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Background. One of the common treatments for prostate cancer is radical prostatectomy, which is performed in different ways. One of the advantages of the nerve bundle preservation method is better exposure, decrease in rectal damage the lower rectum. In addition, the possibility of a positive margin is less. Therefore, this study aimed to examine the results of using the high anterior release (HAR) technique in radical open prostatectomy surgery. Methods. In this cross-sectional study, after examining patients and their entry into the study and obtaining their medical records, questions were asked to assess erectile function and urinary incontinence. The prostate-specific antigen level was checked before and after the operation. In addition, the average surgical time, blood loss, and hospitalization time were evaluated. Finally, the data were analyzed using the SPSS statistical analysis program, version 19. Results. In this study, 102 patients underwent radical prostatectomy, with an average age of 62.33 years. About 56.9% of patients had stage t2b. During the 6-month follow-up after surgery, 70.5% of patients had complete urinary continence. Data analysis demonstrated that there is a direct relationship between urinary incontinence, with a history of radiotherapy (P<0.001), and the stage of the disease (P=0.019). After surgery, 61.8% of patients were satisfied with the erection function . Conclusion. The results of this study revealed that urinary incontinence and erectile dysfunction are relatively common complications of this surgery. However, compared to other similar studies, the incidence of these two complications is lower. Practical Implications. Urinary incontinence and erectile dysfunction are relatively prevalent complications of radical prostatectomy surgery using the HAR technique. Nonetheless, the incidence of these two complications is lower compared to other similar studies. [ABSTRACT FROM AUTHOR]

Background and Objectives Patient blood management reduces unnecessary transfusions to improve patients' health. Familiarity of physicians with this program is necessary to improve the outcomes of patients health. This study was conducted to evaluate the effect of education on the level of knowledge of residents in medical centers in Yazd, 2022-2023. Materials and Methods The study was a before and after quasi-experimental intervention. 57 medical residents participated. A 20 question questionnaire measured the residents' knowledge level in patient blood management before and after the education. The validity of the questionnaire was measured by a survey of experienced physicians in the management of patient's blood. Reliability with Cronbach's alpha test was 0.8. The data were analyzed using t and Paired-t tests in SPSS 20 software. Results 35 participants (61.4%) were women and 22 (38.6%) were men. Their mean age was 30.58 ± 5.45 years.The average knowledge scores were 9.38 ± 3.77 and 14.01 ± 3.50 before and after education, respectively (p < 0.001). The lowest response rate before instructions pertained to evaluation of patients' anemia before surgery and knowledge of autologous blood usage. The knowledge score had no significant relationship with age, sex, blood prescription history, and medical practice duration. Conclusions Education effectively increased the knowledge of residents. It is suggested to include hold targeted educational programs with emphasis on the areas of anemia management and the use of autologous blood, publish educational guides, and include transfusion medicine and the patient's blood management program in medical education curricula. [ABSTRACT FROM AUTHOR]

Introduction: Laser treatment has been highly regarded for removing root canal microorganisms, which are the main causes of treatment failure. This study aimed to assess the effect of 810/980 nm diode laser irradiation on the reduction of Candida albicans (C. albicans) in the root canal. Material & Methods: In this experimental study, 25 healthy single-rooted human teeth were assigned to 20 test groups (two groups of 10), and 5 teeth were assigned to negative control groups. In the first group of the test, a rotary system and in the second group, a rotary laser diode were used to reduce the number of C. albicans. Two microliters of standard microbial suspension were added to each tooth and the samples were incubated (one week, 37°C, aerobic). Samples were taken from the teeth before and after instrumentation and cultured. The results were analyzed using Paired T-Test and T-Test. Results: The results pointed out that the number of yeasts showed a decrease of 92.2% (P<0.001) and 94.5% (P<0.001), respectively, after instrumentation with the mentioned systems compared to before. On the other hand, there was a significant difference (P<0.01) between the rotary system and rotary laser after instrumentation. Discussion & Conclusion: Both methods effectively reduced the number of C. albicans from dental root canals, and the rotary laser system exhibited a significant (P<0.01) reduction in the number of yeasts compared to the rotary method. [ABSTRACT FROM AUTHOR]

Background. Sexual assertiveness is defined as a psychosocial feeling about an individual’s interpretation of how to express her/her feelings in marital relationships. The present study aimed at investigating the effect of sexual assertiveness training on marital satisfaction and happiness of women referring to Tabriz health centers in 2021. Methods. This semi-experimental study was conducted on 66 women of reproductive age, referring to the health centers in Tabriz, Iran. The participants who obtained a Hulbert sexual assertiveness score of less than 33 were randomly assigned to control and intervention groups. The data were collected using an eligibility checklist (inclusion/exclusion criteria), a demographic characteristics questionnaire, the Halbert Index of Sexual Assertiveness (HISA), the Larson Sexual Satisfaction (LSS) scale, and the Marital Happiness Scale (MHS). The educational intervention of HISA was held in three sessions lasting 60-90 minutes. Eventually, the participants completed HISA, LSS, and MHS questionnaires before and after the intervention. Results. The findings of the present study indicated a significant difference between the mean scores of HISA, LSS, and MHS in the post-intervention stage between the two groups (P=0.001). Conclusion. Given the positive effect of sexual assertiveness training on women’s sexual satisfaction and marital happiness, it is recommended that these simple and lowcost educational interventions be considered to improve the mental and sexual status of women. Practical Implications. Sexual assertiveness education program improved sexual satisfaction and marital happiness. It is recommended to apply these simple and low-cost educational interventions to improve the mental and sexual status of women. [ABSTRACT FROM AUTHOR]

Background and Aims: Oral health literacy plays an important role in reducing oral health disparities. Evaluation of oral health literacy can be done at individual and population levels. This study was conducted with the aim of investigating oral health literacy among students of Shiraz University of Medical Sciences in 2023. Materials and Methods: This study was descriptive, applied and cross-sectional. The research population included the students of different academic levels of Shiraz University of Medical Sciences, except the final semester students. The sample size was calculated based on the total number of students studying at different levels at Shiraz University of Medical Sciences in the second half of the academic year in 2023 using an appropriate statistical formula. Sampling was done in a stratified-random manner according to faculty, field, and level of education. The oral health literacy of the participants based on education level, age, and gender was measured by the oral health literacy adult questionnaire (OHL Adults Questionnaire: OHL-AQ). Data analysis was done using SPSS 27 software and descriptive statistics (mean, standard deviation, percentage), independent ttest, Kruskal-Wallis, and Tukey test. Results: The findings indicated that the average oral health literacy score of students was 14.75±1.37. Also, there was a statistically significant relationship between the average oral health literacy score of students and the parameters of education level, gender, and age of students (P-value < 0.05). This indictaed that the oral health literacy of students increased in the doctoral level and also with increasing age. In addition, the female students had higher oral health literacy. Conclusion: Based on the results, the oral health literacy among Shiraz medical students was high. People with higher education level and age had higher level of oral and dental health literacy than people with lower education level and age. Oral and dental health literacy level was higher in girls than boys. It can be suggested that a 1) suitable platform be provided in order to improve the level of education of the society, leading to the improvement of the oral health literacy of the people; 2) regular dental examinations in order to increase the oral health literacy of the society is encouraged and promoted, especially in lower year students; and 3) research in effective training in the field of oral health literacy to increase the oral health literacy of people in the society. [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 and Aim: Early diagnosis and referral of patients with oral cancer can help reduce mortality, and given that dentists are usually the first group to see oral lesions, it is therefore in an ideal position for early cancer screening. the aim of this study was to investigate the knowledge and attitude of clinical students of Yazd Dental School about oral cancer in the academic year 1300-1499. Methods and material: This descriptive _ croos sectional study was performed By census method on 160 students of 7 to 12 academic semester of Yazd dental school. The questionnaire included demographic information including age, sex, academic semester and average, and questions about knowledge and attitudes about oral cancer. Data were entered into SPSS23 and analyzed using ANOVA, T-TEST. Result: The mean score of knowledge and attitude was 4.85 ± 2.88 out of 10 points and 39.53 ± 4.19 out of 50 points. Knowledge had a significant relationship with age and academic year (p=0.034, P=0.05) but had no significant relationship with gender, and average 0.05 and attitude had no significant relationship with any of the variables. Conclusion: Students' knowledge and attitude about oral cancer is insufficient and there is a greater need for education in this field, so a review of the curriculum and more practical experience to improve education and approaches to change attitudes should be considered. [ABSTRACT FROM AUTHOR]

