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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]

Introduction: Female-headed households, due to continuous and chronic exposure to various pressures, often face psychological challenges. Resilience is a crucial variable influencing the mental health of women in such circumstances. This study aims to assess the impact of implementing the Peplau Interpersonal Theory on the resilience of female-headed household members. Materials and Methods: This is a quasi-experimental study. The target population consisted of female-headed households covered by the Welfare Office of Khorramabad. Using convenience sampling, 60 female household heads were selected from those covered by the Welfare Office, and they were randomly assigned into two groups: control and intervention. The intervention for the experimental group included face-to-face and individual training sessions based on the Peplau theory. Data were collected using demographic information questionnaires and the Connor-Davidson Resilience Scale before and one month after the intervention. The gathered data were analyzed using descriptive and inferential statistical tests with SPSS software version 22. Results: Both intervention and control groups did not have statistically significant differences in terms of demographic variables and the level of resilience before the intervention (P>0.05). Comparison of the average resilience score showed a significant increase in the participants of the intervention group compared to the control group (p<0.001). Conclusion: Based on the findings of this research, it can be concluded that education based on Peplau interpersonal theory increases the level of resilience in female-headed households. Therefore, counselors and welfare professionals, as well as other executive bodies, should pay special attention to improving the resilience of female-headed household members. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer is one of the most common cancers among women. Since microarray is a new method in cancer diagnosis, in the current study, the microarray library of MCF-7 breast cancer cells after irradiation was examined to predict the gene expression pattern and metabolic pathways related to it. Materials and Methods: Microarray data extracted from National Center for Biotechnology Information (NCBI) related to MCF-7 cells were analyzed by GEO2R and R software. Then the genes that had increased and decreased expression were extracted and gene ontology analysis was performed using DAVID and Enrichr databases. Results: In this study, after 48 hours of irradiation, 234 genes with Log2FC>1 increased expression and 146 genes with Log2FC<-1 decreased expression (Adjusted p value <0.05). KEGG analysis on genes with increased expression showed that these genes are related to type 1 diabetes (P=2.43E-04). The genes extracted in this pathway included HLA-DRB5, HLA-DRB4, CPE, TNF, HLA-DRB1 and HLA-DM (Adjusted p value <0.05). Also, the findings show that the genes involved in type 1 diabetes in the islets of Langerhans include CPE, MHC-II, and TNF-α. Conclusion: The findings of this study showed that the increase in irradiation time in breast cancer cells probably leads to the activation of pathways related to type 1 diabetes through CPE, MHC-II and TNF-α genes in the islets of Langerhans. [ABSTRACT FROM AUTHOR]

Introduction: Empathy is one of the most effective indicators of nursing performance, therefore understanding the concept of empathy in the ICU seems necessary to provide better care in this challenging environment. However, empathy faces barriers in this area. This study was conducted using the content analysis approach with the aim of explaining the factors that inhibit among in intensive care nurses. Materials & Methods: In this qualitative study, 12 semi-structured interviews were conducted with an average duration of 30- 45 minutes with ICU nurses selected by purposive sampling during the period 2021-2022. The interviewees' statements were analysed after being recorded and converted into text using MAXQDATA 11 software and conventional content analysis methods. Results: The coding process was carried out after removing duplicate codes and merging similar codes as a continuous comparative analysis. Eleven subcategories and three main themes were identified, including "organisational barriers", "individual barriers" and "barriers related to environmental and cultural factors". Finally, the general theme (the main theme) was obtained under the title 'Barriers to empathy in nurses'. Conclusion: The results of this study showed that intensive care nurses face significant barriers to empathy. Given that knowledge of the barriers to empathy and their removal will contribute greatly to improving patient care, it is necessary to identify and remove the existing barriers known to managers and policy makers. [ABSTRACT FROM AUTHOR]

Introduction: Rhinoplasty is one of the most challenging cosmetic surgeries. The nature of surgery itself and hemodynamic instability in patients causes bleeding during surgery, which affects the quality of the surgical field of view, complications during and after surgery, and the outcome of surgery. Therefore, the purpose of this study is the effect of tranexamic acid drug on hemodynamic changes in patients undergoing septorhinoplasty surgery. Materials & Methods: This double-blind randomized clinical trial study was conducted on 51 patients aged 18 to 44 years with anesthesia class І, II who were candidates for septorhinoplasty surgery. The patients were randomly divided into two groups of tranexamic acid and control. Hemodynamic parameters at times; before induction, after induction, 1 minute after induction, 5 minutes after induction, 30, 60, 90 and 120 minutes during the operation, entry into recovery and exit from recovery were measured. Data analysis was done using spss software version 21 and descriptive statistics (mean and standard deviation) and inferential statistical tests. Results: The average trend of systolic and diastolic blood pressure from the time before induction to outside of recovery in the control and tranramic acid groups showed a significant difference (P<0.001). In the times before and after induction, 5 minutes, 15 minutes, 30 minutes, 60 minutes, 90 minutes, 120 minutes, a significant difference in the average heart rate between the two groups was observed (P<0.05). In the control group and the tranamic acid group, the mean trend of O2SAT from the time before induction to the time outside of recovery showed a significant difference (P<0.001). Conclusion: The results of the present study showed that the use of a dose of 250 mg of tranexamic acid had a decreasing trend in the average hemodynamic changes over time, and during these times, the decreasing changes in heart rate were significant. Therefore, it seems that tranexamic acid can be used in septorhinoplasty surgery to maintain hemodynamic stability. [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]

