could be considered as a potential molecular biomarker for ESCC diagnosis and screening. [ABSTRACT FROM AUTHOR]

Background Acanthamoeba spp., can cause severe and fatal diseases including encephalitis, skin granulomatous and keratitis. Contaminated waters can be a threat to high risk people such as contact lens wearers, patients with eye surgery or eye trauma, and immunocompromised patients. Objective The present study aims to investigate the presence of potentially pathogenic Acanthamoeba in coastal water of Caspian Sea in Guilan Province, Iran based on morphological criteria and thermotolerance assay. Materials and Methods In this descriptive study conducted in 2018, a total of 60 water samples were collected randomly from the shores of Rudsar, Chamkhaleh, Kiyashahr, Zibakenar and Bandar-e Anzali (12 samples of 500 mL from each site). Water was filtered by cellulose nitrate membranes with a 0.45 µm pore size and then cultured on non-nutrient agar. They were checked daily for the presence of FreeLiving Amoeba (FLA) based on morphologic characteristics of both trophozoite and cyst using a light microscope (100X). Thermotolerance assay was used to determine the potential pathogenicity of Acanthamoeba spp., and its growth was examined at a temperature of 42°C. Results FLA were grown in 30 out of 60 samples (50%) at a room temperature and in 8 (26.6 %) at a temperature of 42°C. Acanthamoeba were identified in all sampling sites, where 8 samples were potentially pathogenic using thermotolerance assay. Conclusion There is pathogenic Acanthamoeba spp in coastal waters of Caspian Sea in Guilan Province. Since this province attracts many tourists annually, it is necessary that high-risk people including contact lens wearers and immunocompromised patients in this area be warned by health organizations. [ABSTRACT FROM AUTHOR]

Background Allergic rhinitis is an inflammatory disease of the nasal mucosa that can affect the quality of life of patients. Objective The purpose of this study was to evaluate and compare the Health-Related Quality of Life (HRQOL) in patients with allergic rhinitis and healthy people. Materials and Methods In this cross-sectional study, participants were 100 patients with persistent allergic rhinitis (Mean±SD age = 30.1±7.6 years) and 100 healthy individuals (Mean±SD age = 29.7±6.0 years) referred to Amir Al-Momenin Hospital in Rasht, Iran. After obtaining an informed consent from them, a demographic form and the 36-Item Short-Form Health Survey (SF-36) were completed for them. T-test was used to compare the scores between the two groups. All statistical analyzes were performed in SPSS V. 19 software. Results The Mean±SD of the HRQOL score in patients (66.66±13.77) was lower than in controls (72.88±12.40). This difference was statistically significant (P<0.001). Results showed a significant relationship of low HRQOL with male gender and higher level of education (P<0.001). Conclusion HRQOL in patients with allergic rhinitis is significantly poor. Further studies on the effect of this disease in different age groups and the role of pharmaceutical and non-pharmacological treatment methods in improving their HRQOL are recommended. [ABSTRACT FROM AUTHOR]

Background Tuberculosis (TB) is a chronic bacterial infection. Simultaneous onset of diabetes and TB can interfere with the treatment and control of TB. Objective This study aims to investigate the prevalence of TB in diabetic patients living in rural areas of northern Iran. Materials and Methods Participants were 925 diabetic patients living in rural areas of Kordkuy County, Golestan, Iran. Data were collected using a checklist surveying demographic characteristics and medical records of patients. To diagnose TB, they underwent a TB skin test, sputum smear test, chest radiography, and referring to an infectious diseases specialist, if needed. Results Seven hundred sixteen of participants were female. The mean age of participants and their mean duration of diabetes were 58.4±11.1 and 8.39±5.47 years, respectively. Results of test showed that 62 patients had abnormal chest x-ray; 14 had coughing more than two weeks; 1 had fever; 2 had night sweats; 11 had sputum; 152 had positive TB skin test result; 10 had a history of previous TB; and 1 had active TB. Conclusion The prevalence and incidence of TB in diabetic patients is 60 and 6 times higher than in general population, respectively. [ABSTRACT FROM AUTHOR]

