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Aim: This study aimed to determine the clinical profile of patients with seronegative celiac disease (SNCD). Background: Celiac disease (CD) is mainly diagnosed based on positive serology and duodenal mucosal atrophy, but some patients have negative serology. Their diagnosis has some limitations; delays in diagnosis are likely accompanied by a poor prognosis and a high risk of developing complications of CD. Methods: In this retrospective study, 1115 patients were evaluated for CD with mucosal atrophy between 2010 to 2020. SNCD diagnosis requires genetic CD predisposition and improvement of both clinical symptoms and regrowth of duodenal villi after 12 months of a gluten-free diet (GFD) for all patients with IgA deficiency, other IgG-based serology for diagnosis of celiac was done and if these antibodies were negative, consider them as possible SNCD. If they had positive DQ2-DQ8 and improvement of clinical symptoms and mucosal atrophy after 12 months of GFD were confirmed SNCD. Results: Of the 1115 study subjects, 27 had SNCD, 1088 had SPCD with a mean age of 29.7±15.7 years (1 to 76 years) in seropositive celiac disease (SPCD) subjects and 37.1±16.3 years (6 to 63 years) in SNCD participants and 19 female patients with SNCD were presented. The BMI of SNCD and SPCD patients were reported 23.9 and 21.4, respectively. In addition, SPCD subjects were more likely but not statistically significant to have a positive family history. Villous atrophy was shown in 100% SNCD and 95.6% SPCD cases. Scalloping and fissuring in duodenal biopsies were reported in 60% of SNCD and 84.5% of SPCD patients. There was some other cause of seronegative villous atrophy including 3 patients with Crohns disease, 2 with common variable immunodeficiency, 2 drug and one patient with peptic duodenitis. Anemia, neurological symptoms, and liver function tests (LFT) abnormality were common extra intestinal manifestations in SNCD individuals. Levels of Thyroid peroxidase (TPO), TSH were measured, it had been detected that SNCD cases had a higher rate of co-occurrence with thyroid diseases also SPCD cases showed a higher rate of co-occurrence with diabetes. Conclusion: Among patients with celiac disease 2.4% are SNCD. SNCD are older than SPCD at the time of diagnosis and have higher BMI. Most common of cause of seronegative enteropathy also is SNCD followed by inflammatory bowel disease (IBD) common variable immunodeficiency (CVID), medication use, and duodenitis, in this area. [ABSTRACT FROM AUTHOR]

Spirulina platensis is abundant biomass of cyanobacteria (blue-green algae) which is applied in the current study as a biosorbent. A statistical Box–Behnken approach was adopted to remove the toxic dye of alizarin red S (ARS) from synthetic solutions. A polynomial equation was developed to predict the dye removal efficiency and elucidate the interaction effects of variables. The maximum removal efficiency of ARS (69.1%) was obtained at pH 6.5, mixing time of 42.5 min, dye concentration of 100 mg. L−1 and S. platensis dose of 1.5 g. L−1. The findings indicated that the biosorption rate of ARS had a direct relationship with the ARS concentration, pH, reaction time, and S. platensis dose. The quadratic model suggested that the ARS concentration is the major variable in ARS removal. The isotherms and kinetics data could be suitably reflected by the Langmuir model and the pseudo-first-order equation. The maximum adsorption capacity of S. cerevisiae was obtained to be 17.15 mg. g−1 based on the Langmuir model. The results showed that the removal rates of ARS from the first cycle up to the fourth cycle were varied from 55% to 20%, respectively. In conclusion, S. platensis shows suitable adsorptive characteristics and hence could be suggested as a viable option for future studies. [ABSTRACT FROM AUTHOR]