Background and Aims: Oral infections caused by Candida species are increasing worldwide. One of the common topical treatments related to oral candidiasis is nystatin, which has anti-fungal and antimicrobial activity. Common anti-fungal treatments have many side effects and cause drug resistance and repeated recurrence of Candida infection. The use of plant extracts can be a suitable alternative to synthetic drugs such as nystatin. The aim of this study was to compare the anti-fungal effect of Nigella Sativa with nystatin on Candida albicans. Materials and Methods: An experimental study was conducted by referring to the Scientific and Industrial Research Organization of Iran and the standard strain of Candida albicans with PTCC5027 was provided. Ethanol soaking method was used to obtain the Nigella sativa ethanolic extract. Fungal suspension with 0.5 McFarland concentration was cultured in a broth medium. To investigate the anti-candida properties of the Nigella sativa Linn ethanolic extract, Disk diffusion technique was done in a Potato dextrose agar by uniformly inoculating the fungal suspension on the culture medium of potato dextrose agar then using a 100 μl micropipette, the Nigella sativa Linn extract with a concentration of 100 mg/ml and Nystatin in a dose of 0.06 mg was poured on a sterile blank disk and put in the plates and, subsequently the growth inhibition zone of the extract was measured. By diluting the extract and nystatin to 0.09, 0.19, 0.39, 0.78, 1.56, 3.12, 6.25, 12.5, 25.50 the Minimum Inhibitory Concentration (MIC) and the Minimum fungicidal concentration (MFC) were obtained using both Microdilution broth and Macrodilution broth. Each experiment was repeated 3 times and the obtained data were statistically analyzed using SPSS ver:25 software and t-test exam. Results: The length of the inhibition zone measured from the Nigella sativa Linn extract was 19.5mm respectively and the length of the inhibition zone obtained by Nystatin was 24.5 mm respectively. Studying the results of the dilution test in both techniques concluded from the Nigella sativa Linn extract showed that the Nigella sativa Linn ethanolic extract at a concentration of 1.56 mg /ml has the least Minimum Inhibitory Concentration (MIC) and at a concentration of 3.12 mg/ml it has the lowest Minimum Fungicidal Concentration (MFC). Statistical analysis (T-test) showed that the difference in length of the Nigella sativa Linn inhibition zone with Nystatin (P <0.05) was significant. Conclusion: According to our findings, it seems that the Nigella sativa Linn ethanolic extract is quite effective on the growth of Candida albicans and has an antifungal effect. However, the antifungal effect of Nystatin is significantly higher than the Nigella sativa Linn ethanolic extract. [ABSTRACT FROM AUTHOR]

Background and Aim: Pigmented lesions appear with different manifestations in focal, multifocal and diffuse forms and can also be a symptom of a systemic disease. These lesions have a significant prevalence in the head and neck area. The aim of this study was to determine the prevalence of pigmented lesions in the head and neck region in patients referred to Razi Hospital in Tehran. Material and Methods: A cross-sectional descriptive study was conducted on 3000 archived files in Razi Hospital in Tehran in 2018 and 2019. All pigmented lesions in patients under 18 years of age were isolated and analyzed in terms of age, gender, location and histopathological diagnosis. Data were analyzed using SPSS version 26 and Chi-square and T-test statistical tests. The significance level of statistical tests was considered less than 0.05. Result: A total of 138 patients under 18 years of age were found with pigmented lesions 56 patients were male (40.6%) and 82 patients were female (59.4%). The average age of the patients was reported to be 11.1 ± 4.6 years. Meanwhile, compound nevus and intradermal nevus lesions were the most prevalent. The most involved sites were cheek (29.7%), nose (16.7%) and head (15.9%). A total of 6 cases of malignant pigmented lesions were found (4.3%). Conclusion: Nevi types are the most common pigmented lesions in this age group and more frequent in check area. [ABSTRACT FROM AUTHOR]

Background and Aim: With increasing concerns over the stochastic effects of x-ray radiation in dental radiography, effective education of dental students in this field is important. According to studies, educational softwares enhance learning, therefore the aim of this study was to develop an educational software for dental radiation protection and to compare its effectiveness against classic lectures in Islamic Azad University, Tehran Dental branch. Material and Methods: The study was exploratory in the first stage and a clinical trial in the second. Software was developed based on ADA guideline, using ScreenRecorder and MultimediaBuilder. 46 dental students who have never received any education on dental radiation protection were divided into control (N=22) and test (N=24) groups which have been matched based on the GPA and VARK test results. The test group used the software, while the control group attended a lecture. Students’ learning rates were evaluated by using 2 identical 10-question multichoice tests taken immediately and after two weeks. The results were analyzed in SPSS25 using the Mann-U-Whitney test, independent samples t-test, and Pearson's chi-squared test. Results: Educational software was developed successfully. In both exams, the mean score in the test group was higher than that in the control group by a statistically significant difference (p<0.001). The mean scores of test group and control group were 8.91±1.31 and 6.13±1.67 in the first exam and 6.79±1.69 and 4.90±2.09 in the second one respectively. Conclusion: Multimedia educational software can improve learning of principles and methods of dental radiation protection in dental students. [ABSTRACT FROM AUTHOR]

Background & Aim: Up to 60% of breast cancer patients treated with chemotherapy is confronted with cognitive problems, which can have a significant impact on daily activities and quality of life. Therefore, the purpose of the study was to “determine the cognitive function of breast cancer patients receiving adjuvant chemotherapy. Materials & Methods: In this cross-sectional study, the research population was cancer patients referred to the oncology department of Taw Heed Hospital in Sanandaj. All patients were included in the study by census method. The data collection tool in this study was the form of demographic characteristics and cognitive function assessment of cancer patients FACT-cog. To analyze the research data, version 14 of STATA software and descriptive statistics and analytical statistics including independent chi-square t test were used. A significance level of less than 0.05 was considered. Results: In this study, 101 breast cancer patients of Taw Heed Hospital, all of whom were women, were included in the study. Their average age was 44.06 ± 15.15 years. The average duration of disease of the participants was 18.7±23.61 months. The results of the study showed that the average cognitive performance score was (68.32±24.15), which is lower than the average score and in the average range. Conclusions: The results of this study showed that in people with breast cancer who are undergoing chemotherapy, the cognitive function is at an average level, and the necessary training should be done to improve the cognitive function of these patients. [ABSTRACT FROM AUTHOR]

Background & Aim: Puberty is the turning point of passing from childhood and entering adulthood, and the lack of proper knowledge about the functioning of the body during this period and the lack of preparation for menstruation causes fear and negative attitudes about puberty. The present study aims to determine the effectiveness of education on the level of awareness, attitude and performance of teenage girls about menstrual health in high schools. The first secondary school) in Esfarayen city, 2022. Materials & Methods: This study was an intervention type, in which 413 female students of the first secondary school of Esfarayen city were selected using Cochran's formula as the sample size. In this study, sampling was done by cluster method. To collect data, the questionnaire of Nissi et al., which measures the level of knowledge, attitude and performance regarding menstrual hygiene, was used. The reliability rate was calculated to be 0.89. The pre-test was conducted, then the training was conducted in 3 sessions of 60 minutes in the form of lectures and presentations of educational PowerPoints, as well as questions and answers. A few days after the completion of the training course, the post-test was taken and three months later, the follow-up test was conducted. Then the collected data was entered into SPSS software version 24 and analyzed using paired T-test and other descriptive tests. Results: The results of paired t-test showed that there is a significant difference between the performance of girls before (23.68 ± 2.67) and after training (26.12 ± 2.91), which indicates the effectiveness of the intervention (2.44 ± 2.77 and p≤0.05). Also, the results of the research showed that the educational intervention in the field of puberty health was effective in the level of knowledge (2.66 ± 2.95) and attitude (5.09 ± 4.6) of students (p < 0.001). Conclusion: The results showed that the education of health topics during puberty (menstrual hygiene) had a noticeable effect on the level of knowledge, attitude and performance of students, so the correct information in this matter should be provided through correct information sources, especially through mothers and health officials. schools should be transferred to them, therefore, it is suggested that the relevant authorities should make the necessary efforts to increase the awareness of adolescent girls regarding pubertal health through public education in order to improve their attitude, improve their performance and, as a result, improve their health level. [ABSTRACT FROM AUTHOR]