Background and Objectives Chelation therapy is essential for beta-thalassemia major. This study aims to determine the complications clinical and laboratory symptoms of monotherapy and combined treatment of iron chelators in beta-thalassemia major patients in Yasuj. Materials and Methods In this cross-sectional-descriptive-analytical study, 103 patients with beta-thalassemia major in Yasuj city were evaluated during 2021-2022. After collecting the demographic, clinical and laboratory information of the patients, the results were reported as mean ± standard deviation and percentage. The degree of statistical differences between ratios was calculated using the Kruskal-Wallis test. Results The average age of our patients was reported to be 24.74 ± 8.34 years. 54.4% (n = 56) of the study patients were men and 45.6% (n = 47) were women. The results of the present study showed that there was a statistically significant difference in mean ferritin among different study groups (p = 0.028). Patients treated with deferoxamine showed the highest mean serum ferritin (5925.5 ± 3397ng%) and patients who took deferoxamine together with deferiprone or deferasirox had a lower mean ferritin compared to deferoxamine alone (3348 ± 2560, 4269 ± 3322 ng%), respectively. Also, the present study showed that after taking iron removers, 47.6% of patients (n = 49) had no clinical complications and 52.4% (n = 54) had at least one complication. Conclusions Our results showed that Deferoxamine can have a great effect in reducing iron deposition and serum ferritin levels in combination with oral drugs. [ABSTRACT FROM AUTHOR]

Background and Objectives Regular blood donors may experience iron deficiency due to repeated blood donation. Genetic differences might have an impact on iron deficiency in regular blood donors. Some of these genes include those involved in activities related to iron absorption and transfer in blood. In this study, the association of the rs855791 single nucleotide polymorphism in TMPRSS6 gene with iron levels in male regular blood donors was investigated. Materials and Methods In this cross-sectional study, 130 male regular blood donors participated. CBC tests, serum iron, ferritin, and Total Iron Binding Capacity (TIBC) were performed on their blood samples. The genotypes of the target polymorphisms were determined using the allele-specific PCR method. All collected data were analyzed using R software for statistical analysis. Results The average age of the regular male blood donors was 45 years with a standard deviation of 10.5. Among the 130 regular blood donors, 28 individuals (21.54%) were homozygous for the T/T allele, 29 individuals (22.31%) were homozygous for the C/C allele, and 73 individuals were heterozygous for the C/T allele. No significant association was observed between the rs855791 single nucleotide polymorphism and iron assessment indicators. Conclusions Single nucleotide polymorphism of TMPRSS6 gene (rs855791 v736A) was not associated with iron level and related quantities in regular blood donors. [ABSTRACT FROM AUTHOR]

Background and Objectives Various mutations can occur in the HBV genome during chronic HBV infection due to errorprone viral replication and stress on the host immune system. This study aimed to determine the mutations in the BCP and preC regions of the hepatitis B virus genome in asymptomatic carriers and its role in the persistence of hepatitis B infection. Materials and Methods In this descriptive study conducted by easy non-probability sampling method in 2017, 40 asymptomatic blood donors positive in terms of HBsAg and confirmatory tests and negative in terms of anti-HCV and anti-HIV tests were included in the study. Anti-HBc, HBe Ag and antiHBe (Total) tests and ALT and AST tests were performed. Nested-PCR reaction was performed on the extracted DNA and the sequences were determined. Data analysis was done using online software https://hbv.geno2pheno.org. Results Out of the 40 examined samples (94.8%), 38 were men and 2 (5.2%) women with an average age of 38.6 ± 8.6. Mutations in (G1764A) and BCP (A1762T) were observed in 10 (50%) and 8 (40%) cases, respectively, and G54T17 mutation was observed in 3 (15%) samples out of 20 HBV positive and HBeAg negative samples. The mutation in the preC region and the nucleotide position A1896 G was found in 12 cases (60%). Conclusions The highest frequency of mutations was observed in G1764A and BCP which can be considered as one of the effective factors in not clearing and removing the virus by the host's immune system and causing chronic hepatitis B infection. [ABSTRACT FROM AUTHOR]

Background. Since prenatal care may have been affected during the COVID-19 pandemic, this study aimed to compare the content of prenatal care during the COVID19 pandemic with one year before the pandemic in Qazvin, Iran. Methods. This cross-sectional-analytical study included 722 pregnant mothers (361 before and 361 during the COVID-19 pandemic) referring to Qazvin health centers in 2018 and 2019. The "Evaluation of Care during Pregnancy" checklist was used to collect information. The information was extracted from the Integrated Health System (known as SIB), reporting offices of health centers. SPSS version 25 software was used to analyze the data. Results. The results showed a decrease in the number of prenatal care in all care times during the COVID-19 pandemic compared to the pre-pandemic period (P<0.001). The rate of preterm pregnancies increased during the pandemic period (P<0.001). Performing the first round of screening, the first and second rounds of ultrasound and the second round of laboratory tests, respectively decreased by 23.8%, 11.1%, 13.3% (P<0.001), and 7% (P=0.004) in the pandemic period (P<0.001). The follow-up rate of referrals also decreased during the pandemic period (P<0.001). Conclusion. The results showed a decrease in the number and content of prenatal care during the COVID-19 pandemic. Practical Implications. The number and content of prenatal care during the COVID-19 crisis decreased in this study. Therefore, effective measures should be planned for this reduction. There is also a need to provide necessary training and preparations to the providers of prenatal care in critical times. [ABSTRACT FROM AUTHOR]