Introduction: The extent of development of a country is determined by research indicators such as the number of published articles. Many factors can cause a lack of research. Objective: The present study aimed at identifying obstacles to the implementation of the research from the viewpoint of faculty members of Guilan University of Medical Sciences in 2018. Materials and Methods: In this combined research, the quantitative data were collected by the faculty members of the research pathology questionnaire. The appropriate statistical indices were used to describe the data. In the qualitative section, sampling was purposeful and continued until data saturation. Data were collected through semi-structured interviews and data analysis was carried out using a seven-step content analysis approach. The accuracy and accuracy of the data were also determined by Lincoln & Guba's proposed criteria. Results: In the quantitative part, the most important inhibitor factors include management factors (low communication between university and foreign universities), empowerment factors (lack of familiarity with relevant statistical techniques), administrative rules (length of paper publishing stages), and personal factors (teaching too much), social factors (inadequate intellectual incentives) and economic factors (inadequate research budget and lack of research facilities). In the qualitative section, the four main categories (individual challenges, dysfunctional infrastructure, Limited Research Partner, and discouragement of the research result) and fifteen sub-floors were extracted. Conclusion: According to the results of this study, in order to improve the quantitative and qualitative research among faculty members, it is suggested that the respective authorities consider such issues as strengthening the research motivation of faculty members taking advantage of research facilities and special privileges, and also equivalence of research tasks. [ABSTRACT FROM AUTHOR]

Introduction: Exclusive breastfeeding protects infants from diseases in the first 6-months of life. Awareness and attitude affect breastfeeding performance.This study assessed maternal awareness and attitude toward breastfeeding in Alzahra Hospital, a baby friendly, in Rasht, Iran. Objectives: To determine knowledge and attitudes of mothers on various aspects of breastfeeding and factors related to them among mothers under postpartum, Alzahra educational, medical and research center. Materials and Methods: This descriptive cross-sectional study was conducted on 384 post-natal mothers. It was done by sampling and simple random in post-partom unit of Alzahra Hospital, Rasht. A questionnaire consisting of 3 main parts; demographic information, knowledge and attitude, was used in the study. Attitude and knowledge scores were also calculated. Data were analyzed by Man-Whitney, Kurskal-Wallis and Spearman Correlation Coefficient tests, using SPSS-software in version21. Results: In this study, 32.6% had good levels of knowledge about breastfeeding and majority of them (39.1%) had an average knowledge. All of mothers had positive attitude, but 20.3% of mothers had more positive attitude and most of individuals (67.2%) were in the intermediate state and the rest had a more negative attitude. In the multivariate analysis in the regression logestic model attitude status (P<0.0001), experience of breastfeeding(P=0.006), breastfeeding training (P=0.004), income (P=0.03) and mother’s job (P=0.001) were anticipating factors of high knowledge, and the status of knowledge(P=0.043), mothers’education(P=0.004), natural delivery compared to cesarean section (P=0.008), type of infant’s feeding (P=0.0001) were anticipating factors related to positive attitude status. Also, a significant poor positive relationship was found between age and the score of knowledge (r=0.158, P=0.002) and attitude (r=0.128, P=0.062). Conclusion: A significant number of mothers had moderate knowledge about breastfeeding, which necessitates intervention programming, especially for mothers with low levels of education. [ABSTRACT FROM AUTHOR]

Introduction: Extracts of Achillea wilhelmsii C. Koch are used as anti-inflammatory, antispasmodic, antihypertensive, and topical anti-dandruff, and skin moisturizer. Given the increasing consumption of this medicinal plant among the people, it is necessary to conduct laboratory research in order to know more about its useful properties and possible harms. Objective: To evaluate the effect of methanolic extract of Achillea wilhelmsii on the liver and kidney functions in rats Materials and Methods: Twenty male Wistar rats were randomly divided into 4 groups (each group 5) and were studied for 7 days under the effect of 50, 100 and 150 m/kg herbal extracts. Serum levels of liver and kidney biochemical parameters were then measured. Significant differences between the control and treatment groups were analyzed by t-test at the level of P<0.05, using SPSS 21 software. Results: Oral administration of A. wilhelmsii extract at doses of 100 and 150 mg/kg significantly increased Alanine aminotransferase (ALT) and Aspartate Aminotransferase (AST), compared to the control group (P<0.05). Also, Alkaline phosphatase (ALP) and Creatinine showed a significant increase only at the dose of 150 mg/kg, compared to that in the control group. But bilirubin in combination with ALP and alanine ALT at 50 mg/kg showed a significant decrease, compared to the control group (P<0.05). Recipients of other doses of extract did not show any significant differences. Conclusion: According to the findings of this study, oral administration of A. wilhelmsii extract at 50 mg/kg dose significantly reduced liver and kidney enzymes, but at higher doses it did conversely. In order to be more certain about the protective or toxic effects of the plant extract on the liver and kidney, the histopathological effects of different extracts of this plant need to be studied further. [ABSTRACT FROM AUTHOR]