Background & Aim: Medication adherence is one of the important health issues and key aspects of the desired quality of care in patients with diabetes, and one of the important factors affecting it is their health literacy. Therefore, the present study was conducted with the aim of determining the relationship between the level of health literacy and medication adherence in type 2 diabetes patients who referred to comprehensive health centers in Gorgan city during 2023. Materials & methods: This study was conducted cross-sectional on 400 patients with type 2 diabetes who referred to comprehensive health centers in Gorgan city in 2023. The data was collected by stratified sampling method according to the volume and in each stratum of the convenience type. Moriski medication adherence questionnaires (MMAS-8) and short version health literacy questionnaire (HELIA-SH) were used. Data were analyzed in SPSS software using independent t-test, chi-square, analysis of variance and Pearson correlation. Results: The average score of medication adherence and the total score of health literacy were 4.06 ± 1.46 and 36.47 ± 3.53, respectively. Among the participants in the study, only 8.20% of patients had high compliance and 16.80% had moderate compliance, and the rest (75%) had poor drug compliance. Patients' medication adherence had a direct and significant relationship with basic health literacy skills (P=0.004, r=0.14) and decision-making skills (P=0.003, r=0.15). Conclusion: The findings of this study showed that the majority of patients had poor medication adherence and the level of health literacy was related to the dimensions of medication regimen adherence in patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background and Objectives Developing a vision without understanding the organizational culture is a failed attempt. The purpose of this research is to understand organizational culture for understanding expectations in order to prioritize issues and compare work groups by managers for greater productivity Materials and Methods This study was carried out in Iranian Blood Transfusion Organization between 2020 and 2022. The statistical population for this research was the employees of the central headquarters and the general administrations of blood centers, and 384 of them were included in the study using stratified random sampling. To collect the required data, a 60-question organizational culture questionnaire based on Denison's model was used. For data analysis, descriptive statistics (frequency distribution, mean, standard deviation) and inferential (independent t, analysis of variance, Tukey and Pearson's coefficient) according to demographic variables, SPSS22 and Excel 2013 software were used. Results The findings show that Iranian Blood Transfusion Organization has a medium/strong organizational culture with a score of 179.31 and the highest impact after mission with a score of 46.60. Also, the indicators of "customer orientation and development of capabilities" need to be improved. Conclusions According to the findings, most employees have understood the vision, strategic intentions and mission of the organization, but their capabilities are not well seen. According to the score of customer orientation, the skills and abilities of the employees should be developed by using retraining courses, while motivating the personnel, respecting the clients, and the provinces should take advantage of the experiences. [ABSTRACT FROM AUTHOR]

Background and Objectives Uncontrolled post-operative bleeding can lead to several problems and tissue repair disorder indentistry. This study has been conducted to compare the effect of Chitohem and natural silk on the onset of clot formations. Materials and Methods This laboratory study was carried out with a dependent parallel design. Three drops of blood were taken from each of 32 participants in the study. Fifty milligram Chitohem and natural silk powder were poured on two blood drops, respectively. The clot formation time was measured for all three groups simultaneously. Duration between pouring powder and starting of clot formation was recorded. Data analysis was performed using paired t-test and repeated measure ANOVA methods using SPSS 17 software. Results Participants composed of 20 (62.5%) women and 12 (37.5%) men. The average age of the participants was 43.33 ± 4.08 years. The average time periods of the onset of blood clot formation in Chitohem group, natural silk and control group were 90.97 ± 29.99, 141.97 ± 49.10, and 195.44 ± 58.70 second, respectively. Paired t-test showed the mean time of clot formation was significantly different among groups (p = 0.0001). Conclusions Based on the obtained results, it seems that although effect of “organic natural silk” on coagulation time was less than “Chitohem”, but silk has an acceptable hemostatic effect. The simultaneous use of natural silk and Chitohem can have a synergistic effect. [ABSTRACT FROM AUTHOR]

Introduction: Inflammation can cause damage to the central nervous system, leading to neuropathological diseases such as stroke, pain, schizophrenia, and Alzheimers. AIM2 is a member of the PYHIN hematopoietic nuclear protein family that binds to cytosolic DNA and activates caspase-1, one of the inflammatory-mediated caspases that activates proinflammatory cytokines. The aim of this research is to investigate the effect of a swimming training course on the expression of caspase-1 and AIM2 proteins in the hippocampus of male Wistar rats. Methods: The statistical population of this study included 16 male Wistar rats (6 weeks) divided into two groups: a group without training and an endurance training group. Eight rats were placed in each group. The group without training did not engage in any sports activities, while the training group participated in a swimming training session. After a 4-day familiarization period, the rats swam for 30 minutes from the fifth day. Independent T-test was used to evaluate the interventions, and all statistical calculations were done using SPSS statistical software. Results: The results of this research showed that exercise caused a significant decrease in the level of caspase-1 and AIM2 proteins in the hippocampus of male Wistar rats. Conclusions: Overall, this study suggests that endurance swimming training can effectively reduce caspase-1 and AIM2 proteins. Therefore, it is possible that exercise, by reducing inflammatory factors, can be a potential treatment for diseases caused by inflammation, such as sclerosis, diabetes, cancer, and Alzheimers. [ABSTRACT FROM AUTHOR]

Background. Quarantine and social distancing due to COVID 19 has led to anxiety, anger, stress, and anger in people and has had a negative impact on physical and mental health and the quality of marital relationships. Due to the lack of sufficient studies and also the fact that no study was found in the literature review that compared this approach over the phone and face-to-face, this study was conducted with the aim of comparing the effect of telephone and face-to-face counseling with the explicit approach on women's marital interactions. Methods. This quasi-experimental study was conducted in 2022 in the health centers of Tabriz city on women aged 18 to 40 with a sexual performance score of less than 28. The participants were assigned to two groups of face-to-face counseling and telephone counseling with a ratio of 1:1 using a computerized random number table with blocks of four and six. Counseling based on explicit approach was done in the face-to-face counseling group during three meetings of 60-90 minutes, and for the telephone counseling group, there were three individual telephone counseling sessions of 60-90 minutes. Pre-test questionnaires including sexual performance, quality of sexual life and marital satisfaction were completed before and eight weeks after the end of the intervention. Results. The mean (standard deviation) score of the quality of sexual life after the intervention was significantly increased in both face-to-face and telephone counseling groups compared to before the intervention. Also the mean (standard deviation) of the total score of sexual performance and marital satisfaction after the intervention in the face-to-face counseling group was significantly higher than that of the telephone counseling group. Conclusion. Using counseling based on ex-PLISSIT approach in both face-to-face and telephone counseling groups, are effective in sexual health. Therefore, during crises such as a pandemic, or other restrictions to hold face-to-face counseling sessions, telephone consultations are useful. Practical Implications. Counseling based on ex-PLISSIT approach is effective for sexual health. [ABSTRACT FROM AUTHOR]

Background. Sperm motility is a fundamental factor for sperm penetration into the oocyte and fertilization. According to the World Health Organization (WHO) 2021, less than 42 percent of motility is called asthenozoospermia, which is one of the most common causes of male infertility. This retrospective cohort study aims to investigate sperm DNA damage with TUNEL and SCSA methods and its relationship with sperm parameters, age, and body mass index (BMI) in severe asthenospermia (<2% sperm motility) and normozoospermia. Methods. The study parameters between 111 subjects with severe asthenozoospermia and 113 subjects with normozoospermia were investigated. The 2010 World Health Organization guidelines were used to evaluate sperm parameters, and TUNEL and SCSA methods were used to assess sperm DNA damage. The statistical analysis was done using the t-test of two independent samples. Pearson's correlation coefficient was used to investigate the relationship between sperm DNA damage and sperm parameters, age, and BMI P<0.05 was considered significant. Results. The mean seminal volume, sperm concentration and count, and the percentage of sperm total motility and progressive motility were significantly lower in severe asthenospermic subjects compared to normozoospermic subjects (P<0.001). In addition, the mean percentage of sperm DNA damage in severe asthenozoospermic individuals was significantly higher than in normozoospermic individuals (P<0.001). There was also a positive and significant relationship between sperm DNA damage and the age of severely asthenozoospermic men. Conclusion. Sperm motility, sperm DNA damage, and the father's age are essential in the successful conception, development, and health of the embryo. Therefore, the evaluation of sperm DNA damage is recommended in examining male fertility and selecting the appropriate treatment approach for men with severe asthenozoospermia. Practical Implications. Considering that the sperm genome constitutes 50 percent of the genetic material of the next generation, evaluating sperm DNA health to determine the appropriate treatment approach in infertile men can be influential in the success of assisted reproductive techniques and in maintaining the next generation’s health. [ABSTRACT FROM AUTHOR]

Background & Aims Nurses on the frontline of fight against COVID-19 faced with many stressors. The unpredictability of the situation and the seriousness of the risk can lead to intolerance of uncertainty (IU) in them. Nurses with IU perceive uncertainties about COVID-19 as distressing and stressful, and experience severe anxiety and worry. Anxiety in such situations leads to cognitive avoidance, rumination or other maladaptive coping strategies. The present study aims to determine the IU status during the COVID-19 pandemic in nurses working in teaching hospitals in Tehran, Iran. Materials & Methods This descriptive cross-sectional study was conducted in 2020 on 240 nurses working in the coronavirus wards of teaching hospitals affiliated to Iran University of Medical Sciences, whowere selected by a census sampling method and based on the inclusion criteria. A demographic form and Freeston et al.’s intolerance of uncertainty scale (IUS) were completed by them. Data analysis was performed in SPSS software, version 16, using descriptive and inferential statistics. Results The mean score of IU was 62.58±20.36. The stress dimension of IUS showed the highest score (2.49±0.78) while the dimension of inability to take action showed the lowest score (2.15±0.80). The COVID-19 infection was significantly associated with IU (P=0.048). Conclusion The nurses working in the coronavirus wards of selected teaching hospitals had IU during the COVID-19 pandemic such that they had more IU regarding stress, but the amount of IU was not so high that can make them unable to perform their duties. Providing education to nurses on how to break the cycle of anxiety and IU, changing their beliefs about IU, reducing their negative orientation to problems, controlling and monitoring their performance, and facilitating the provision of care can help optimize nursing care and achieve quality patient care during health-related crises. [ABSTRACT FROM AUTHOR]