Background. Having problems in regulating the emotions is considered as the main core of depression disorder and rumination is one of the cognitive components in individuals with depression disorder. The objective of this study was to consider the effect of mindfulness training on rumination and cognitive regulation of emotion in students with depressive symptoms. Methods. This study was a semi-experimental method with a pre-test-post-test design with a control group. The statistical population included all 350 students of the Faculty of Nursing of Tabriz University of Medical Sciences in 2023-2022, among whom the Beck Depression Questionnaire was administered. Among them, 30 students with symptoms of depression (15 as experimental and 15 as control) were selected by purposive sampling method. The emotion regulation scale and rumination questionnaire were used to collect data. Results. The findings showed a significant difference between the experimental and control groups in terms of rumination and cognitive regulation of emotion (P<0.001). The mean of rumination in the experimental group was significantly reduced compared to the pre-test and the control group, and the mean of the cognitive regulation of emotion was significantly increased. Conclusion. The results of the research showed that mindfulness training has an effect on rumination and cognitive regulation of emotion in students with depressive symptoms. Practical Implications. The results of the present study can be used to prevent and treat people with symptoms of depression, especially students. [ABSTRACT FROM AUTHOR]

Background. Kawasaki disease is an acute and rare febrile disease that affects children and is characterized by conjunctivitis, redness of the lips and mouth, diffuse skin lesions, edema and redness of the hands and feet, and cervical lymphadenopathy. Since the start of the COVID-19 pandemic, Kawasaki disease has become much more prevalent and has more diverse manifestations. Methods. This retrospective cohort study included patients diagnosed with Kawasaki symptoms between January and October 2021 at the Tabriz Children's Education and Therapeutic Center. The diagnosis was made using the guidelines of the American Heart Association (2017) and the American College of Rheumatology. Results. All referred patients had fever, and additional symptoms may include skin involvement (93%), mucosal involvement (87%), end changes in the peripheral exterimities in the form of erythema and scaling (75%), gastrointestinal manifestations (51%), cardiac manifestations (42%), followed by respiratory (27%), and finally cervical lymphadenopathy (18%). Conclusion. Manifestations of Kawasaki disease during the COVID-19 pandemic can be much more diverse and severe. Knowing the variety of clinical symptoms and uncommon findings of Kawasaki disease in these patients can help to early distinguishing between Kawasaki and Kawasaki like disease and prevent the progression of the disease. Practical Implications. It was noteworthy that patients with complete Kawasaki manifestations were less than five years old. The age range of the patients was between 11 months and 13 years, and the average age range was between 5 and 6 years (65±37 months). [ABSTRACT FROM AUTHOR]

Background. Menopause is associated with an increase in blood sugar and an increase in inflammatory cytokines. Exercise and genistein have biological activities, including anti-inflammatory and antidiabetic activity. This study examined the combined effects of regular swimming exercise and genistein as a preventive strategy against inflammation and pancreatic cell damage in ovariectomized diabetic rats. Methods. A total of 42 female Wistar rats were divided into six groups: Sham, ovariectomy (OVX), diabetic ovariectomy (OVX.D), diabetic ovariectomy + exercise (OVX.D.E), diabetic ovariectomy + genistein (OVX.D.G), and diabetic ovariectomy + exercise + genistein (OVX.D.E.G). Animals underwent swimming training or received genistein or a combination of both for eight weeks. At the end of this period, the levels of TNF-α, Nf-κB, IL-1β, and SIRT1 proteins were evaluated using western blot in pancreatic tissue. Results. Ovariectomy increased the expression of TNF-α, Nf-κB, and IL-1β and decreased the expression of SIRT1, and these effects were more significant in ovariectomized diabetic rats. Treatment with genistein and swimming exercise individually reversed these changes in the level of proteins and improved the inflammation, but the combined effect of these two interventions exhibited more effect. Conclusion. The combination of genistein and regular swimming exercise provides enhanced protection for pancreatic tissue and effectively prevents damage to it. Therefore, performing appropriate physical activities and consuming compounds containing phytoestrogens can prevent the occurrence of disorders such as diabetes during menopause. [ABSTRACT FROM AUTHOR]

Background. Various methods have been proposed to treat plantar fasciitis. Among these, autologous blood transfusion has been discussed and investigated in the past few years, the findings indicate its effects in the medium term, and in some studies, better results were observed compared to corticosteroids. This study was conducted with the aim of comparing the effect of two therapeutic methods of local injection of autologous blood and corticosteroid with the control group in the treatment of plantar fasciitis. Methods. In this prospective study that took place in Shahid Beheshti Hospital, Babol, during 2020–2021, 90 plantar fasciitis patients were examined in two treatment groups by corticosteroid injection or autologous blood. Their levels of pain and satisfaction were recorded during three and six months by the visual analog scale (VAS) and the Roles and Maudsley Scale (RMS). The data were described and analyzed by SPSS-22 using descriptive indices and statistical analysis tests at a significance level of 0.05. Results. There was no significant difference in pain and satisfaction during the third month of steroid and autologous blood transfusions. However, in the sixth month, the patients in the autologous blood group had significantly less pain than those in the steroid group (P= 0.001), and their level of satisfaction was significantly higher than that of patients in the steroid injection group (P= 0.018). The mean pain intensity based on VAS in six months was 5.40 ± 1.37 and 3.76 ± 1.87 in the steroid and autologous blood groups, respectively (P< 0.001). Based on the Wilcoxon test, the VAS score increased significantly in the steroid group in the sixth month compared to the third month (P= 0.011), while it decreased in the autologous blood group (P< 0.001). Conclusion. Based on the findings, autologous blood injection in plantar fasciitis over six months had significant pain-reducing effects and satisfaction versus corticosteroid injection. However, after three months, these effects were not significant compared to corticosteroids. Practical Implications. Based on the findings, autologous blood injection in plantar fasciitis over six months had significant pain-reducing effects and satisfaction versus corticosteroid injection. However, after three months, these effects were not significant compared to corticosteroids. [ABSTRACT FROM AUTHOR]