Introduction: Anabolic-androgenic steroids are one of the powerful drugs that cause long-term hormonal and psychological changes that can have a wide range of side effects for the athletes. Objective: The purpose of this study was to compare the Behavioral Activation-Inhibition Systems and Sense of Coherence in Bodybuilders with and without Use Anabolic-Androgenic Steroids. Materials and Methods: The method of this research is descriptive - comparative. The statistical population consisted of all bodybuilders with and without taking anabolic-androgenic steroids in Rasht in 2019, of which 140 individuals (70 natural bodybuilders and 70 steroids bodybuilders) were selected purposefully and included questionnaires of Carver & White (1994) behavioral activation-inhibition systems and sense of coherence Antonovsky (1993) responded by the participants. Data were analyzed using multivariate analysis of variance by SPSS 24. Results: The findings of the present study showed that there was a significant difference between the two groups in the activation/inhibition system and the sense of coherence (P<0.01). Compared with natural bodybuilders, steroid bodybuilders had less behavioral inhibition (15.95) and sense of coherence (18.87) and more behavioral activation systems (37.77). Conclusion: According to the results, we suggest that bodybuilders who have used steroids derivatives have many irreversible problems in their cognitive and physical functions. Therefore, coaches need to pay more attention to the psychological problems of the athletes and examine them before competitions. [ABSTRACT FROM AUTHOR]

Introduction: Hospitals are among the service centers that cause the greatest environmental pollution. Green Hospital refers to a hospital that views the environment as part of its service quality processes and seeks to avoid harming itself and others by employing effective approaches in each of its dimensions including management, water, energy, buildings, waste, medicine, and shopping. Objective: This study aims to determine the extent of medical services centers readiness for the establishment and implementation of Green Hospital standards in Rasht. Materials and Methods: This is an applied research, and a descriptive cross-sectional method is used. Also, survey method is implemented. The statistical population of this study included all public and private hospitals in Rasht. Among them, 8 hospitals were selected as the sample using convenient sampling method. The data collection tool was the hospital checklists, obtained through observation and interviews. The checklist information consists of two parts, demographic information and information about seven variables in the green hospital, in which respondents should state their hospital readiness in each part of the green hospital checklist. SPSS statistical software was used to analyze the data. Also, descriptive statistics (Frequency distribution and percentage and mean) and analytical statistics (t-test, Kolmogorov-Smirnov, etc.) were used. Results: The results indicated that the 8 under studied hospitals were not in good condition regarding the relevant standards of the green hospital (the rate of meeting standards was 36.8%). Also, these hospitals are not prepared to implement green hospital standards. Only given the drug use (score 65.6), they meet green hospital standards; however, they are not in the right position for the establishment of a green hospital in terms of energy management; waste management; water conservation (score 34); use of chemicals (score 43); green architecture (score 35)and purchasing Hospital Requirements (23.2 points). Conclusion: Green hospital standards are of critical importance in sustainable management and cost saving for hospitals. Apart from the general discussion of green buildings, meeting these principles in hospitals, in addition to its sustainability aspects, has a significant role in improving the patient's therapeutic quality. Implementation ofsuchstandards in the province requires a comprehensive planning of the 7 under-studied variables and clarification of relevant guidelines and rules, training and documentation of actions. [ABSTRACT FROM AUTHOR]