Background: Survival after breast conserving surgery (BCS) vs. modified radical mastectomy (MRM) is a controversial issue. In this study, we want to compare the disease-free survival (DFS) of women who underwent BCS with those treated by MRM. Method: In this historical cohort study, a total of 1097 women who were diagnosed with breast cancer between 2001 and 2007 and received modified MRM or BCS were entered into the study and followed up to March 2017. Kaplan-Meier estimator and extended cox model, and Cox proportional hazards model with propensity score weighting were implemented to compare overall survival between two groups. Results: A total of 283 women with a maximum follow-up of 11.1 years and age 47.17 ± 11.278 were met the inclusion criteria. The results of the extended cox model did not show any difference between the survival of two groups (P = 0.35). After implementing the Cox model with propensity score weighting, the inferences remained unchanged (P = 0.67). Conclusion: The patients treated with BCS tend to have the same DFS rate as those who underwent a mastectomy in a randomized controlled trial-like setting using propensity score weighting. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the effect of crocin on the prevention of atrial fibrillation after coronary artery bypass grafting (CABG) and heart valve replacement. Materials and Methods: 100 patients who were scheduled for CABG or heart valve replacement surgeries were randomly assigned into two groups of treatment and placebo. In the treatment group, patients received crocin tablets from three days prior to surgery and on the first three postoperative days (for a total of six days). During the first three days after surgery, postoperative atrial fibrillation (POAF) was assessed by electrocardiogram monitoring. Prooxidant-antioxidant balance (PAB) and c-reactive protein (CRP) levels were also assessed. Results: POAF developed in 7 patients in the treatment group versus 18 patients in the control (p=0.02). PAB levels were significantly lower in the crocin group (p<0.001), while differences in CRP levels were insignificant (p=0.39). Conclusion: It seems that prophylactic use of crocin is effective in reducing the incidence of POAF in patients undergoing heart surgeries. [ABSTRACT FROM AUTHOR]

Background: Perineal trauma is a common problem seen after vaginal delivery, which has negative effects on different aspects of women's lives. Poor skin elasticity has been introduced as a predictor of perineal trauma, and the appearance of striae gravidarum is associated with poor skin elasticity. This review aimed to determine the association between perineal trauma and striae gravidarum through a systematic review and meta-analysis. Materials and Methods: We searched with MeSH terms ("Perineum" AND "Lacerations" OR "Rupture" AND "Striae Distensae") and their equivalents in databases PubMed, Scopus, Science direct, Web of Science, ProQuest, Scientific Information Database (SID), Magiran, and Google Scholar search engine without time and language restrictions from the beginning of May until the beginning of September 2020. After reviewing the inclusion and exclusion criteria, and quality evaluation, ten articles were included in the systematic review, and we analyzed data of 6 articles using Stata ver 11.2. Results: The results indicated that the rate and severity of perineal trauma were directly related to the severity of striae gravidarum (OR = 8.28, 95%CI = 2.49–27.54, I2 = 86.64%). Conclusions: Based on the research results, the probability of perineal trauma was higher in individuals with moderate to severe striae than those with mild or without striae; therefore, we suggest evaluating striae score in the third trimester of pregnancy as a simple and noninvasive method to predict the risk of perineal trauma during childbirth. For reducing perineal injuries in women at risk, some supportive measures such as episiotomy and perineal massage are recommended. [ABSTRACT FROM AUTHOR]

Purpose: To identify the predictors of nurses' presence at hospitals at the time of three types of disasters. Design: This cross‐sectional study was performed using a researcher‐generated questionnaire. Methods: This study was performed on 350 nurses of five public hospitals. Data was collected using a questionnaire in which the respondents were asked about their decisions on reporting for work in the event of three scenarios: epidemic of an unknown contagious respiratory disease, earthquake, and flood. Multiple logistic regression was used to analyze the data. Findings: The four predictors of nurses reporting for work include receiving trainings on disasters, and concerns on the non‐compensation for providing services following the disaster, concerns about family safety and workplace safety. Conclusion: Although slightly different factors affect the willingness of participants to report for work in each scenario, they can be put in two main categories; namely as personal and impersonal. Devising a family disaster plan and providing educational programs on self‐care are two main strategies to increase the chances of presence at work following disasters. Clinical relevance: The presence of more nurses in the hospital at the time of disasters can significantly improve the quality of care, and clinical outcomes of patients and disaster victims. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) not only has put populations at risk for mental and sexual health risks. This systematic review and meta-analysis was performed on published articles reporting female sexual function before and during COVID-19 pandemic in PubMed, Web of Science, Scopus, Google Scholar, Magiran and SID databases till August 2021. From the initial 3198 articles, 8 articles were included in the review. Meta-analysis showed no significant difference in total FSFI score and its domains during the COVID-19 pandemic and the pre-pandemic period. Further studies should separately evaluate the effect of lockdown on female sexual function. [ABSTRACT FROM AUTHOR]