Background. Recurrent pregnancy loss is defined as at least two consecutive clinical pregnancy losses before 20th week of gestation. In this study, we investigated microRNA-1 and microRNA-1229 in recurrent miscarriage patients before and after lymphocyte therapy in comparison to control group. Methods. First, a written and informed consent will be obtained from the target population of this study, who are people with RPL referring to Waliasr International Hospital. According to the standard protocol, the number of 2×107 is injected subcutaneously to patients. Real-time PCR technique will be used to check the expression level of microRNA-1 and microRNA-1229. Results. The gene expression level of micro-RNA 1 in RPL women before of lymphocyte therapy was 2.030±1.445 and the gene expression level of the same microRNA after the lymphocyte therapy of the mother was 1.101±0.4780. Also, the expression level of micro-RNA 1229 in these women was reported to be 2.100±0.6296 before treatment and 1.247±0.9631 after treatment with lymphocytes. This level of gene expression in control group, for micro-RNA 1 and micro-RNA 1229 genes is 1.000±0.08334 and 1.000±0.08091, respectively. Conclusion. The results of our study showed a noticeable decrease in the gene expression of microRNAs under study, both microRNAs 1 and 1229, in women with a history of three consecutive injections of the father's subcutaneous lymphocytes. Practical Implications. This study can show the therapeutic effect of lymphocyte for patients with recurrent miscarriage so that this treatment can be used along with other treatment methods. [ABSTRACT FROM AUTHOR]

Background. Diabetes is one of the most common chronic and metabolic diseases. This systematic review and meta-analysis study aimed to compare the effects of multiple daily insulin injections against permanent subcutaneous insulin injections on glycated hemoglobin (HbA1C) levels in type 2 diabetic patients. Methods. Studies that compared the impacts of multiple daily insulin injections against permanent subcutaneous insulin injections on HbA1C levels and were published until the end of 2022 in international databases were searched and retrieved (nine randomized clinical trial studies). The Chi-squared test and I2 were used to determine the presence and size of heterogeneity. Results. The results of the analysis demonstrated that compared to the group of multiple daily insulin injections, HbA1C was significantly reduced in the group of permanent subcutaneous insulin injections, so that the standardized mean difference was equal to -0.26 (95% confidence interval: -0.46– -0.06 P=0.025). According to the results of Egger’s (P=0.333) and Begg’s (P=0.667) tests, publication bias was not observed in this study. Conclusion. Based on the available evidence, permanent subcutaneous injection of insulin could be significantly successful in reducing and controlling the level of HbA1C because the patients in the permanent subcutaneous injection group had lower levels of HbA1C. Practical Implications. In patients with type 2 diabetes, insulin treatment with the permanent subcutaneous injection method can better control the level of HbA1C than the multiple daily injection method. [ABSTRACT FROM AUTHOR]

Background: Parasitic infections in children are one of the most important health and health problems worldwide, especially in developing countries. Diarrheal diseases such as those caused by Entamoeba histolytica are among the causes of death in children, so the purpose of this systematic review and meta-analysis is to determine the prevalence of Entamoeba histolytica in Iranian children. Materials and Methods: This study is a systematic review and meta-analysis by examining the Scientific Information Database (SID), Medline (PubMed), Scopus and Google Scholar until March 2023. Results: In a review of 12 studies with a sample size of 10,982 Iranian children, the prevalence of Entamoeba Histolytica in Iranian children was reported to be 1% (95% CI 0.6-1.7%). The meta-regression results showed that in examining the factors influencing the heterogeneity of studies and examining the effect of sample size on this heterogeneity, it was reported that with increasing sample size, the prevalence of Entamoeba histolytica in Iranian children decreased (P<0.05) and also with the increase in the year of conducting studies, the prevalence decreases in Iranian children (P=0.289). Conclusion: The results of the present study show that the prevalence of Entamoeba histolytica in Iranian children is not at a very high level, but to continue preventive measures and reach lower levels, it still requires the attention of health policymakers in this area to carry out extensive information and screening to prevent the effects of this parasitic disease on children. [ABSTRACT FROM AUTHOR]

Background: The Celiac National Institute has recently devised a diagnostic algorithm for celiac, which has been adopted from the most recent guidelines and articles worldwide. All Iranian provinces are requested to set all diagnoses based on the newest national protocol devised by the National Institute of Celiac Disease; however, some incompatibilities are observed. Therefore, this study was conducted to demonstrate these incompatibilities. Materials and Methods: In this descriptive-analytical study, we enrolled 250 cases of celiac disease referred to the province registry system and revised the diagnosis based on the national protocol for celiac disease diagnosis. All data were analyzed using SPSS software version 26. Results: Among the 250 patients diagnosed with celiac disease, 88 (35.2%) had incompatibility. The mean age of the patients was 37.19 years. 28 people (31.8 %) were men. Results indicated that in 40.9% of incompatibility cases, only pathology tests were performed, and in 52.3% of incompatibility cases, only serological tests were performed. In 6.8% of cases, both tests were performed, but the diagnosis was indefinite. Pathological results indicated that 0.5% of patients were in Marsh 1, 19% in Marsh 2, 35.7% in 3a, 23.8% in 3b, and 19% in Marsh 3c phases. Conclusion: There are cases of diagnostic incompatibilities between the most recent national protocol for celiac disease and physicians' practice. Therefore, it is vital that practitioners are trained with the national protocol for celiac disease diagnosis. [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 and Objectives Constant control of electrical panels is effective in ensuring the safety of users. This study was conducted during the years 2022-2023 to evaluate their structure in blood transfusion centers by ETBA method. Materials and Methods In this descriptive-analytical study with the ETBA method, the performance and quality of the grounding system, capacitor bank, connections, the location of the panels, the arrangement structure of the components, and their cleanliness and safety in the centers of Kermanshah, Hamadan, Ilam, Sanandaj, Arak, Karaj, Semnan, Bandar Abbas, Sari and Yazd were investigated. The obtained information was analyzed statistically with SPSS 25 software. Results The results showed 74.3% electrical panels with unprincipled volume and distribution of connections, 72.4% due to the selection of inappropriate location and distance from tools and devices, deployment in users' traffic area without provision of fence and safety devices, 70.5% not equipped with warning devices, 43.3% non-standard arrangement, 51.4% insufficient cleaning, 66.3% not having an active earth connection, and 60.3% not having a capacitor bank did not have reliable electrical safety. Conclusions Based on these results, the regular and continuous establishment and implementation of the medical equipment maintenance management system can be a fundamental and effective factor in identifying risks and the pertinent degree of risks and damages in the process of activity. [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]