Background & Aims One of the consequences of the COVID-19 pandemic was its impact on marital relations. In health workers, including midwives, who have longer and more contact with mothers who may be infected with COVID-19, the fear of transmitting the virus to their partners is more. This fear can affect their personal lives, including sexual relationships and sexual health. This study aims to determine the relationship of the fear of COVID-19 with sexual function and sexual satisfaction in midwives working in teaching hospitals in Tehran, Iran. Materials & Methods This cross-sectional study was conducted on 122 midwives working in teaching affiliated to Iran University of Medical Sciences. They were selected using a census method from May 13 to August 6, 2022. Data collection tools included a demographic/ COVID-19-related form, Ahurso’s fear of COVID-19 scale, female sexual function index (FSFI) and sexual satisfaction index. Data were analyzed in SPSS software, version 24. Results The mean age of participants was 32.21±6.27 years. Most of them had a bachelor’s degree. Sexual satisfaction had no significant relationship with any demographic factors (P>0.05). There was a negative and significant correlation (weak) between fear of COVID-19 and sexual satisfaction (r=-0.214, P=0.019). Also, there was a negative and significant correlation (moderate) between the fear of COVID-19 and sexual function (r=-0.450, P<0.001). Conclusion It seems that the fear of COVID-19 is related to sexual function and sexual satisfaction of Iranian married midwives. Therefore, during similar pandemics in the future, midwives need support such as receiving more personal protective equipment and stress management and resilience training workshops . [ABSTRACT FROM AUTHOR]

Background & Aims Providing quality nursing care has always been the main concern of nurses. Clinical competence and moral courage are effective factors in providing quality nursing care. The present study aims to determine the relationship between clinical competency and moral courage in Iranian nurses. Materials & Methods This is a descriptive-correlational study with a cross-sectional design that was conducted in 2022 on 123 nurses working in teaching hospitals affiliated to Hamadan University of Medical Sciences, who were selected using a simple random sampling method. Data collection tools were Sekarka et al.’s moral courage questionnaire, Liu et al.’s competency inventory for registered nurses, and a demographic form. Data analysis was done using descriptive statistics, independent t-test, one-way analysis of variance and Pearson’s correlation test in SPSS software, version 16. Results The mean scores of clinical competency and moral courage scores were 151.18±22.32 and 59.56±7.47, respectively, indicating a moderate clinical competency and high moral courage. There was a significant and positive (weak) relationship between moral courage and clinical competency (r=0.272, P=0.001). Conclusion Due to the moderate clinical competency of nurses, educational workshops are recommended to improve their clinical competence. Moreover, since there is a weak relationship between clinical competency and moral courage of nurses, factors other than clinical competence may be related to moral courage, which requires further studies. [ABSTRACT FROM AUTHOR]

Background & Aims Patients with leukemia face mental distress that can affect their hope. One of the effective components in measuring psychological well-being is illness perception, which refers to the cognitive evaluation and understanding of a medical condition. This study aims to determine the relationship between illness perception and hope in patients with leukemia hospitalized in selected hospitals in Tehran, Iran. Materials & Methods This is a descriptive-correlational study conducted on 200 patients with leukemia hospitalized in selected hospitals affiliated to Tehran University of Medical Sciences in 2023. Data collection tools were a demographic form, Broadbent et al.’s brief illness perception questionnaire (BIPQ) and Snyder’s adult hope scale (AHS). The collected data were analyzed in SPSS software, version 16 using descriptive and inferential statistics such as Pearson’s correlation test, independent t-test, and analysis of variance. Results The mean total score of BIPQ was 37.45±9.10 and the mean total score of AHS was 32.39±1.88. There was negative and significant correlation between illness perception and hope (r=-0.489, P<0.001). Conclusion A more positive perception of leukemia can improve the hope of patients. It is recommended to implement interventions to create a positive illness perception in these patients to increase their hope. [ABSTRACT FROM AUTHOR]

Background & Aims The spread of COVID-19 pandemic caused anxiety in the medical staff, especially nurses, which contributed to many physical and mental problems in them. The relationship between cognitive flexibility and COVID-19-related anxiety is still unknown. This study aims to measure the relationship between cognitive flexibility and COVID-19-related anxiety in nurses, and find the related factors. Materials & Methods This is a descriptive-analytical study with a cross-sectional design that was conducted in 2021 on 120 male and female nurses working in one of the hospitals affiliated to Arak University of Medical Sciences. Sampling was done using a stratified and random sampling method for three months. The cognitive flexibility inventory (CFI) and the corona disease anxiety scale (CDAS) were employed to collect data. Data analysis was performed in SPSS software, version 23, using independent t-test, analysis of variance (ANOVA), and Pearson correlation test. Results The mean total score of CDAS was 21.09±3.96, ranged from 12 to 32. The mean total score of CFI was 52.78±9.97, ranged from 30 to 81. Based on Pearson’s correlation test results, there was no significant relationship between cognitive flexibility and COVID-19-related anxiety (P>0.05). The mean scores of CFI and CDAS were not significantly different based on age, number of children, work experience, physical activity level, and educational level; however, nurses with permanent employment (P=0.007) and female nurses (P=0.03) had higher cognitive flexibility, and married nurses had lower anxiety (P=0.021). Conclusion There is no significant relationship between cognitive flexibility and COVID-19-related anxiety in nurses. The personality traits such as cognitive flexibility is not enough to reduce the high level of anxiety caused the pandemics such as COVID-19 and it requires multiple measures and strategies. [ABSTRACT FROM AUTHOR]

Introduction: Considering the broad spectrum of using nanoparticles in food coatings as a potent antimicrobial agent and their possible cytotoxic effects and accidental consumption of these toxic materials, this study was performed. The present study aimed to investigate the cytotoxicity of chitosan and nano-chitosan in vitro. Material & Methods: This cross-sectional study was conducted in 2019 in the Laboratory of the Department of Food Hygiene and Public Health, School of Veterinary Medicine, Shiraz University, Shiraz, Iran. The XRD and FITR techniques were employed to study the characteristics of these nanoparticles. Moreover, two cell lines, HT-29 and Vero, were used to study the cytotoxic effects of chitosan and nanochitosan by MTT assay, acridine orange, and ethidium bromide staining. One-way ANOVA and independent t-test were used to analyze the collected data with the help of SPSS software (version 19). Results:Based on the obtained findings, the maximum values of XRD at the angle of θ2 were observed at 20°. The highest peak appeared at 1530 cm-1, which was associated with tensile vibration of N-P-N. The spectrum diagram of chitosan due to the tensile vibration of synthetic nanochitosan of N-H bound appeared at 1646 cm-1. The results showed a proportional increase in the cytotoxicity with time and concentration of nanoparticles in the cells. Discussion & Conclusion: Since by increase in time and concentration of nanoparticles, toxicity was observed in cells; therefore, the time and concentration of chitosan nanoparticles are important in causing cytotoxicity. Considering the toxic effects of these nanocomposites on cancer cells, they can be used in cancer treatment, which requires further studies. [ABSTRACT FROM AUTHOR]

Introduction: One of the problems of the elderly is a decrease in balance and quality of life of senior citizens. Therefore, the present study aimed to assess the effect of fatigue on balance, motor function, lower limb strength, and quality of life of the two groups of elderly people at home and in a nursing home. Material & Methods: The present study was conducted based on a prospective quasiexperimental design. For this purpose, 35 elderly women at home and 35 elderly women in nursing homes in Miyaneh were selected via available sampling. To carry out the fatigue protocol, the subjects performed sitting and standing movements with their hands on their chests. Subjects were administered the relevant tests under normal conditions and without fatigue. In the second session, which was held 48 hours later, the subjects performed the fatigue protocol and then performed balance, motor function (TUG), and lower limb strength tests (number of takeoff and landing chairs). The quality of life in both groups was assessed using the Leipad Elderly Quality of Life questionnaire. Data were analyzed in SPSS software (version 24) using independent and dependent t-tests. Results: The results demonstrated a significant difference (P=0.001) between the two groups of elderly women in nursing homes and those living at home in terms of motor function, strength, and quality of life. Nonetheless, there was no significant difference (P=0.127) in the balance of the two elderly groups. Discussion & Conclusion: As evidenced by the results of this study, the quality of life of the elderly in nursing homes was lower than that of the elderly at home, and fatigue can exert a more marked effect on the motor function and strength of these people. Therefore, it is recommended to prioritize the design of exercise interventions with the approach of increasing the fatigue threshold to improve the parameters related to the quality of life of the elderly. [ABSTRACT FROM AUTHOR]