Background and Objective: One of the negative emotions that any person can have is stress, it seems that emotional intelligence can help to deal with it. The purpose of this study was to determine the predictive power of emotional intelligence components on coping skills in Neishabour medical students in 2020. Materials and Methods: This cross-sectional study was performed on 200 students of Neishabour University of Medical Sciences by convenience sampling method. Data were analyzed using SPSS software version 19 and inferential statistics (MannWhitney, Kruskal-Wallis, Pe arson-Spearman correlation and linear regression). Results: In this study, the mean (± standard deviation) of academic stress was 137.5 (23.7) and emotional intelligence was 98.8 (13.1.). The results showed that the components of emotio nal intelligence including self-management (p <0.001), relationship management (p <0.001) and self-awareness (p = 0.01) were significantly predictors of coping skills in academic stress in students of Neishabour University of Medical Sciences and They were able to predict 27.1% of academic stress. Conclusion: Based on the results, an emotional intelligence component could be used as a suitable method to predict academic stress coping skills. Furthermore, given that the components of self-management, relationship management, and self-awareness have the greatest impact on predicting academic stress, there is a need to pay more attention to these issues in educational programs. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BC) is the most frequent cancer in Iranian females. Due to the changes in lifestyle and reproductive risk factors, the BC incidence rate has been rapidly increasing. Knowing risk factors of BC could significantly contribute to improve preventive behaviors. To investigate the relationship between menstrual and reproductive factors and BC in Iranian female population. Methods: Web of Science, PubMed, Scopus, and SID as well as references of included studies were searched. Among relevant published observational studies, 27 studies met the inclusion criteria. Pooled risk estimates for the risk factors were determined using random-effects models due to the presence of substantial heterogeneity (P < 0.05). Results: All of the selected studies had case-control design. There was a positive relationship between maternal age at first pregnancy and risk of BC (OR = 1.79 95% CI: 1.36-2.35). Also, menopausal status was associated with higher risk of BC (OR = 1.60 95% CI: 1.18-2.17), whereas, there was no association between menarche age and increased risk of BC (OR = 0.55 95% CI: 0.29-1.03). History of abortion (OR = 1.21 95% CI: 0.97-1.5), nulliparity (OR = 1.43 95% CI: 0.89-2.31), and breastfeeding history (OR = 0.68 95% CI: 0.42-1.09) were not associated with BC risk. Conclusions: Our findings suggest that age at the first pregnancy and menopausal status were significantly associated with BC risk among Iranian women, whereas menarche age, nulliparity, and history of breastfeeding were not. In regard to the history of abortion, our findings revealed no association with BC, but in high-quality studies, this relationship was significant. [ABSTRACT FROM AUTHOR]

Background: Nurses play an essential role in the hospital's response to accidents and disasters. Assessing nurses' preparedness is the starting point to improve and increase their preparedness for disasters. Therefore, this study aimed to investigate the preparedness of nurses of a 650-bed district hospital in Herat, Afghanistan in the face of disasters in 2020. Materials and Methods: This was a cross-sectional study, and the study subjects included all nurses working in a 650-bed district hospital in Herat Province. The data collection tool was a standard questionnaire to determine the level of preparedness of nurses against accidents and disasters, which was localized. This questionnaire included three areas of knowledge, attitude, and performance. The maximum score in each of the domains was 100. To analyze the data, descriptive indicators, such as mean, median, standard deviation, and quartiles, and analytical methods such as independent t-test, 1-way analysis of variance, the Mann-Whitney and Friedman nonparametric tests, and the Spearman correlation coefficient-test were used. Results: The Mean±SD scores obtained by the participants in each of the areas of knowledge, attitude, and performance (behavior) were 30±12, 81±12, and 40±7, respectively. The study's findings showed a statistically significant relationship between knowledge score and the duration of disaster education and management history. Also, a statistically significant association was observed between performance and variables of age, gender, marital status, education level, work experience, management history, duration of training received on disasters, and history of previous disaster exposure. Conclusion: Considering that the preparedness of nurses participating in this study was lower than average in two of the three areas, the level of preparedness of nurses for disasters is low and undesirable and requires measures, such as holding regular theoretical and practical training courses to increase it. [ABSTRACT FROM AUTHOR]

Background: The impact of initiation time of radiotherapy after breast surgery on disease-free status of patient is a controversial issue. We assessed the relationship between the delay in adjuvant radiotherapy and surgery and relapse or metastasisfree survival in women with breast cancer taking heavy censoring into account. Method: This was a historical cohort study on 284 patients with breast cancer, who underwent surgery between 2001 and 2007 and followed up until March 2017. The association of the duration between radiotherapy and surgery, as well as other demographic and clinical factors with occurrence of local relapse or metastasis of breast cancer was examined through penalized Cox regression modeling. The obtained data were analyzed using R 3.6.3. Results: A total of 284 women with the mean age of 47.2 ± 11.3 years met the inclusion criteria. The maximum follow-up time was 11.1 years and the time between surgery and radiotherapy was 168 ± 84.3 days. About 10% of the patients experienced local relapse and 19% had metastasis. In multiple analysis of factors related to diseasefree survival, the stage of disease was significant, while surgery to radiotherapy interval (≤180 days vs >180 days) did not have any significant impact on hazard of failure. Analysis of 3, 4, or 5 months of delay in radiation therapy did not imply any significant affects. Conclusion: In the studied patients, the delay in radiotherapy initiation after surgery did not lead into outcomes of local relapse or metastasis. [ABSTRACT FROM AUTHOR]

