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ABSTRACT Background and Aim Delay in diagnosis and treatment of lung cancer is thought to be a major cause of its poor outcomes. We evaluated the delays within the presentation to the initiation of diagnostic and therapeutic interventions amongst lung cancer patients in Southern Iran. Methods This cross‐sectional study was conducted from March 2019 to March 2021. The data collected through interview included socio‐demographic, medical and clinical findings, and the time intervals needed to visit physician, refer to specialist, request diagnostic procedures, reach diagnosis of lung cancer, and hospitalization. Results Eighty‐nine patients (58 males and 31 females) with a mean age of 61.01 ± 12.25 years were included. The median time of symptom presentation and first physician visit interval was 25 days. Sixty‐five days were spent for requesting, performing, and evaluating the diagnostic procedures. The median interval between diagnosis and initiation of treatment was 16 days. Totally, it took an average of 122 days from the presentation to the definite diagnosis of lung cancer. Patient‐, diagnosis‐, and treatment‐related delays were not significantly correlated with any of the demographic, socioeconomic, and clinical (disease stage, symptom) variables, as well as the diagnosis tool and the first physician who visited the patient (p > 0.05). Conclusions There was a significant delay but relatively similar to other countries in the diagnosis and treatment of lung cancer patients in Southern Iran. The largest portion of delay could be attributed to the raising clinical suspicion in the physicians, referral for diagnostic assessments, and the diagnosis process.

Background: Intimate partner violence (IPV) is a significant public health issue, especially in developing countries. This study aimed to provide a systematic review and meta-analysis of IPV among married Iranian women.Methods: In this systematic review and meta-analysis, following PRISMA guidelines, eight electronic databases were searched for quantitative articles, with the target population of married Iranian women. Articles from 2010 to 2020 were extracted and assessed with an 8-scored checklist for risk of bias. Different types of IPV include mental, physical, and sexual types. Heterogeneity was assessed with I2 and Q tests. Random effect model was used for meta-analysis. Factors such as income, education, employment, mean age, urbanization, and human development index (HDI) were assessed within homogenous groups.Results: Thirty-four studies (19,445 participants) were included. The mean age of women was 33.4 years. The overall prevalence of past-year IPV was estimated at 62.6% (CI: 53.6-71.5). Mental, physical, and sexual violence were estimated at 59% (CI: 53.7- 64.4), 30.8% (CI: 26.2-35.4), and 29% (CI: 22.4-35.5), respectively. The results revealed that a negative correlation existed between the occurrence of violence and higher education, higher HDI indices for regions, and employment.Conclusion: The findings of this study indicate that IPV exists in high proportions in Iran. Improving the economic situation, increasing education, and raising public awareness through social media are the preventive factors.

Clinical Key Message In patients receiving anti‐TNF‐α drugs for ankylosing spondylitis, monitoring purpuric and ischemic skin lesions is crucial. This case underscores the significance of identifying and addressing drug‐induced vasculitis while stressing the necessity for prompt evaluation and exploration of alternative treatment options to safeguard patient well‐being. Abstract The case discusses a 38‐year‐old female with a history of ankylosing spondylitis (AS) who presented with skin lesions, including purpuric skin lesions and ischemia of her right foot digits, after initiating treatment with adalimumab. After excluding other potential causes, such as infections and malignancies, the patient received a diagnosis of moderate‐sized vascular vasculitis associated with adalimumab use. Discontinuation of adalimumab and treatment with high dose glucocorticoids and intravenous pulse of cyclophosphamide resulted in the resolution of her ischemic lesions. This case underscores the importance of considering drug‐related side effects in patients with new skin lesions, particularly in the context of rheumatic diseases such as AS.