Introduction: Various studies have shown that stress is one of the environmental factors affecting the symptoms of patients with inflammatory bowel disease. Objective: The purpose of this study was to determine the effectiveness of mindfulness-based cognitive therapy on perceived stress in patients with ulcerative colitis. Materials and Methods: This study was a quasi-experimental study with pretest and posttest design and control group. 32 patients with ulcerative colitis were selected by voluntary sampling and randomly divided into two groups. Data from 17 patients (9 experimental and 8 controls) were analyzed finally. Data were collected using the perceived stress scale 10-item (Cohen, 1983) in two stages of pretest and posttest. The experimental group underwent a mindfulnessbased cognitive therapy program in 10 sessions of 2-hours per week. For data analysis, Mann-Whitney U analysis was used. Results: The findings showed that the effect of mindfulness-based cognitive therapy on positive dimension of stress was significant (P<0.05, Z= -1.976), but not significant on the negative dimension (P>0.05, Z= -1.976). Conclusion: Mindfulness based therapy can help UC patients reduce cognitive distortions involved in the perception of stress by changing their assessment of events, so that they can manage stressful events better by increasing their effective coping abilities with disease. [ABSTRACT FROM AUTHOR]

Introduction: Antibiotics are one of the most important drugs used in treatment. Because of the cost and association of their use with resistance to them, their consumption pattern is important and the first step is to optimize the use of such drugs. Objective: Since the use of prophylactic antibiotics was also unreasonable and occasionally continued while the patient was hospitalized, the use of such prophylaxies was also considered. We decided to determine the pattern of antibiotic use in the different wards of three educational hospitals of Ahvaz (Golestan, Imam Khomeini and Razi). Materials and Methods: This study was a descriptive cross-sectional study that evaluated the pattern of antibiotic use in three hospitals of Golestan, Razi and Imam Khomeini (RA) in Ahvaz. 1554 patients were enrolled in three hospitals and items such as age, sex, ward, start and end dates, administration intervals, dosage, and the type of antibiotic used were evaluated. 759 received systemic antibiotics. Antibiotics administration was analyzed separately and completely in hospitals and departments based on DDD / 100 Bed days (consumed per 100 bed occupied days) and the results were evaluated. Results: 48.8% of the patients received antibiotics, equivalent to 93.9 DDD / 100 Bed days. 90% of the antibiotics were injected and 10% oral. The highest use of antibiotics was in the Golestan Hospital and the lowest in the Razi Hospital. Among the wards, the highest rate was in the infectious ward of the Razi Hospital (226) and the lowest in Neonatal Department of Imam Khomeini Hospital (5.7). The most used antibiotics were first-generation cephalosporins (20%) or 21% of total consumption, and the highest belonged to cefazolin (18). Conclusion: Antibiotic use in these hospitals was very high, as evaluated, which needs to be reviewed inthe light of the association between incorrect use of antibiotics, emerging resistance and increased cost of treatment. [ABSTRACT FROM AUTHOR]

Introduction: When the patient discharges from the hospital against medical advice because of dissatisfaction, the treatment will not be complete and can lead to serious complications for the patient. Objective: This research is done, with the aim of reviewing the reasons of discharging against medical advice of hospitalized patients in emergency department in Razi hospital, Rasht, 2016-2017. Materials and Methods: The type of research is descriptive and retrospective. Sampling of this study was done by census method so that all patients discharged against medical advice from emergency department of Rasht, Razi hospital in 2016-2017, were evaluated. To collect the data, we used the information in discharging forms against medical advice, available in the discharged patient’s files. Results: In this research, most of the discharged persons against medical advice were males (60/9%), and married (81/3%) with 49/7% of them were admitted at night shift. A number of important reasons for discharging against medical advice were unwillingness to continue treatment (39/4%), general improvement (19/3%) and continued treatment in the private center (11/7%). Conclusion: Based on the results, it seems better to review and rewrite the form of discharge from the hospital against medical advice. The option of unwillingness to continue treatment that is ambiguous should be replaced with more detailed questions and further details. Also, giving the necessary information to the treatment staff about discharging against medical advice and its outcomes, how to properly write the forms of discharging against medical advice and legal issues related to this matter, are all highly recommended. [ABSTRACT FROM AUTHOR]