Background and Objectives Nowadays, it is necessary to evaluate the prevalence of HBV and HCV viruses all around the world due to the importance of preventing infections transmitted through transfusion of blood products. In this study, we investigated the prevalence of these two viruses that cause viral hepatitis among blood donors in Sistan and Baluchestan province. Materials and Methods This retrospective study is conducted on blood donors in Sistan and Baluchestan province in order to evaluate the prevalence rate and trend of Hepatitis B and C during the years 2011- 2022. The data were analyzed using Mann–Whitney U test, chi-square (χ2), and SPSS 22. Results The prevalence rates of hepatitis B and C infections among blood donors were 0.329% and 0.05%, in Sistan and Baluchestan province respectively. During the years 2011 to 2022, the prevalence of hepatitis B infection decreased from 818 cases per hundred thousand people in 2011 to 109 cases in 2022. Similarly, the prevalence of hepatitis C decreased from 102 cases in 2011 to 27 cases in 2022 Conclusions The results of the present study indicated a decrease in the prevalence of hepatitis B and C infections over a decade, which can show the effective trend of health indicators and prevention programs of HBV and HCV. [ABSTRACT FROM AUTHOR]

Background. Climatic and geomorphological characteristics of a region are vital factors in the regional spread of diseases. Geographic Information System (GIS) is a useful tool for studying cancer epidemiology. This study was conducted with the aim of investigating the prevalence of childhood leukemia in Khuzestan based on 10-year GIS data of temperature, wind speed and dust level. Methods. The medical characteristics of all cases of leukemia in children admitted to Bagai 2 Ahvaz Hospital, which were diagnosed with leukemia for the first time. We collected what was diagnosed. Results. Five hundred and twelve children had acute lymphoblastic leukemia (ALL) and 100 children had acute myeloblastic leukemia (AML). The year 2015 had the highest and the year 2018 the lowest ALL rate. The peak of AML was in 2013 and the lowest was in 2018. Central cities had the highest mean particulate matter, temperature, wind speed, and the highest rate of leukemia. Conclusion. The results show that dust, temperature and wind speed are related to the prevalence of childhood leukemia in Khuzestan, Iran. Practical Implications. A wide range of environmental and genetic factors can play a role in the occurrence of cancer, so additional studies are needed to confirm the effect of particles and environmental factors such as temperature and dust on the occurrence of cancer. [ABSTRACT FROM AUTHOR]

Background. The Urban Family Physician Program (UFPP) has been implemented in Fars and Mazandaran provinces of Iran since 2013 with the aim of improving access and utilization of health services, with a particular focus on children and adolescents. In order to evaluate the effectiveness of the program in achieving this goal, this study aimed to compare the access and utilization of health services among children living in areas covered by the UFPP with those living in other regions of Iran. Methods. A secondary analysis was performed using data from the 2015 National Health Utilization Survey. The data of people aged under 18 were extracted and indicators on the use of health services based on three main models of health service provisions were compared:(1) cities in Fars and Mazandaran provinces (UFPP implemented);(2) cities in other Iranian provinces (excluding Fars and Mazandaran); and (3) villages and cities with a population under 20,000. Results. The study included 20,689 children. The outpatient and inpatient visits in children living in Fars and Mazandaran provinces were higher than in children from other provinces and smaller towns (11.89 vs. 7.92 and 7.21 for outpatient and 4.74 vs. 3.51 and 4.27 for inpatient, respectively). Furthermore, UFPP was found to be associated with a higher utilization of health services in children residing in cities (odds ratio=1.50 (1.98-1.15)). Additionally, the cost of outpatient and inpatient health services in areas where the UFPP was implemented was lower compared to other parts of the country. Conclusion. The urban family physician program has been successful in increasing the access to health services and reducing health costs in children. Practical Implications. The findings suggest that the urban family physician program can be an effective strategy for improving healthcare access and reducing costs, especially in areas with high population density. Policymakers and healthcare providers can use the results of this study to inform the development and implementation of similar programs in other countries, with the aim of improving healthcare access and reducing healthcare costs in children and adolescents. [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. Attention deficient-hyperactivity disorder (ADHD) is the most prevalent psychiatric diagnosis in preschool children. The present study aimed to translate and determine the validity and reliability of the Persian version of Conners Early Childhood Attention Deficit-Hyperactivity Disorder Questionnaire–Parents’ Form in Iranian children aged 3-6 years. Methods. We included 1,013 pediatrics aged <6 years in 2017-18 in Tabriz, Iran. In the first step, the questionnaire was translated into Persian using the re-translation method. Then, the content validity of the questionnaire was evaluated by ten specialists. Finally, the concurrent validity of the questionnaire was simultaneously compared with the children’s Strengths and Difficulties Questionnaire (SDQ). ROC curve was used to determine the best cut-off point, and sensitivity and specificity were measured to determine the questionnaire’s diagnostic value compared to the clinical psychiatric interview. The test-retest method was used to determine reproducibility using the intra-class correlation coefficient (ICC). The internal consistency was also evaluated with Cronbach’s alpha test. Results. Of all the 1,013 participants, 569 (56.2%) were female. The overall modified kappa agreement and concurrent validity coefficients were 0.76 and 0.70, respectively. The sensitivity and specificity of the questionnaire was estimated 86.8% and 79.4%, respectively. The ICC was calculated at 0.90, and the questionnaire’s internal consistency was calculated at an overall Cronbach’s alpha coefficient of 0.88. Conclusion. The Persian version of Conners Early Childhood Attention Deficit-Hyperactivity Disorder Questionnaire–Parents’ Form exhibited proper reliability and validity for screening the Iranian pediatric population. Practical Implications. The emerged validated tool from the present study can be used in the first-line health system in the public and private sectors for physician and non-physician healthcare providers, especially family physicians in primary health care. [ABSTRACT FROM AUTHOR]