Introduction: It seems that education focusing on the perceived threat is effective in informing people about water scarcity. Therefore, due to the position of educated people as role models in society, the present study aimed to assess the effect of education based on the perceived threat on water conservation behavior of students of Behbahan Faculty of Medical Sciences. Material & Methods: This quasi-experimental study was conducted on 62 operating room students of Behbahan Faculty of Medical Science in the academic year of 2017- 2018, selected via multistage random sampling. The data collection tool was a researcher-made questionnaire assessing demographic characteristics, perceived threats, and water conservation behavior which was completed by students before the intervention. Thereafter, written and visual messages based on the perceived threat were prepared and presented in PowerPoint format with the cooperation of professors for four sessions in the last minutes of the classroom, and an opportunity was given for group discussion and exchange of opinions. In addition, message posters were installed in appropriate places, such as restrooms, and were sent to students using the SMS system. Two months later, the questionnaires were completed again. The data were analyzed in SPSS software (version 15) using the Paired t-test, Covariance analysis, and Pearson correlation coefficient. A p-value less than 0<0.05 was considered statistically significant. Results: The mean age of participants was 20.61±1.32 years. There were 32 (51.6%) female and 30 (48.4%) male students. Before the training, the mean water conservation behaviors, susceptibility, and severity scores were 47.98±16.36, 61.74±21.23, and 59.03±21.09, respectively. After training, the aforementioned mean scores increased significantly to 77.55±14.59, 86±0.54, and 83.38±8.53, and there was a significant relationship between the variables (P<0.05). Discussion & Conclusion: The education caused an increase in students' perceived threat to the water shortage crisis and promoted water conservation behavior. It is suggested that similar studies be carried out in other groups to check the generalizability of the results at the community level. [ABSTRACT FROM AUTHOR]

Background and Aim: Mouthwashes play an important role in oral hygiene and prevention of tooth decay by reducing the proliferation of oral microbial flora. The purpose of this study was to investigate the antibacterial and anti-biofilm activity of Persica herbal mouthwash, Mouthwashes with fluoride (Misswake), without fluoride (Irsha) and chlorhexidine 0.2% against Streptococcus mutans and Streptococcus sanguinis, in vitro. Materials and Methods: To evaluate the antibacterial effect of mouthwashes on two standard strains of S. mutans and S. sanguinis, were used well diffusion and microbroth dilution methods and to examine their anti-biofilm effects, the microtiter plate method was used. The results were analyzed using SPSS software, version 21 and t-test. Results: In the well diffusion method, Misswake and 0.2% chlorhexidine mouthwashes had an inhibition zone at concentrations of 500 mg/ml and 500 mg/ml to 125 mg/ml, respectively. The MIC of Persica and Misswake mouthwashes were determined at concentration of 500 mg/ml and chlorhexidine 0.2% at concentration of 31.25 mg/ml. Irsha mouthwash did not have any antibacterial effect. In microtiter plate method, anti-biofilm activity was observed only for 0.2% chlorhexidine mouthwash at concentrations of 125 mg/ml to 31.25 mg/ml. Persica, Misswake and Irsha mouthwashes did not have any anti-biofilm effects on the studied bacteria. The results showed that 0.2% chlorhexidine had a significant antimicrobial and anti-biofilm effects on the studied bacteria compared to other mouthwashes (P<0.05). Conclusion: 0.2% chlorhexidine mouthwash has a very high antimicrobial power than other mouthwashes, but our study suggests that Persica and Misswake mouthwashes can be used as a mouthwash with proper antiseptic properties. [ABSTRACT FROM AUTHOR]

Background and Aims: The purpose of this study is to evaluate the effect of the type of zirconia (multilayer or monochrome) on the marginal and internal fit of a three-unit bridge. Material and Methods: In a maxillary model, the first premolar and first molar were prepared to receive 3-unit zirconia fixed dental prostheses and then scanned. Each scan was used to make two bridges (one with multi-layer and the other with monochrome zirconia). With Exocad software, the bridge was designed and then milled. The bridges milled in the previous stage were evaluated and compared with the replica method in terms of internal and marginal fit. For statistical analysis, an independent t-test was used to evaluate marginal, cervical, and axial fit, and the Mann-Whitney test was used to evaluate occlusal fit. (P = 0.05) Result: The average marginal and cervical gaps in monochrome zirconia were 65.30±20.00 and 72.42 ±10.11 micrometers, respectively, and in multi-layer zirconia were 70.76±14.71 and 78.74±11.91 micrometers, and this difference was not statistically significant (P>0.05). The average axial and occlusal gaps in monochrome zirconia were 102.5±10.70 and 118.9±18.52 micrometers respectively and in multilayer zirconia 114.8±18.88 and 141.6±29.88 micrometers, this difference was statistically significant and the average gap in monochrome zirconia was less than multilayer zirconia (P<0.05). Conclusion: Monochrome zirconia restorations show similar marginal and internal fit compared to multilayer zirconia restorations. Although the occlusal and axial gap in multi-layer zirconia is more than in monochrome zirconia, it is within the clinically acceptable range. Multilayer zirconia is generally clinically usable. [ABSTRACT FROM AUTHOR]

Background and Aim: Determination of the exact working length is one of the most important steps in root canal treatment. Various devices and methods, such as electronic apex locators, have been developed for the determination of the working length. The present study aimed to compare the accuracy of four electronic apex locators, DTE, Denjoy, Woodpecker and Coxo, in determining the actual working length. Materials and Methods: In this descriptive study, fourty mandibular premolar teeth that fulfilled the inclusion criteria were selected and examined. First, each tooth was measured with four apex locators. The electronic measurements were performed following the manufacturers’ instructions within ±0.5 mm, ±1 mm and exactly at apical constriction. To calculate the actual working length, 4 mm of the root end was buccolingually cut from buccal side of the canal, and the distance between the coronal reference point and apical constriction was measured under a microscope. Then, data were analysed with Paired T test. Results:. Within ±0.5 mm from the apical constriction and at the apical constriction, the accuracy of apex locators DTE, Woodpecker, Coxo and Denjoy were 87% and 45%, 85% and 37%, 85% and 45% and 82% and 42%, respectively. All specimens measured with four types of apex locators were within the range of -1 to +1 mm to the apex with an accuracy of 97.5%. Conclusion: None of the four apex locators reported an accuracy of 100% at apical constriction. There was no statistically significant difference between the working length measured by four apex locators and the actual working length. [ABSTRACT FROM AUTHOR]

Background and Objectives Despite the success of CAR-T cells in the treatment of hematologic malignancies, the use of allogeneic sources of T lymphocytes to produce these cells is associated with risk of GvHD. Cytokine induced killer (CIK) cells are a population with a lower risk of GvHD. Therefore, CAR-CIK cells can be evaluated as a potential alternative for CAR-T cells. Materials and Methods In this experimental study, after isolation and culture of mononuclear cells isolated from the peripheral blood of two healthy donors, T and CIK cells are transduced with CD19 gene containing lentiviral vector. On the 16th day of culture, to compare the cytotoxicity of CAR-T and CAR-CIK cells, these cells were co-cultured with CD19+ K562 target cells, and the death rate among the target cells was measured using a lactate dehydrogenase release assay kit. Student T-test, Anova and post-hoc Tukey were used for statistical analysis using Graph Pad prism software 8. A p-value less than 0.05 was considered statistically significant. Results In both CAR-CIK and CAR-T cell, CAR receptor caused a significant increase in cytotoxicity. So that no significant difference was observed between the cytotoxicity of CAR-T cells (67.8% ± 1.7) and CAR-CIK (65.1% ± 1.8). Conclusions CAR-CIK cells show a suitable in vitro cytotoxicity, so they can be considered as a potential alternative for CAR-T cells. However, more preclinical and clinical studies are needed to compare other effective dimensions in the function of these two cell types. [ABSTRACT FROM AUTHOR]

Background and Objectives Blood transfusion is a major challenge in treating trauma patients. This study investigated blood transfusion rates and related factors in trauma patients. Materials and Methods This retrospective cross-sectional study analyzed 849 trauma patients admitted to a trauma center in Shiraz, Iran during 2019-2021. Blood components usage and its relation to demographics, clinical status, lab values, and ABC score were assessed. The frequency of massive blood transfusion and the average number of blood units and blood components consumed in these patients were surveyed. Data were analyzed by T-test, Chi-squared test, and logistic regression with SPSS-23. Results The mean age was 38.6 ± 19.40 years and 80.9% were male. The mean blood units, platelets, and plasma used were 5.74 ± 4.57, 1.21 ± 4.87, 2.73 ± 4.32, respectively. 62.01% received massive transfusion with mean blood, platelets, and plasma units used being 8.17 ± 5.21, 3.92 ± 4.88 and 1.85 ± 6.01, respectively. Blood use correlated with systolic/diastolic pressures, blood sugar, lymphocyte count, pH, bicarbonate, base deficit, and hematocrit. 13.3% had positive ABC score and received more blood products (p < 0.001). Conclusions Blood transfusion in trauma patients depends on various clinical and lab factors. Identifying high-risk patients requiring urgent blood transfusion and rapid preparation of blood products is vital for optimizing trauma patient management and outcome. [ABSTRACT FROM AUTHOR]