Introduction: psychiatric disorders in children and adolescents are very important.To understand more of etiology, diagnosis and treatment as well as prevention, the first step is epidemiological studies. Objective: To evaluate the prevalence of psychiatric disorders in children and adolescents aged 6 to 18 years in Rasht city and suburbs and the relation between the presence of a mental disorder and demographic characteristics of the children and the families. Materials and Methods: This study is a cross-sectional analytical study conducted in Rasht city and suburbs.The statistical population includes 147653 children and adolescents aged 6 to 18 years in Rasht and suburbs.We selected 1024 children and adolescents aged 6-18 years by multistage cluster random sampling method from urban and rural parts of Rasht. The clinical psychologists completed the Persian version of Kiddie-SADS-Present and Lifetime Version (K-SADS-PL). Data were analyzed by SPSS version 16 and were interpreted using descriptive statistics (mean, standard deviation) and odds ratios. Results: The overall prevalence of psychiatric disorders in children and adolescents aged 6 to 18 years in Guilan province was 20/7% (95% confidence interval 18.33-23.29%). The most common disorder was any Anxiety disorder (14.1%). Based on the results,Separation anxiety disorder (6.6%), Generalized Anxiety (5/9%), Phobia (3/4%) and Agoraphobia (3/2%) were the most prevalent disorders in this population. Conclusion: The high prevalence of anxiety disorders demands further consideration and treatment plans on the part of corresponding authorities. [ABSTRACT FROM AUTHOR]

Introduction: Today, hospitals are faced with severe constraints on financial resources and a large amount of hospital fees are not reimbursed annually by health insurances leading to irreparable financial damages to hospitals. So knowledge of the reasons responsible for such conditions is essential. The purpose of this study was to determine the rate and causes of deductions for social insurance and health insurance applications in a rasht educational hospital. Objective: Exploring the rate and causes of the deduction by health insurance and social security insurance in an educational hospital in rasht. Materials and Methods: This study was a cross section one conducted on one of the educational hospitals affiliated with Guilan University of Medical Sciences. Social insurance deductions reported for 2017 were organized by referring to the unit of income with differentiating the type of fraction by determining the minimum and maximum deductions and its relationship with different months of the year as comparative tables The resulting data were analyzed through descriptive statistical methods, using the SPSS software, version 16. Results: The most deductible applied to social insurance policies with a total of 19,030,679,568 Rials were related to counseling, visit and surgeon, with a total of 38,597,297,828 Rials being related to counseling, visit and pathology in health insurance. Conclusion: The highest deductions were due to the lack of documentation by personel due to lake of knowledge. Therefore, in order to reduce deductions, the use of a multilateral mechanism, including the formulation of policies on the use of clinical guidelines, the training of doctors and contracting with the doctors who have the most cooperation in this field are recommended.At the same time, continuous explanation and implementation of these activities in the hospital organizing a committee is necessary. [ABSTRACT FROM AUTHOR]

Introduction: 30 to 60% of patients admitted to non-psychiatric wards have at least one significant psychiatric illness. Objective: The aim of this study was to investigate the frequency, causes, and quality of psychiatric counseling requested. Materials and Methods: This descriptive study was carried out on all patients admitted to educational hospitals in Rasht, Iran from 2012 to 2014, for which psychiatric consultation was requested and their counseling sheets were available. Data were extracted based on the checklist. Assessment of the quality of the consultation request and the response quality of the counseling were done. Data were analyzed by SPSS21. Results: The frequency of psychiatric counseling application in this study was calculated to be 0/3%. A total of 905 counseling papers were reviewed. According to the data, 51/1% of patients were female and 48/9% were male, with the mean age of 45/7 years. For 54/7% of the patients, emergency counseling and for 45/3%, of them non-emergency counseling was requested. The most requesting counseling departments were surgery and internal medicine (14/6% and 12%, respectively). The lowest frequency of consultation requests was for anesthesiology department (0/1%). The most common reason for requesting psychiatric counseling was restlessness (26/75%) and then medication setting (14/45%). The most common diagnostic suspicion in response to counseling was delirium and the average duration for requesting counseling was 2.9 days after admission. Conclusion: Considering the relatively low frequency and quality of counseling in this study, more attention to the use of psychiatric counseling in medical patients and coherent training of assistants to improve the quality of counseling seem necessary. [ABSTRACT FROM AUTHOR]