Background. Warts are a common skin disease affecting individuals of all ages worldwide. This clinical trial aims to compare the effectiveness of furosemide 0.125 percent topical gel and KOH 10 percent topical gel in treating patients with warts. Methods. Patients diagnosed with warts by dermatologists were included in the study and treated with either 0.125 percent furosemide or 10 percent KOH for two months. Patients were examined and imaged at the beginning of the study and in weeks 4 and 8 to assess the number, diameter, and height of warts and complications. Results. The study included 40 patients (48 lesions) with common warts, with 20 patients in each intervention group. In the furosemide group, the average diameter of warts decreased from 4.25 ± 1.43 mm in the first visit to 4.14 ± 1.47 mm in the final visit. In contrast, the average diameter of warts in the KOH group decreased from 3.89 ± 1.67 mm to 3.02 ± 1.49 mm. No complications were reported in the furosemide group, whereas seven complications related to redness and burning were observed in the KOH group. Conclusion. Furosemide 0.125 percent is effective and safe for treating skin warts. However, it is less effective than KOH in reducing the diameter and height of warts. This study's findings suggest that furosemide can be a promising alternative to KOH in treating warts, especially for patients with sensitive skin or those who experience complications with KOH treatment. Further research is needed to determine the optimal treatment duration and dosage of furosemide for treating warts. Practical Implications. We can find new ways to reduce complications in treating warts. [ABSTRACT FROM AUTHOR]

Background and Aims: The white color of teeth is one of the most essential factors in smile esthetics. Therefore, various whitening agents such as bleaching mouthwashes have been produced in response to the people’s high demand for having whiter teeth. The present study evaluated the efficacy of three whitening mouthwash products on tooth enamel whiteness. Materials and Methods: In the present in vitro study, 32 bovine incisors were assigned to four groups in terms of the mouthwash used (n=8): control (C); Xenon Smart White (ZSW), containing pyrophosphate and triphosphate; Signal White Now (SWN), containing Blue Covarine; and Pasta Del Capitano whitening mouthrinse (PCW), containing Plasdone. Colorimetry was carried out using a spectrophotometer at the baseline and 2, 4, 8, and 12 weeks after treatment with mouthwashes. Data were analyzed using CIELab parameters with ANOVA, RM two-way ANOVA, and post hoc Tukey tests (α=0.05). Results: The results showed that the whiteness created by the SWN mouthwash was clinically visible (ΔE>3.3). However, the functions of all the mouthwashes were statistically similar with no significant differences from the control group (P>0.05). Conclusion: Although, Blue Covarine-containing mouthwash was somewhat effective in whitening of tooth enamel, none of the mouthwashes had significant efficacy compared to distilled water. [ABSTRACT FROM AUTHOR]

Background and Aim: The Accreditation program has been increasingly expanding around the world. Implementing the Accreditation program directly affects patients' quality and safety. Also increasing the productivity of the manpower to reach the predetermined goals of the organization, is of the utmost importance. As a result, this research was conducted to assess the effect of the Accreditation program on job productivity from the nurse's point of view. Methods: This descriptive-analytical study was conducted cross-sectionally in 2021. A total of 250 nurses working in a military hospital were included in the study and all subjects completed the questionnaire. To collect the data related to the Accreditation program, the Scholarly inquiry created by Jardali was used the validity and reliability of which were assessed and confirmed. The data related to the productivity of the nurses was collected using the Standard Hersey and Goldsmith inquiry (ACHIEVE). Also, the data was analyzed using analytical statistics in the form of Confirmatory Factor Analysis and the path analysis was done using Structural Equation Modeling based on the Partial Least Squares method with the Smart-PLS3 software. Results: The results show that Accreditation has a meaningful effect on the productivity of nurses. The average score of the total accreditation and productivity was equal to 3.03 ± 0.75 and 2.47 ± 0.64. From all the different accreditation dimensions the highest score belonged to the qualitative results of accreditation (3.23 ± 0.83) and the lowest score they have belonged to the leadership, commitment, and support dimension (2.80 ± 0.96). Also in the productivity dimensions the highest score belonged to the capability (2.77 ± 0.84) and compatibility (2.75 ± 1.12) dimension and the lowest score belonged to the motivation dimension (2.08 ± 0.86). Conclusion: The accreditation program has had an impact on the productivity of nurses. Hospital managers can increase their productivity by strengthening dimensions such as leadership, commitment, support of nurses, use of production factors and existing technology, and work better towards achieving organizational goals. Managers and policymakers should provide conditions where nurses can participate in determining the strategies and goals of the organization and consider themselves a part of the organization. [ABSTRACT FROM AUTHOR]