Introduction: The dentist's level of knowledge and abilities is one of the determining factors in the correct selection and application of dental cements. This study aimed to investigate the level of knowledge, attitude, and practice of general dentists and specialists about the application of different dental cements. Methods: This descriptive-analytical study was cross-sectional one which conducted on 150 specialist and general dentists in governmental and private centers in Kurdistan province (2019) who performed fixed prosthetic treatments, was done through census and available sampling. The data collection tool was a questionnaire. To analyze data, T-test and ANOVA tests were used in SPSS-22 software. A significance level was considered less than 0.05. Ethical considerations: This study was conducted after the approval of the protocol in the research ethics committee and receiving the ethical code number IR.MUK.REC.1398.302 and according to the Declaration of Helsinki. Results: The overall average score of dentists' knowledge was 6.5, which was close to and higher than the average scores and had a significant relationship with the grade and place of employment (P<0.05). The overall average score of attitude was 3.4, which was almost equal to the average scores. There was a significant relationship between grade and gender with attitude score (P<0.05). The overall average score of the dentists' practice was 5, which was higher than the average scores, and the practice score had a significant relationship with gender, place of employment, and grade (P<0.05). Conclusions: The average score of knowledge, attitude, and practice of dentists was average, and in general, the scores of specialists were higher than general dentists. Women had a higher attitude and practice score. People working in the private sector had a higher knowledge score. To increase the knowledge, attitude, and practice of general dentists, there is a need to hold training courses. [ABSTRACT FROM AUTHOR]

Background. Sertraline is one of the most commonly used selective serotonin-reuptake inhibitors for patients with major depressive disorder. The prevalence of sexual dysfunction among patients who use selective serotonin-reuptake inhibitors is 40%–45% for women and 20%–30% for men. A strategy to prevent this side effect is combination therapy with medications such as buspiron and Ritalin. The aim of this study was to compare the effects of bupropion and Ritalin on sexual dysfunction among patients who use sertraline. Methods. This single-blind randomized controlled trial was conducted in 2018. Fifty eligible women aged 20–45 years old were purposefully selected from the psychiatric clinics of Yahyanejad and Ruhani hospitals, Babol, Iran. Structured interview was used to screen participants for major depressive disorder, sertraline use, and sexual dysfunction. All participants completed the Arizona Sexual Experience Scale and were randomly allocated to the bupropion and the Ritalin group through block randomization. All participants re-completed the Scale one month after the intervention. Data were analyzed through SPSS software by repeated measure analysis of variance. Results. All fifty participants (25 in each group) completed the study. The mean of participants’ age was 36.38±5.64 years and the mean score of their sexual dysfunction was 23.44±3.14 at pretest and 19.52±4.92 at posttest. Between-group differences respecting the mean scores of sexual dysfunction and all its items were insignificant both at pretest (P=0.886) and posttest (P=0.872). However, within-group comparisons revealed that the mean score of sexual dysfunction significantly decreased in both groups (P<0.001). Conclusion. This study concludes the same efficacy of sustained release bupropion and Ritalin in significantly reducing sexual dysfunction among patients who used sertraline. Practical Implications. According to the results of the present study and the similar efficacy of slow-release bupropion and Ritalin in improving sexual dysfunction caused by sertraline, it seems that Ritalin, due to its effectiveness in treatment, is an easier drug to use. It is more cost-effective and a better alternative to bupropion in improving sexual dysfunction in patients who are candidates for treatment with serotonin- reuptake inhibitors. [ABSTRACT FROM AUTHOR]

Background & Aims Despite the significant impact of immunosuppressive drugs on controlling and treating certain diseases, their continued use can predispose patients to infectious diseases such as COVID-19, leading to anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms. This study aims to determine the levels of anxiety, depression, and PTSD symptoms in patients treated with immunosuppressive drug during the COVID-19 pandemic. Materials & Methods This descriptive cross-sectional study was conducted on 330 individuals treated with immunosuppressive drug such as those with autoimmune diseases, cancer, and transplant recipients in Firoozgar and Rasoul-e-Akram hospitals in Tehran, Iran, from July to December 2022. They were selected using a continuous sampling method. The instruments were a demographic/disease related questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the Impact of Event Scale-Revised (IES-R). Data analysis was done in SPSS software, version 16 using descriptive (frequency, percentage, mean, standard deviation) and inferential (Independent t-test, analysis of variance, and Pearson’s correlation test) statistics. Results In this study, the mean age of participants was 51.35±12.95 years, and 148 (44.8%) were female. The majority of the patients had normal levels of anxiety and depression (91.2% and 92.1%, respectively). The mean total IES-R score was 27.71 out of 88. The anxiety and depression scores did not have a significant relationship with any demographic, disease-related, and COVID-related characteristics of the study participants, but a significant correlation between income level and total score of IES-R was observed (P=0.043). Conclusion The individuals receiving immunosuppressive drugs in this study, despite being susceptible to COVID-19, had normal levels of anxiety and depression and obtained lower than average score in the IES-R. This finding can reduce the concerns about the mental health of these patients. Further studies using other questionnaires or a qualitative study on the experiences of these patients during the COVID-19 pandemic are recommended. [ABSTRACT FROM AUTHOR]

Background & Aims Due to the effects of COVID-9, health care workers, including nurses, faced many psychological challenges, including death anxiety. This study aims to determine the death anxiety level of nurses working in the intensive care units (ICUs) for COVID-19 patients in hospitals affiliated to Tehran University of Medical Sciences in 2020. Materials & Methods This is a descriptive cross-sectional study that was conducted on 179 nurses working in the ICUs for COVID-19 patients in two hospitals located in Tehran and Qom cities. Continuous sampling method was used for their selection. Data collection was done using a demographic form and Templer's 15-item death anxiety scale. Results The mean death anxiety score of nurses was 8.74±2.007 out of 15, which is higher than the median score (i.e., 7.5). The results of one-way analysis of variance showed that the death anxiety score was significantly different between nurses only in terms of age (P=0.000). Tukey's post hoc test showed that the mean DAS score in nurses aged 30-39 was lower than in nurses aged ≥40 years and <30 years. There was no statistically significant difference in death anxiety between nurses in terms of other demographic factors (P>0.05). Conclusion The nurses working in ICUs experienced a high level of death anxiety during the COVID-19 in Iran. It is necessary that the policy makers and educational, medical or hospital managers develop educational and interventional programs including online in-service programs or educational booklets to help nurses overcome the COVID-19-related conditions [ABSTRACT FROM AUTHOR]

Background & Aims Chronic obstructive pulmonary disease (COPD) is a debilitating respiratory disease and one of the main causes of death and disability in the world. Respiratory support treatments are among the methods for the recovery of these patients. The present study aims to assess the effect of breathing exercises and chest physiotherapy on the fatigue of patients with COPD. Materials & Methods This is a quasi-experimental study on 45 patients COPD who were selected by convenience sampling method and randomly assigned to two experimental groups of breathing exercises (n=15) and chest physiotherapy (n=15) and one control group (n=15). Before and 6 weeks after the intervention, Krupp’s Fatigue Severity Scale was completed by the patient. Data analysis was done using paired t-test, one-way analysis of variance and chi-square in SPSS software, version 26. Results The mean scores of fatigue severity were significantly different in all groups between pretest and post-test phases (P<0.001). The fatigue severity in the intervention groups was reduced, while it increased in the control group, after intervention. There was no significant difference in fatigue severity among the three groups at baseline, but the difference was significant after the intervention (P<0.001). Conclusion Considering the reduction in fatigue severity after two supportive treatments, it is recommended that breathing exercises and chest physiotherapy should be used along with drug treatments for patients with COPD to improve their respiratory conditions. [ABSTRACT FROM AUTHOR]

Background & Aims Suicide and suicidal thoughts among adolescents have become a worrying psychosocial problem. This study aims to evaluate suicidal ideation among adolescents from the west of Tehran, Iran. Materials & Methods In this descriptive cross-sectional study, 256 boys and girls were selected from second-grade high schools in the west of Tehran by a convenience sampling method in 2022. The data collection tools were a sociodemographic form and the Beck scale for suicidal ideation (BSSI), which were completed using a self-report method. The collected data were analyzed in SPSS software, version 16 using descriptive and inferential statistics (independent t-test, analysis of variance). Results The mean age of the participants was 17.33±0.67 years. The mean score of BSSI was 3.19±5.66 out of 5. Among the sociodemographic factors, suicidal ideation had a statistically significant relationship only with the grade point average (P=0.004). Conclusion It is recommended to design and implement programs to educate and provide psychiatric services to high school students in Iran to reduce their suicidal ideation. [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]