Elderly patients undergoing surgery often suffer from sleep disorder. Holistic therapies might help them sleep better. The aim of this research was to determine the effect of guided imagery along with breathing relaxation on sleep quality in elderly patients undergoing abdominal surgery. A double-blind randomized clinical trial was conducted on 90 elderly patients undergoing abdominal surgery in 2 educational hospitals in 2018, Mashhad, Iran. The elderly patients with different abdominal surgical procedures were distributed to the wardrooms and then the rooms were randomly assigned into 2 groups. In the intervention group, the patients learned breathing relaxation the day before surgery and then an audiotape was provided to perform the guided imagery from the day before surgery for 5 days (twice) along with breathing relaxation. St Mary's Hospital Sleep Inventory was completed the night before, 48 hours and 96 hours after the surgery. Data analysis was done using SPSS 21 through analytical tests. Results of the test indicated that the score of sleep quality was significantly higher in the intervention group the night before surgery (P = .001). The total scores of sleep quality in the intervention group 48 and 96 hours after the surgery were significantly higher (P < .001). Based on results of generalized estimating equation model, the score of sleep quality for patients was 8.76 units higher in the intervention group than in the control group by controlling for the effects of time. Guided imagery along with breathing relaxation improved the sleep quality of the elderly patients undergoing abdominal surgery. Trial registration: IRCT20180731040652N1. [ABSTRACT FROM AUTHOR]

Introduction: The correlation between the timing of radiotherapy commencement following breast surgery and the disease - free status of patients remains a topic of debate. In this study, we investigated the association between the delay in adjuvant radiotherapy post - surgery and the survival free from relapse or metastasis in women with breast cancer, considering the substantial presence of censored data. Methods: Conducted as a historical cohort investigation, this study involved 284 individuals diagnosed with breast cancer who underwent surgical procedures between 2001 and 2007 and were subsequently monitored until March 2017. The research delved into the relationship between the interval separating radiotherapy and surgery, along with various demographic and clinical factors, and the incidence of local relapse or metastasis in breast cancer. This analysis was carried out using penalized Cox regression modeling, and the acquired data were subjected to analysis using R 3.6.3. Results: A total of 284 women, with a mean age of 47.2 ± 11.3 years, fulfilled the inclusion criteria for this study. The maximum follow - up period extended to 11.1 years, with the duration between surgery and radiotherapy averaging 168 ± 84.3 days. Approximately 10% of the patients encountered local relapse, and 19% experienced metastasis. In a comprehensive analysis of factors influencing disease - free survival, the disease stage emerged as a significant factor, while the interval between surgery and radiotherapy (=180 days vs. >180 days) did not exhibit any significant impact on the hazard of failure. Furthermore, the analysis of delays in radiation therapy lasting 3, 4, or 5 months did not reveal any significant effects. Conclusions: In the studied patients, the delay in radiotherapy initiation after surgery did not lead into outcomes of local relapse or metastasis. [ABSTRACT FROM AUTHOR]

Background: From the students' viewpoint the evaluation of teachers is one of the most important tasks of faculty evaluation aiming to strengthen the abilities, modify teachers' weaknesses, and improve the quality of teaching system. The present study aimed to determine the suitable structure to evaluate faculty members by the students' questionnaire, at the Health School of Mashhad University of Medical Sciences (MUMS), in the first semester of 2018-2019. Methods: The present research is a descriptive-analytic crosssectional study. The statistical population consisted of students from the School of Health of MUMS, in the first semester of 2018-2019. The Evaluation of Faculty Members by the Students Questionnaire (EFSQ) used at the School of Health of MUMS consisted of 12 questions with a 10-point Likert scale and 4 dimensions. This study used the exploratory and confirmatory factor analysis to assess the suitable structure of the EFSQ. Results: The mean of the total score of the EFSQ was 8.77±1.30 out of 10. The four-dimensional structure was not respectable, and the three-dimensional structure was appropriate. Conclusion: The current EFSQ used in MUMS is inadequate, and it is necessary to be revised. [ABSTRACT FROM AUTHOR]