Introduction: Considering the importance of screening for diagnosis of tuberculosis (TB) infection among medical students and the necessity of annual TB tests and effectiveness of preventive programs, there is an ever increasing need for undertaking research to investigate the effect of residence in hospital on the risk of tuberculosis infection among students, and planning strategies for reducing and controlling the risk. Objective: this study was undertaken to investigate the probability of tuberculosis infection in medical students during clinical education at infectious disease wards.. Materials and Methods: This is a cross-sectional comparative study performed on 70 medical students selected via census sampling method during 2015-2017. In this research, Tuberculin skin test was done on the students once in the first week of externship rotation at infectious diseases ward and the second test on that students with negative results in the internships course at the infection diseases ward, with the results analyzed accordingly. Collected data were analyzed using SPSS v.20 Software and investigated based on descriptive statistics (frequency, mean, and standard deviation) and Fisher's exact and logistic regression tests. Results: In the present study, the rate of positive PPD reaction at the first clinical rotation in infectious disease ward was 13% and the rate of PPD conversion during internship was 16% . No significant relationship was found between any of the considered variables and the results of the second tuberculin test. However, a significant relationship was observed between age and positive result of the second tuberculin test (p = 0.01). Conclusion: There is a significant risk of tuberculosis infection in medical students during clinical education. It is recommended not only monitor the students periodically in terms of TB infection but also in case of infection prophylactic interventions to prevent new infection and active TB disease in those with PPD conversion seems necessary. [ABSTRACT FROM AUTHOR]

Introduction: Considering the effective role of nutritional behaviors in the health of individuals, the family and society also importance of the health volunteers as a one of the most important circles of community health care system in providing education to individuals; developing of these volunteers' competence in order to promote public health is critical. Objective: This study aimed to determine the effectiveness of educational intervention based on PRECEDE PROCEED Model on Nutritional Behavior in Health Volunteers. Materials and Methods: This research was a randomized controlled trial conducted on 153 health authorities in Rasht. The research instrument was a self-report, reliable and valid and based on the PRECEDE PROCEED model, completed in two periods before and two months after intervention by the groups. Using this tool, predisposing factors (knowledge and attitude), enabling factors, reinforcing factors and nutritional behavior were measured. After pre-test, 4 educational session classes were performed in intervention group. Data were analyzed by SPSS18 and one-sample and two-sample Kolmogrof-smirnov, Chi-square, T-Test, Paired T-Test, Mann-Whitney U and Wilcoxon. Results: Linear regression test showed that PRECEDE PROCEED Model structures altogether account for 40 percent of healthy dietary behavior changes (R2=0.400, P<0.0001) .Among the structures, Attitude (β=0.396, P<0.0001) was the most important predicting factor. The mean scores of Knowledge (P<0.0001), Attitude (P<0.0001), Enabling factors (P<0.0001) and health nutritional behavior (P<0.0001) in the intervention group were significantly different from those of control group after the educational intervention. Conclusion: The study results indicate a positive effect of educational intervention program based on PRECEDE PROCEED Model and components (Predisposing and Enabling factors) on the promotion of health Nutritional Behavior of Health Volunteers. [ABSTRACT FROM AUTHOR]