Introduction: Insomnia and sleep disorders are related to a decrease in physical and mental health and quality of life. The purpose of this study was to investigate the effect of sleep deprivation on blood sugar, cortisol and insulin levels in athletes compared to non-athletes. Methods: In this semi-experimental study, 14 healthy men participated in two groups of athletes (7 people) and non-athletes (7 people). One night of sleeplessness (8 hours) was applied to the subjects of both groups. According to the objectives of the research, blood samples were taken from all the subjects in two stages. The data were analyzed using the dependent t test for intragroup comparison and independent t test for inter-group comparison at a significance level of 5%. In conducting the research, the principles of the Declaration of Helsinki, the general guidelines for ethics in research with human subjects and the regulations governing it were observed and the code of ethics was issued by the ethics committee of Lorestan University. Results: Insomnia did not lead to a significant difference between the blood sugar and insulin levels of athletes and non-athletes when faced with a (p ≤ 0.05). Also, insomnia did not cause a significant difference in the amount of cortisol between two groups of athletes and nonathletes (p ≤ 0.05). Conclusions: It seems that changes in blood sugar, cortisol and insulin are related to the duration of insomnia and are not affected in short-term and intermittent insomnia. [ABSTRACT FROM AUTHOR]

Background and Aim: PGE2 plays a very important role in the mediation of orthodontic therapies and dental reactions. Laser therapy in dentistry can be used to reduce pain, increase genetic bone, stimulate teeth, and reduce localized pain in time periods. The purpose of this study was to determine the effect of low-power laser therapy on the surface of PGE2 gingival fluid during orthodontic treatment. Material and Methods: In this double blind clinical trial study, 15 patients with crowning or protrusion of teeth requiring constant orthodontic treatment, along with pulling of the first two right and left prime mules, and then retracting the anterior teeth, were selected. After the first periodontal period examinations was performed in patients undergoing orthodontic treatment. One quadrant was selected as the experimental group and the opposite quadrant was selected as the control group. In the experimental group, low power diode laser irradiation was performed along the entire length of the gingival groove on days 0 (start of treatment), 2, 18 and 30 (total 4 days) after orthodontic treatment and sampling. The samples were transferred to the laboratory and determined at PGE2 level using an ELISAR device. Data were analyzed by Repeated Measure test, Friedman test and paired t-test. Results: The mean the PGE2 fluid in the orthodontic treated teeth, In the days of treatment, 30,18,2 laser radiation was significantly different between the experimental and control groups (P <0.001). In laser therapy, with significant increase in time, there was a significant reduction in PGE2 (p<0.05). Conclusion: Regarding the effect of reducing the pain of using and not using the laser in orthodontic movement, adjuvant treatment with low power laser reduces PGE2 as a mediator causing pain. [ABSTRACT FROM AUTHOR]

Background and Aim: Recurrent Aphthous Stomatitis (RAS) is a disorder characterized by recurrent ulcers limited to oral mucosa in patients who have no other symptoms of systemic disease. The main factors currently associated with RAS include genetic factors, hematological defects, immunological problems and local conditions such as trauma and smoking. The aim of this study was to evaluated serum vitamin D levels, neutrophil to lymphocyte ratio and mean platelet volume in patients with RAS. Materials and methods: In this case control study, 30 patients with RAS and 30 healthy individuals were compared as controls, serum samples were evaluated for vitamin D, neutrophil to lymphocyte ratio and mean platelet volume. Findings were analyzed by Mann- Whitney and sample-t-test. Results: Serum vitamin D levels in patients with RAS were 21.44±12.09 ng/ml and in healthy individuals were 24.87 ±18.65 ng/ml. Also neutrophil to lymphocyte ratio in patients with RAS were 1.89± 1.23 and in healthy individuals were 2.03± 1.79. Mean platelet volume in patients with RAS were 10.36± 0.93 fl and in healthy individuals were 10.65 ±1.12 fl. There was no significant difference between the two groups. All three markers were not significantly different between the two groups. respectively (P=0.4), (P=0.8) and (P=0.27) Conclusion: It seems that serum vitamin D levels and neutrophil to lymphocyte ratio and mean platelet volume not statistically significant in patients with RAS and healthy individuals. [ABSTRACT FROM AUTHOR]

Background. Health systems are responsible for providing healthcare services for all people in a community with reasonable costs. The primary objective was to evaluate and minimize the various expenses the patients incur consistently. The current study aimed to examine the direct non-medical and indirect expenses incurred to hospitalized patients infected with the Omicron variant of COVID-19. Methods. This cross-sectional study was conducted in February 2022 at Kosar Hospital in Semnan, Iran to investigate 400 hospitalized patients infected with the COVID-19 Omicron variant. The data were collected using a standardized instrument and conducting interviews with the patient. The descriptive findings were presented as frequencies (percentages) for qualitative variables and as means (standard deviations) for quantitative variables. The statistical relationship between demographic and background variables and the types of costs imposed on patients was examined performing T-test, ANOVA, and Tukey's post hoc test. Results. The study findings revealed that the patients and their families spent 20,260,000 IRR on direct non-medical treatment and 28,300,000 IRR on indirect treatment. A comprehensive statistical analysis was conducted to examine the correlation between demographic and background variables and the types of the costs incurred by patients and their families. The results indicated that a previous lung disease, asthma, diabetes, an admission to the intensive care unit (ICU), a coma in the patient, and COVID-19-induced heart complications were statistically and significantly associated with the direct non-medical costs. Furthermore, it was found that variables such as age, gender, educational status, employment status, engagement in occupational and physical activities, as well as the occurrence of a coma imposed additional indirect costs on the patients and their families (P<0.05). Conclusion. In sum, an infection with the Omicron variant of COVID-19 placed a substantial financial burden on the individuals and their households. Various factors may have influenced the magnitude of these expenses; therefore, it was recommended that these factors should be considered when implementing the promotional initiatives. [ABSTRACT FROM AUTHOR]

Background & Aim: Screening examinations are usually used to identify people at risk of disease, in order to allow the use of early interventions in order to prevent or treat diseases. In this study, we have compared the awareness and performance of medical intern students and nurses regarding screening examinations, 2022. Materials & Methods: The current research is a descriptive-comparative research. A total of 45 nurses and 45 medical interns were studied using available sampling and based on the inclusion criteria. The research questionnaire consisted of three parts: demographic information, questions to check awareness and questions to check performance. Data were analyzed with SPSS software version 25 and using statistical tests of frequency, percentage, T-test and Pearson's correlation coefficient. Results: The level of knowledge of nurses and medical interns was average (10.22±2.610 and 11.36±3.309, respectively) and in terms of performance, 82.2% of nurses and 46.7% of medical interns performed well. There was no statistically significant difference between the level of knowledge of nurses and medical interns (P=0.061), but in the field of performance, nurses performed better than medical interns (P=0.000). Conclusion:The findings of the present study showed that there are deficiencies in the knowledge and performance of medical interns and nurses in the field of screening examinations, therefore, there should be urgent plans in the field of training for screening examinations and their timely performance, especially in the treatment staff. And it must be done. [ABSTRACT FROM AUTHOR]

Background & Aim: Emotional intelligence includes a series of characteristics that have the ability to affect a person's overall ability to respond to environmental needs and stress. Due to the stressful nature of the clinical environment, this study was conducted with the aim of determination the relationship between psychological stress in the clinical environment and emotional intelligence of nursing students of Hamadan University of Medical Sciences in 2022. Material & Methods: In this descriptive cross-sectional correlational study, 214 nursing students of the 2nd to 8th terms of Hamedan University of Medical Sciences were included in the study by census method. Data collection tools included demographic characteristics checklist, Siberia Schering's Emotional Intelligence questionnaire and Cohen's psychological stress in clinical setting questionnaire. Data analysis was done by descriptive statistics, Pearson correlation coefficient, one-way ANOVA and independent sample t-test in SPSS 25 software. Results: According to the results; the mean (standard deviation) of emotional intelligence scores was 106.15 (10.59) and psychological stress in the clinical environment was 52.01 (12.38). It was also found that there is an inverse and significant statistical relationship between emotional intelligence and psychological stress of students in the clinical environment (r = -0.26, P < 0.001). Conclusion: Higher emotional intelligence effectively reduces the psychological stress in the clinical environment of nursing students. Therefore, it is suggested that relevant officials with targeted planning and holding classes and workshops to strengthen emotional intelligence; take steps to strengthen it in different students, especially nursing students. [ABSTRACT FROM AUTHOR]