Background and Aim: Ionizing radiation protection is one of the most fundamental research and application fields in reducing the absorbed dose of sensitive internal organs. The presence of lead as the first radiation shield with a series of good features such as high density and having some flexibility and a series of bad features such as toxicity, low physical and chemical stability and high weight, have been thinking about replacing it for a long time. In the mammography section, the lead shields present during mammography cause limitations in the patient's work and are generally not used. As a result, they lose their efficiency. Therefore, it is necessary to propose and design a lead-free shield that can have suitable radiation attenuation in the range of mammography energy up to 60 keV and does not create limitations for the patient compared to the existing shields in this sector. Methods: In this study, the evaluation of X-ray and gamma-ray shielding for nine different proposed compounds was done using a computational code MCNPX based on the Monte Carlo method, in the photon energy range of 15 to 400 keV, which is the energy range used in Covers the mammography section. Results: Among the selected protective compounds, the combination of Kennertium showed a more suitable protective function than the other compounds. To reach such a result, the mass attenuation coefficient of the Kennertium compound has been calculated in three thicknesses of 0.1, 0.5, and 1 cm. In the following, to check the performance of selected shields of ionizing radiation, for the thickness of 1 mm of Kennertium composition, the dose reached the tissues close to the tumoral area located in the patient's left breast, such as the left lung, thyroid, and heart, has been calculated with the presence of such protection. Conclusion: Quantitative results show that the Kennertium compound completely covers the energy range above 60 keV and as a proposed compound for interacting with X-rays, does not produce secondary particles. [ABSTRACT FROM AUTHOR]

Background & Aim: The postpartum period is accompanied by rapid physiological changes that expose mothers to sleep pattern disturbances and threaten the health of mothers and their infants. In order to maintain and improve mental health and sleep quality in this era, it is necessary to empower mothers with a suitable model. Therefore, the present study was conducted to investigate and compare the effects of family-centered and individual-centered empowerment programs on the sleep quality and mental health of primiparous women in the postpartum period. Materials & Methods: This randomized clinical trial study was conducted on two groups, from late 2019 to June 2020. After sampling using the convenience method, 86 women were randomly assigned to either the family-centered or individual-centered group. The research tools included a demographic information questionnaire, a questionnaire on personal and environmental factors affecting fatigue and sleep, the Pittsburgh Sleep Quality Index, and the General Health Questionnaire. In the family-centered group, the empowerment program was implemented based on the four-stage model of perceived threat, self-efficacy enhancement, self-esteem, and assessment of quality of life components for primiparous mothers in the postpartum period, along with their spouse and infant. However, in the individualcentered group, the mothers were the only ones undergoing the intervention. In the three stages prior to the intervention and one month after the intervention, sleep quality and mental health questionnaires were completed by the research units. Finally, the data were analyzed using descriptive and analytical statistical tests, including the Mann-Whitney, Friedman, Wilcoxon, and Smirnov-Kolmogorov tests, using SPSS-21 software due to the non-normal distribution of the data. Results: The results of the study showed that the sleep quality score and mental health score of primiparous women after delivery in the two family-centered and individual-centered empowerment groups did not show any significant statistical differences before and immediately after the intervention(P>0.05). However, one month after the intervention, in the family-centered group, both research variables had significantly improved(P<0.05). Conclusion: Postpartum empowerment of primparous women using family-centered and individualcentered patterns lead to improvements in their sleep quality and mental health. Empowerment with family support plays a more effective role. Therefore, empowerment programs should be implemented with the support of spouses and key family members during pregnancy and continued in postpartum care. [ABSTRACT FROM AUTHOR]

Background & Aim: One of the most important aspects of nurses' performance is their adherence to the principles of professional ethics, which can affect the spiritual health of nurses. This study was conducted with the aim of determining the relationship between professional ethics and spiritual health of Iranian nurses. Materials & methods: This correlational study was carried out on 250 nurses working in medical and educational centers affiliated to Hamadan University of Medical Sciences, Hamadan, Iran, in 2018 using stratifies random sampling technique. Data collection tools were a demographic form, a performance measurement scale based on nursing professional ethics, and Paloutzian and Ellison’s Spiritual Well-being Scale. The validity and reliability of the questionnaires were confirmed. Descriptive statistics including mean, standard deviation, relative frequency, Pearson correlation coefficient and structural equation modeling (SEM) technique were used to analyze the data. Results: The results showed that the mean age of the participants was 23.2±7.8 years.The mean scores of spiritual wellbeing and professional ethics were measured as 69.69±10.28 and 180.89±19.47, respectively. The findings of the present study indicated a significant relationship between the mean scores of spiritual wellbeing and professional ethics (r=0.478; P<0.001). Moreover, professional ethics showed a significant correlation with the dimensions of spiritual wellbeing (r=0.398) and existential health (r=0.302; P<0.001). Conclusions: According to the results of this study, there was a statistically direct relationship between spiritual well-being and professional ethics. On this basis, it is necessary to pay attention to these variables in the community of nurses. [ABSTRACT FROM AUTHOR]

Background & Aim: Caregivers of cancer patients play an important role in the admission and treatment process. Sometimes caregivers suffer from mental and physical problems that can have a negative impact on the treatment and recovery process of cancer patients. The aim of this study is to investigate the rate of major depression in caregivers of breast cancer patients undergoing chemotherapy referred to 5 Azar Hospital in 2021. Materials & Methods: In this cross-sectional study, caregivers of breast cancer patients undergoing chemotherapy referred to the clinic and oncology department of 5 Azar Hospital in Gorgan in 2021 were examined. A number of 127 caregivers were selected based on the inclusion criteria. after obtaining a written consent form from the caregivers, the Beck depression questionnaire (BDI-II) and the demographic information checklist were completed. Data were measured with SPSS23 statistical software and frequency tests (number-percentage), chi-score and Fisher's exact test. The significance level was 0.05. Results: 61.4% of caregivers were female and 56.7% of them were over 35 years old (middle age). 69.3% were married, 81.1% were from Fars, and 56.7% had university education. 16.5% mothers, 52.8% children and 30.7% husbands were sick. Out of 46.5% caregivers, 9.4% had mild depression, 25.2% had moderate depression, and 11.8% had severe depression. There was no significant relationship between depression and age, gender, and education level. Conclusion: The level of depression among the studied subjects was significant, but the level of depression of the patients' caregivers had no significant relationship with their gender, age, education and ethnicity. [ABSTRACT FROM AUTHOR]