Abstract The Pittsburgh Sleep Quality Index (PSQI) is a self-reported questionnaire evaluating sleep quality based on seven domains of sleep disorders. However, the factor structure of PSQI needs to be well-established among medical students. This study was conducted to establish the factor structure of PSQI among medical students. Four-hundred and four medical students completed the PSQI. Considering each PSQI component as an "observed variable," exploratory factor analysis was conducted. Six models explaining the factor structure of PSQI were compared by confirmatory factor analysis to achieve the best model. All PSQI components were loaded on three factors. The first factor included sleep duration and habitual sleep efficiency, the second was subjective sleep quality and sleep latency, and the third was sleep disturbances, sleeping medications, and daytime dysfunction (root mean square error of approximation =

Lyrical literature, as one of the most widespread types of literature, is presented in the context of the "literary and emotional" function of language and expresses the personal feelings and emotions of the "speaker". The purpose of this type of literature is to report and express the feelings of the speaker and, at the same time, to please the audience. Each of the speakers of lyrical literature, according to the theme of their work, has used components that have given a lyrical color to their work and have distinguished it from other literary works. The methods of using lyrical elements in each of the systems of Persian literature are numerous and diverse. Factors such as "lyrical compositions and interpretations", "soft and delicate descriptions", "sad and isolationist atmosphere", "loving and beloved action", "inner monologues of the main character", etc. are the most prominent manifestations of lyrical literature. This study tries to study the lyrical poems of "Badnauni's Sinner", one of the unknown poets of the return period, by using the ideational metafunction in the Functional Approach of Halliday. This lyric poet used different methods to express his lyrical thought, and it is noteworthy that he changed his attitude during his poetic period, and from his initial attitude, which was similar to the love poems of the Iraqi style house, in a period of his life he leans towards the view of the poets of "Maktab Voqou’". This study tries to answer the question that based on the paradigm of thought and the evolution of the worldview of the "Bedouin sect" in lyrical poems, what changes have caused the level of use of "verbs"? Findings show that the change, decline, and ultimately degradation of the status of "beloved" as the main character of his lyric poems are shown through the reduction of the presence of this participle in "material and mental processes" and the high frequency of "interrogative clauses" which mean "reproach and exclamation".Keywords: Lyrical Literature, Functional Approach, Ideational Metafunction, Mozneb Badayouni. IntroductionSome of the valuable works of Persian culture and literature are manuscripts that remain unknown and have not yet been corrected or published. In this regard, one of the tasks of Persian literature researchers is to revive precious works. Mozneb Badayouni is one of the poets of the Qajar period and the return literary style, whose Divan (book of poems) remains unknown to researchers and lovers of Persian literature. After searching in the system of important libraries such as the National Library, the Central Library of Tehran University, the Malik Library, the Islamic Council, Astan Quds Razavi, and some libraries of other countries such as the Michigan Library and the National Library of England, it was found that no proofreading and research was done on this copy; therefore, it is necessary to address this issue in order to introduce a poet of the Qajar period and the return literary style to the literary community of the country, so that researchers and those interested in the hidden treasures of Persian literature can take the next steps to clarify areas such as the worldview of the poet from the political-social situation of the period. So far, no significant action has been taken regarding Mozneb Badayouni and his divan; no special research has been done about the life and cultural and literary personality of Mozneb, and some biographies have only mentioned his name and sign. Therefore, this research about Mozneb is considered an unprecedented and new work.The author of these lines, as the first researcher, corrected the Divan of Poems of a creative poet, so that in this way, interested people will get to know one of these valuable and neglected works, called "Divan of Poems of Mozneb Badayouni"."Lyric literature" as one of the most extensive types of literature, is presented within the framework of the "literary and emotional" function of language and expresses the personal feelings and emotions of the "speaker". The purpose of this type of literature is to report and express the feelings of the speaker and, at the same time, to give pleasure to the audience. Each of the speakers of lyrical literature has used components that give their work a lyrical color and make it different from other literary works. The ways of using lyrical elements in each of the Persian literature systems are numerous and diverse. Factors such as "lyrical compositions and interpretations", "soft and tender descriptions", "sad atmosphere and isolation", "lover and beloved activism", "inner monologues of the main character", etc. are among the indicators. The most expressive forms of literature are lyrical. This research tries to study the lyrical poems of "Mozneb Badayouni", one of the unknown poets of the return period, by using ideational metafunction in Halliday’s Functional Approach. The main content of his poems is the concept of "love" and specifically "earthly love". In many of his romantic lyric poems, he looked at the concept of "love" and the relationship between "lover and beloved" in the manner of his predecessors, such as Saadi, Kamal al-Din Isfahani, Hafez, etc, and presented the same picture that the likes of Saadi have drawn of the lover.Besides this concept, traces of "Malamatiyya thought" can also be seen in many cases in his Ghazals. Mozneb has considered "love" as the highest concept of existence and "May, Maykadeh" as one of the most popular concepts and places in his Malamati attitude. In his Ghazal, words such as "bloody", "killed", "cruel", "ruthless", "hard-hearted" etc. have a significant frequency, which clearly reminds us of "beloved" in the poetry of the Iraqi period. Of course, sometimes the semantic load of these words has intensified and they have been replaced by words such as "murder", "killer" and "killed". Mozneb Badayouni, the lyrical poet, used different methods to express his lyrical thought, and the point to consider is that during his period as a poet, he changed in his attitude, from his initial attitude in a period of his life to the viewpoint of the poets of the Maktab Voqou’ and Va Soukht. It tends to occur and burn. This method has created the most changes and transformations in the poetic subjects after the Iraqi style. According to political and social reasons and, as a result, cultural and literary issues during half a century, this school established principles and foundations for itself, which continued its life purposefully and coherently during the Qajar era. The language of the poetry of the mentioned period is generally an imitation of the poetry of the Iraqi and Khorasani periods. but by studying the works of the poets of this period, we find out that the poets of the return, as they should, do not have a good command of the rules of morphology and syntax and other aspects of the language of the poetry of the past periods (Iraqi-Khorasani), which is why their language is crude and elementary. On the other hand, some linguistic issues of this period are influenced by the Indian style, or the Afshariya and Zandiye periods. This research tries to answer the question that, based on the ideational metafunction, the evolution of the worldview of "Mozneb Badayouni" in lyric poetry has caused what changes in the level of used "verbs"?Systemic Functional Grammar is organized based on three metafunctions: ideational metafunction, interpersonal metafunction, and textual metafunction. Ideational metafunction means re-expressing the experiences that were created in connection with the outside world and then transferred to the mind. Since the ideational metafunction is the result of the combination of the process (verbal group), the participants of the process (nominal and adjective group), and the event (adverbial group), it can represent past experimental realities through grammatical structures. This potential capacity is provided by the mechanism or system of expressing ideational metafunction in language, which is called the "Transitional System". Literature ReviewAfter the emergence of functional linguistics in the West, some researchers in Iran also analyzed literary texts based on the teachings of this approach. Aghagolzadeh (1384) has discussed the role, application, and importance of the Functional approach in the analysis and explanation of literary works, and while explaining Halliday's theoretical issues, he has analyzed Hafez's Ghazals in the framework of the functional approach. Khan Jan and Mirza (2005) tried to provide a functional analysis of poetic discourse and effective factors in poetic communication. Jahani and Hosseini (2019) in research entitled "Analysis of ideational metafunctions in the Poem "Khan-e Hashtom" by Mehdi Akhavan Sales… showed that in this poem, Akhavan makes the most use of mental processes and then relational and verbal processes. The narrative form of the story, the presence of a narrator in the narration and then the presence of the poet as the second narrator, the predominance of the descriptive structure of the story, and also the connection with the story of Haft Khan Rostam can be considered the most important reasons for the use of these types of processes in this poem. Monshizadeh and Elahian (2014) tried to understand the fundamental components of Saadi's Golestan and explained their main features in the construction and selection of various processes, and concluded that since the subject of Golestan is related to humans and the relationships between humans, the behavioral process is the most obvious in Saadi's intellectual poetry. Miladi and Vafaei (2017) investigated the functional mystical experiences in the intuitive dreams of Kashf al-Asrar and Mokashefat al-Anwar by Rozbahan Baghli and showed that the specific course of language processes in different stages of revelation from "material" to "mental" is used to explain the upward course of the devotee from the position of " quest " to the position of "perdition".In their research, Delbari and Sadeghinia (2016) classified the verbs in six short stories of Zoya Pirzad into six material, mental, communicative, behavioral, expressive, and existential processes, respectively, and based on these frequencies, they have shown the way of thinking and attitude of the author. The findings of this research show that the material process and then the behavioral process are the stylistic characteristics of Pirzad's stories. On the other hand, due to the abundant use of the material process, it can be said that Pirzad's view is realistic. MethodologyThe method of gathering information has been done by referring to the poet's divan (book of poems) and using library resources. In the first stage of the research, the required manuscripts are first prepared, and the original version that is the basis is determined. Of course, our basis was the availability of the version. The available copies of this work are the manuscript of the National Assembly Library (3 copies in one volume including Ghazals and quatrains) and the fourth copy from the Central Library and Document Center of Tehran University (copy number: 4548). With the guidance of the advisor and reader (taking into account criteria such as oldness, completeness, good handwriting, and few mistakes), the basic version (the third version of the National Council Library) is determined.Considering that the title of the research is related to the poet of the 13th century, in compiling the introduction and background of the research, he has used the library and descriptive-analytical method in the usual way in the humanities. The study method is in-text and with a critical view. The type of study is descriptive-analytical, and the method is descriptive (including the investigation of how the ideational