Background and Objectives Exercise may play a role in regulating hematopoietic function as an activator and stimulator of hematopoietic stem cells. The purpose of this study was to investigate the effect of one week of regular aerobic exercise on the mobilization of CD34+ stem cells and the amount of new platelet production and the duration of hospitalization in leukemia patients. Materials and Methods In this clinical trial study, 39 patients with an average age of 46.93 ± 14.76 including 22 men (56%) and 17 women (44%) who were candidates for stem cell transplantation were randomly divided into two experimental (18 patients) and control groups (21 patients). Both groups received G-CSF. Patients in the experimental group did one week of treadmill training, but the control group did not receive any intervention. Blood samples were taken from patients immediately after training, during hospitalization and at discharge. In order to analyze the data, t-tests and SPSS 22 were used Results CD34+ cells increased after training in two groups (p< 0.0001), but there was no significant difference between the two groups. The average amounts of platelets at the time of discharge in the experimental and control groups were 88687 ± 75077 and 42714.29 ± 32023 per microliter of blood, respectively, and it showed a significant difference between the two groups (p= 0.01). Conclusions Combination of G-CSF treatment and one week aerobic exercise have a positive effect on the amount of blood platelets in patients undergoing autologous peripheral blood stem cell transplantation. [ABSTRACT FROM AUTHOR]

Background and Objectives Blood transfusion in thalassemia patients has side effects such as endocrine iron overload. It is necessary to use iron chelators. The aim is to investigate the prevalence of hypothyroidism and its relationship with the level of iron overload and the results of the heart and liver MRI as a new method for diagnosing iron deposition, and iron removal treatment. Determining the factors affecting this complication can help prevent or improve it. Materials and Methods This cross-sectional study was conducted on 232 beta-thalassemia major and intermedia patients of Tehran adult thalassemia clinic in the year 1400 who were selected by convenient sampling method. The comparison of the level of thyroid hormones and ferritin was done with Chi-squared, independent t, Mann-Whitney and Kruskal-Wallis tests by SPSS 26. Results The prevalence of hypothyroidism in patients with an average age of 40.79 ± 9.02 year was 27.6% There was no significant relationship between hypothyroidism with ferritin levels or heart and liver iron deposition. TSH level was significantly (p= 0.01) higher in men than women. Most of patients used combined iron chelators, but the type of drug was not significantly different. Conclusions It seems that iron overload may be effective in hypothyroidism, but it does not necessarily lead to it. Despite the treatment of iron deficiency, this complication is still one of the main problems. It is suggested to consider the amount of iron load and iron removal treatment before and after the onset of hypothyroidism in future studies. [ABSTRACT FROM AUTHOR]

Introduction: Self-efficacy during pregnancy is a self-assessment of one's ability to manage stress and perform important behaviors, especially in coping with pain. Women who benefit from the support of others during pregnancy feel more self efficacious. The studies show that involving family members in education, support or presence during pregnancy has contradictory consequences. This study was therefore conducted with the aim of determining the effect of an accompanying training programme based on Bandura's theory on the mother's self-efficacy during childbirth. Material & Methods: This RCT was conducted on 60 primiparous mothers between 20 and 23 weeks of gestation who were admitted to Umm al-Banin Hospital in Mashhad and were randomly assigned to two intervention and control groups. The control group received 8 sessions of 90 minutes of oral and practical training. In addition to these sessions, training sessions based on Bandura's theory were held for the intervention group, including two sessions of companions and pregnant mothers together and two sessions alone. A demographic questionnaire and a Childbirth Self Efficacy Inventory (CBSEI, Lowe, 1993) were completed by both groups before and immediately after the training. Data were analyzed using independent t-tests, paired t tests, Mann-Whitney and Wilcoxon in SPSS 16 software. A significance level of less than 0.05 was considered. Findings: The average age of the mothers in the intervention group was 26.7±8.3 years and in the control group 28.3±5.9 years. In most cases, the mother 's companion was her sister (73.3%). Before the training, the mean value of self-efficacy was 82.5±22.3 in the intervention group and 87.5±32.4 in the control group (P = 0.492, independent t-test). After the training, the mean value of self-efficacy was 132.4±18.5 in the intervention group and 115.2±26.4 in the control group (P=0.006, Mann-Whitney test). Self-efficacy after the intervention compared to before increased by 49.9±31.3 in the intervention group and by 27.7±29.5 in the control group (P=0.007, Mann-Whitney test). In intragroup comparison, the difference between the intervention group after and before the training was significant (P<0.001, Wilcoxon test). The difference between before and after the training was also significant in the control group (P<0.001, paired t-test). Discussion & Conclusion: Companion training based on Bandura's theory has an effect on the self-efficacy of pregnant women during childbirth and is recommended as a training method for childbirth preparation. [ABSTRACT FROM AUTHOR]

Background & Aims Caring for a patient undergoing hemodialysis is a stressful experience that causes a heavy care burden. With the outbreak of COVID-19, family caregivers of these patients had increased worry about the risk of infection in the dialysis centers. This fear can make their care burden heavier. This study aims to investigate the impact of coping skills training on the care burden experienced by family caregivers of patients undergoing hemodialysis. Materials & Methods This quasi-experimental study was conducted in 2020 on 60 family caregivers of patients undergoing hemodialysis at the Comprehensive Treatment Center for Special Diseases in Birjand, Iran. Participants were randomly assigned to intervention and control groups. The intervention group received coping skills training in six sessions. All participants completed the Zarit burden interview before, immediately after, and one month after the intervention. The data were analyzed in SPSSsoftware, version 19. Results The two groups were homogeneous regarding demographic information (P>0.05). Both groups had a moderate to severe care burden before the intervention. A significant difference was reported in the care burden score of the intervention group after training (P<0.001). Conclusion Coping skills training can reduce the care burden of the family caregivers of patients undergoing hemodialysis. Therefore, coping skills training can be used by nursing managers to reduce the care burden of family caregivers of patients with hemodialysis. [ABSTRACT FROM AUTHOR]

Background & Aims Tracheostomy is often performed for people hospitalized in intensive care units (ICUs), but it can cause larynx damage and discomfort in the patient. Given that the final outcome and possible complications of tracheostomy are directly related to the quality of nursing care, this study aims to evaluate the effect of tracheostomy care training on the performance of nurses working in the ICUs of selected hospitals affiliated to Iran University of Medical Sciences. Materials & Methods This quasi-experimental study was conducted on 64 nurses working in the ICUs of Rasul Akram and Firouzgar hospitals in 2021. The data collection tools were a demographic form and the tracheostomy patient care evaluation questionnaire of Atashzadeh et al. (2015). data analysis was performed in SPSS software, version 16 using descriptive and inferential statistics (paired t-test, and analysis of variance). P<0.05 was considered statistically significant. Results The mean age of nurses was 31.49±6.02 years. Most of them were female (70.3%) with a bachelor's degree (90.6%). Their mean overall work experience was 6.74±5.13 years, and their average work experience in the ICU was 4.92±4.66 years. Most of the nurses (43.8%) had permanent employment. Most of the nurses had rotating shift (89.1%), and had not completed the course of tracheostomy care (93.8%). The results of the paired t-test showed a statistically significant difference in the mean performance score of nurses before training (45.85±8.87) and after training (93.3±42.33) (P<0.001). Conclusion Considering that the performance of nurses in caring for patients with tracheostomy in the ICUs of selected hospitals is not satisfactory, educating nurses and providing sufficient facilities based on guidelines and opinions of experts are recommended to improve the quality of services to these patients by nurses in the hospitals. [ABSTRACT FROM AUTHOR]

Background & Aims One of the concerns of nurses and physicians is the adherence to treatment in patients with heart diseases. In Iran, there are no accurate statistics on the treatment adherence of patients with coronary artery stents, and the risk of cardiovascular diseases (CVDs) in these patients has not been investigated. Therefore, this study aims to determine the relationship between treatment adherence and the risk of CVDs in patients with coronary artery stents. Materials & Methods This descriptive cross-sectional study was conducted from June to August 2021 in Shahid Madani Hospital in Tabriz, Iran. Participants were 200 patients who underwent coronary angioplasty in the past year and had coronary artery stents. They were selected by a simple random sampling method. To collect data, a demographic form, the treatment adherence questionnaire, and the Framingham risk score (FRS) were used. The collected data were analyzed in SPSS software, version 22 using descriptive statistics, Pearson correlation test, t-test, and one-way analysis of variance. Results The mean age of the patients was 61.6±10.62 years. Most of them were male (60.5%) and married (68%). The overall mean score of treatment adherence was 41.50±8.48, indicating moderate adherence. Patients had poor adherence in domains of dietary regimen and regular physical activity such that most of them used high-fat food (87%) and had the least amount of physical activity per week (92.4%), but they used prescribed medicines on time (70.3%). Based on the FRS, men were twice as likely to have CVDs as women. There was a significant association between treatment adherence and the risk of CVDs, such that the risk of CVDs in the next 10 years among patients decreased with increasing their adherence to treatment (r=-0.25, P<0.001). Conclusion Given that there is a significant relationship between treatment adherence and the risk of CVDs in patients with coronary artery stents, and considering that these patients have poor adherence to a low-fat diet and regular physical activity, it is recommended that nurses in their patient education programs emphasize adherence to having a low-fat diet and regular physical activity and identify the barriers to achieving it, so that, by increasing patients’ adherence to treatment, the risk of CVDs in the next 10 years can be reduced in these patients. [ABSTRACT FROM AUTHOR]