Background: One of the major indications for digoxin use is the treatment of heart failure (HF). Although the clinical application of digoxin in long-term outcomes in patients with HF and reduced ejection fraction (HFrEF) patients is well explained, the association between digoxin therapy and outcomes in patients with HF and preserved ejection fraction (HFpEF) is not very clear., Objectives: The aim of this study was to show the clinical efficacy of digoxin on long-term outcomes in subjects with HFpEF., Methods: PubMed, Embase, Scopus and Web of Science (ISI) electronic databases were searched until May 2021 to obtain relevant studies. The primary outcome was all-cause mortality attributed to treatment with digoxin. The secondary outcomes were "all-cause hospitalization", "hospitalization because of HF" and "all-cause mortality or hospitalization of HF"., Results: Seven studies with more than 23000 patients with HFpEF, of which more than 4900 were treated with digoxin, fulfilled the eligibility criteria and were included in this meta-analysis. Treatment with digoxin was associated with a neutral effect on all-cause mortality (HR 1.04, 95 % CI 0.91-1.20, I2 = 57.9 %), all-cause hospitalization (HR 0.97, 95 % CI 0.88-1.07, I2 = 0.0 %), HFhospitalization (HR 0.96, 95 % CI 0.90-1.02, I2 = 41.4 %), and all-cause mortality or HFhospitalization (HR 1.07, 95 % CI 0.91-1.26, I2 = 81.2 %). In subgroup meta-analyses based on ejection fraction (EF), treatment with digoxin did not significantly alter these outcomes in each subset of patients., Conclusion: The results of this meta-analysis suggest that digoxin does not have any significant effect on long-term outcomes of HFpEF patients, including "all-cause mortality", "all-cause hospitalization", "hospitalization because of HF" and "all-cause mortality or hospitalization of HF"., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Objective: The aim of this study was to evaluate the effect of crocin on the prevention of atrial fibrillation after coronary artery bypass grafting (CABG) and heart valve replacement., Materials and Methods: 100 patients who were scheduled for CABG or heart valve replacement surgeries were randomly assigned into two groups of treatment and placebo. In the treatment group, patients received crocin tablets from three days prior to surgery and on the first three postoperative days (for a total of six days). During the first three days after surgery, postoperative atrial fibrillation (POAF) was assessed by electrocardiogram monitoring. Prooxidant-antioxidant balance (PAB) and c-reactive protein (CRP) levels were also assessed., Results: POAF developed in 7 patients in the treatment group versus 18 patients in the control (p=0.02). PAB levels were significantly lower in the crocin group (p<0.001), while differences in CRP levels were insignificant (p=0.39)., Conclusion: It seems that prophylactic use of crocin is effective in reducing the incidence of POAF in patients undergoing heart surgeries., Competing Interests: The authors have declared that there is no conflict of interest.

Purpose: To investigate the long-term changes of intraocular pressure (IOP) after pars plana vitrectomy (PPV)., Methods: This was a retrospective historical cohort study. Patients with a history of vitrectomy in one eye by a single surgeon were enrolled. IOP of the operated eye was compared to the fellow eye. Previous scleral buckling, IOP rise due to surgical/anatomic complications, silicone oil (SO) emulsification, and contralateral ocular hypertension/glaucoma at recruitment were exclusion criteria. "Significant IOP rise" (>6.0 mmHg) and development of open angle glaucoma (OAG) were the main outcome measures., Results: Two hundred and twenty-five eyes were included. Mean and median follow-up duration were 20.6 and 9.0 months, respectively. Mean baseline IOP and mean final IOP were 13.53 ± 3.75 mmHg and 16.52 ± 6.95 mmHg, respectively ( P < 0.001). Forty-three patients developed "significant IOP rise" with no statistically significant relation to the indication of vitrectomy, the postoperative lens status, and number of vitrectomies ( P = 0.410, P = 0.900, and P = 0.160, respectively). SO injection raised the probability of IOP rise in the long-term ( P = 0.028). OAG occurred in 17 patients (7.5%) with no association to SO tamponade ( P = 0.840). "Significant IOP rise" and OAG occurred in 3 and 1 control eyes, respectively, significantly lower than the rates in study eyes ( P < 0.001)., Conclusion: Mean IOP slightly rose in the long-term after PPV. SO tamponade was associated with IOP rise in the long-term but not with the incidence of OAG. Both IOP rise and OAG were more probable after vitrectomy., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Current Ophthalmology.)