Introduction: Postpartum Depression (PPD) is the common psychological problem after child's birth that could affect women's health. The limited studies have assessed the relationship between PPD and quality of life. Objective: This study aimed to determine this relationship in a sample of Iranian population. Materials and Methods: In a longitudinal cohort study, 618 pregnant women referred toMazandaran primary health centers(2015-2016) were recruited to this study via cluster sampling. Data were collected using Edinburgh Postnatal Depression Scale (EPDS) and 36-Item Short Form Health Survey (SF36) during 6-8 weeks ofpostpartum. The mean scores of whole SF36 and all domains of it in two groups of postpartum,i.e., depressed and non- depressed women were compared. Data were analyzed using T-test, ANOVA, person correlation and linear regression. Results: The prevalence of postpartum depression was 22.7%. There was a significant difference between mean scores of whole SF36 of postpartum depressed and non- depressed women (64.65 ,11.59 and 74.42 ,10.77, respectively). Also, depression during pregnancy and postpartum were the predictor factors of women' quality of life (p<001). The mean scores of physical functioning, mental health, social role functioning, physical role functioning, emotional role functioning, vitality and general health perception domains of SF36 in depressed women were lower than that in nondepressed ones(P<0.05).Moreover, the mean score of bodily pain in depressed women was more than the non-depressed counterparts. Conclusion: Due to the high prevalence of postpartum depression and its effect on quality of life during an important period of women’s life, the screening and intervention programs to prevent postpartum depression and education of women on improving their quality of life are suggested. [ABSTRACT FROM AUTHOR]

Introduction: According to literature, eligible family and socio-economic status with spiritual acumen can decrease the vulnerability of individuals to substance use. Objective: The aim of this research was to investigate the mediating role of spirituality intelligence in relationships of family function and socioeconomic status with vulnerability to addiction. Materials and Methods: This study was a kind of a correlational one which has been conducted on a sample of 495 students in Payame Noor University of Urmia. The Students were taken apart in research by answering the Identifying People in Risk of Addiction Questionnaire, Family Assessment Device, socioeconomic status questionnaire and Spiritual Intelligence Self-Report Inventory. The Data were analyzed using descriptive statistics, correlation matrix and Structural Equation Model Results: For evaluating adequacy and goodness of fitness of the model, RMR, RMSEA, CFI, AGFI, GFI, X2, X2/df, indices were computed. Findings supported the goodness of fitness of suggested model in this study Conclusion: We can conclude that family function and socioeconomic status by mediating role of spirituality intelligence dimensions strongly predict the vulnerability to addiction in university students. On the basis of such findings, we can reinforce the family functions and spirituality potential of individuals, and consequently enhance their resiliency to substance use disorder. [ABSTRACT FROM AUTHOR]

Introduction: The concept of organizational learning has become increasingly popular because of organizational need for adaptation to environmental changes. As learning is essential for the people’s growth it is also important for organizations. Since the organizational knowledge is a strategic asset in an organization, organizational learning has been proposed as a vital source of competitive advantage in strategic management. In addition, the organizational conditions can provide some situations in which organizational learning and knowledge creation can lead to new and better services. Organizational structure iso ne of the most important factors. Objective: The purpose of this research is to investigate the relationship between organizational structure and organizational learning in Guilan University of Medical Sciences. Materials and Methods: This research is descriptive and co-relational. The variables are by no means controlled and manipulated and the research environment for conducting is natural. Questionnaires were used to collect information for testing hypotheses. To test the reliability of the questionnaires, Cronbach's alpha method was used. The statistical population of this research was all the employees of Guilan University of Medical Sciences (nurses, staff, doctors, etc.). Sample size was determined by using the limited statistical methods (Cochran sample size formula). The samples consisted of 385people. To analyze the data, descriptive statistics (descriptive statistics, mean and standard deviation) and inferential statistics (data normalization, correlation analysis and regression analysis, structural equations) were used. Results: Finally, the research hypotheses were tested using the collected data. It was found that there is a significant relationship between organizational structure and organizational learning in Guilan University of Medical Sciences. The intensity of the relationship between organizational structure and organizational learning was 67%, reduction of formalization and organizational learning 63%, reduction of organizational centralization and organizational learning 61%, and reduction of complexity from a vertical point of view and organizational learning 62%. Beta coefficients show that 24 percent of organizational learning changes are through complexity, 43 percent through formalization, and 13 percent are predicted through centralization, and the rest are due to factors other than organizational structure. Conclusion: It is suggested that attention of Guilan University of Medical Sciences to issues such as employee participation in decision making, delegation of authority to managers, reviewing past activities and facilitating learning can lead to more employees’ satisfaction with organizational structure and organizational learning. [ABSTRACT FROM AUTHOR]