Background & Aim: Delirium is a multifactorial phenomenon that can be influenced by demographic factors. The present study was conducted with the aim of determining the relationship between demographic and clinical components with the occurrence of delirium in patients hospitalized in the intensive care unit of hospitals affiliated to Kurdistan University of Medical Sciences. Maerial & Methods: The present study was conducted between June 2021 and August 2022 in Kurdistan province and on the number of 118 patients hospitalized in the intensive care unit who were selected by available sampling method. The evaluation of delirium between the hours of 4 and 8 in the afternoon was checked by the researcher. The patients were divided into two groups and both groups were evaluated for delirium with the CAM (ICU) tool. The data were analyzed with the help of STATA version 12 software. A significance level of P<0.05 was considered statistically significant. Results: Most of the patients participating in the study did not have delirium (56.78%). A significant relationship was observed between marital status, education level and the reason for hospitalization with delirium (p<0.05). Also, body temperature, blood pressure and heart rate had a statistically significant relationship with the occurrence of delirium (p<0.001). Conclusion: Because the core of delirium management protocols is based on prevention and diagnosis, evaluation and compilation of the accurate history of patients in the form of demographic components can play a significant role in the prevention and management of delirium. [ABSTRACT FROM AUTHOR]

Background & Aim: Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract that affects 5-30% of the world's population and is characterized by abdominal pain and changes in bowel habits. It has been shown that mood; anxiety and physical disorders are associated with different degrees of psychological distress in patients with IBS. The purpose of the present study is to compare the frequency of psychiatric symptoms of irritable bowel syndrome patients one year after diagnosis with the control group using self-assessment method. Materials & methods: In this descriptive-cross-sectional study, the number of 48 patients with irritable bowel syndrome (according to the Rome IV criteria) and 48 non-sufferers among those who referred to the gastroenterology clinic of Shahid Sayad Shirazi Hospital in Gorgan, with the available sampling method Selection and study were entered. Informed consent was obtained from the participants. Data were collected using checklist and SCL-90-R questionnaire. Then, using SPSS version 16 software and chi-square and Mann-Whitney tests, they were analyzed statistically. Results: The two groups of case and control were similar in terms of demographic variables, including age, gender, education, marital status, and place of residence (p<0.05). There was no difference between the two groups in terms of the total score and the score of the subscales of SCL-90-R (p<0.05). None of the demographic variables and psychiatric symptoms were identified as risk factors for IBS (p<0.05). Conclusion: Based on the results of this study, patients with irritable bowel syndrome are similar to non-affected people in terms of psychiatric symptoms. Also, demographic variables and psychiatric symptoms are risk factors for they did not suffer from irritable bowel syndrome. [ABSTRACT FROM AUTHOR]

Background & Aim: Vaginismus disorder is the second most common sexual dysfunction in women. Therefore, a therapeutic strategy that specifically deals with the symptoms and psychological problems caused by it will be the way forward. Therefore, the present study was performed with the aim of the effectiveness of vaginismus-specific schema therapy on the fear of intimacy in women with vaginismus disorder. Materials & Methods: This research was a semi-experimental study with a pretest, posttest and follow-up design with a control group. In the winter of the year 2022, a statistical society of women with vaginismus symptoms referred to the midwifery clinic and women's hospital of Piambaran in Tehran. Among them, 45 individuals were purposefully selected and divided into three groups, each consisting of 15 participants. Descutner & Thelen (1991) fear of intimacy questionnaire was used to measure the dependent variable. Two experiment groups were treated in 10 sessions of 90 minutes each, and the control group did not receive any intervention. The data were analysed using variance analysis of repeated measures and Bonferroni's post-hoc test in SPSS software-22. Results: Both vaginismus-specific schema therapy and common schema therapy affected reducing the perceived fear of intimacy in women with vaginismus disorder compared to the control group (p<0.001). According to the comparison of the difference between the averages of the two intervention groups and the control group, the vaginismus-specific schema therapy had a greater effect on the improvement of the fear of intimacy than the common schema therapy (p<0.001). Conclusion: The results of the research showed that the new schema therapy package for vaginismus can reduce the fear of intimacy among women with vaginismus by identifying their problems. [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 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]

Introduction: Domestic violence occurs in different ways in families. Parent abuse is a type of psychological, physical, or financial violence practiced by children against their parents. This study aimed to investigate the prevalence of parent abuse in high school boy students during the coronavirus pandemic. Material & Methods: The research method was descriptive-cross-sectional. The statistical population was all mothers of high school boy students in Khuzestan, Iran, in the academic year 2020-2021, of which 676 were selected by multistage cluster sampling. In this study, the Parent Abuse Scale (boy version) and demographic inventory were used. The data were analyzed with descriptive statistics (mean, standard deviation, and percentage) and t-test using SPSS software (version 22). Results: The findings of this study showed that the prevalence of physical abuse is 6.2%, emotional abuse 5%, financial abuse 11.4% and parental abuse in Corona epidemics is 4.1%. In addition, the findings of this study compared to the studies before the Corona outbreak showed that the prevalence of parental abuse of high school boy students in Khuzestan province was lower in the context of the coronavirus epidemic. Discussion & Conclusion: Despite the fact that the number of parental abusesin Iranian society is significant, the rate of parental abuse in high school boy students during the Coronavirus in Khuzestan showed no increase. It is suggested to investigate strategies that have created and maintained positive interactions in the family. [ABSTRACT FROM AUTHOR]