metafunction processes are arranged) and analytical (including the exploration of the contexts and the reason for the particular formation of those processes). The statistical population of this research is 100 romantic Ghazals with the theme of "earthly love" from the Divan of poems of this poet of the return period. The sample unit is "Ghazal" and the unit of analysis is "verb". ConclusionBy studying the text of these Ghazals and analyzing their content, it was found that these poems can generally be placed in two main categories:First, the Ghazals that express the "relationship between lover and beloved" following the style of Iraqi poets; in this category of Ghazals, Mozneb is a follower of great poets like Saadi Shirazi and Kamaluddin Abdul Razzaq Esfahani in his poetic style.The second category is the Ghazals, which were formed by the evolution and transformation of the poet's attitude towards the "relationship between lover and beloved". The style and content of this category of Ghazals are similar to the styles of Maktab Voqou’ and Va Soukht and poems like "Vahshi Bafghi" and "Babafaghani". In the first type of Ghazals, according to the content of each Ghazal, Mozneb Badayouni used different linguistic processes. In these Ghazals, three characters with the title "Love, Lover, and Beloved" are the main characters. In the textual context of these Ghazals, relational processes have the highest number of processes,with about 45%. The poet in the position of "lover" has described the appearance, physical characteristics, and moral characteristics of the beloved in the form of these processes. In these Ghazals, the beloved has a face similar to the beloveds in the Iraqi style of poetry. The beloved's "face, eyes, lips, cheeks, height, face, and hair" are introduced to the audience through relational processes; in the next order, "material" processes have a higher frequency than other processes, with about 28%. In most of these processes, "you/beloved" has appeared in the form of the semantic role of "active" and in front of " I/lover," it has a passive face that has been affected by the cruel actions of the beloved. The beloved has the largest share in the arena of actors in Mozneb’s Ghazal.Mental processes with a frequency of about 23% are in the next order. The most commonly used verbal infinitives in these processes are "seeing", "looking" and "knowing"."Behavioral processes" with a limited percentage of "about 3%" are one of the less frequent processes in the textual context of this category of Ghazals. The most commonly used verbal infinitives in these processes are "crying" and "moaning" and their main participles are "me/lover". "Beloved" also participates in behavioral processes, but unlike the lover, constantly "laughs" and has no pity for the lover.In the "second type" of his Ghazals, Mozneb has found a real and true view of the concept of "love and beloved" and there is no sign of "pure helplessness and submission" in front of the beloved in his poetry. The beloved he depicts in such poems is no longer the "cruel and powerful beloved" who possesses the lover, and the lover has no choice but to cry and wail against their cruel actions. The transformation of the attitude of Mozneb towards the concept of "love" and "earthly lover" originates more than anything from the social and political developments of the Qajar era and the anxiety and tensions that prevailed in this historical period. The social and political conditions have gradually changed Mozneb’s attitude to the relationship between "lover and beloved" and in many of his sonnets, "lover" is no longer an oppressed and inevitable figure; rather, he is fed up with the cruel actions of the unfaithful lover and opens his mouth to protest. The main manifestation of this attitude change at the level of language processes is the reduction of the presence of the beloved in material processes and the semantic role of the actor.The findings of the research show the change, decline, and finally degradation of the position of "beloved" as the main character of his Ghazals through the reduction of the presence of this participant in "material and mental processes" and the high frequency of "interrogative clauses" that have the meaning of "reprimand".

Background: Prostate cancer remains one of the most common and lethal cancers among men worldwide. This study aimed to investigate the characteristics, prognostic factors, and outcomes of patients with prostate cancer who were treated and followed up in Shiraz, southern Iran over the past 12 years.Method: This retrospective medical chart review was performed on 872 patients with prostate cancer who were treated and followed up in the Radiation Oncology Department of Shiraz University of Medical Sciences. The survival analysis was conducted for the patients, and the receiver operating characteristic (ROC) curve analysis was performed for the prostate-specific antigen (PSA) level.Results: The median age of the patients at presentation was 69 years (range 35-91 years). In terms of local treatments, 28% of the patients underwent prostatectomy, and 23% were treated with transurethral resection of the prostate. The remaining 49% of patients were treated with non-surgical therapies. Patients between 55 and 75 years had the longest survival duration. The shortest survival was observed in the third Gleason group and those over 75 years old, while the first Gleason group and patients younger than 55 years had the longest survival duration. Hypoalbuminemia had no effect on the survival duration. A PSA level of 33.8 ng/dl was the most suitable cutoff point to predict bone metastasis, and patients with a PSA level of more than 33.8 ng/dl had significantly less survival duration than the others.Conclusion: More aggressive treatment and shorter follow-up intervals are recommended for patients with an initial PSA level of more than 33.8 and those younger than 55 years old.

Background: Medical students are exposed to high risk mental health disorders. Owing to the higher probability of exposure to the mentioned risk factors among dorm-resident students and senior students, the present study was conducted to explore mental health disorder and its relationship with higher academic year and dorm residence, amongthe medical students of Shiraz University of Medical Sciences.Methods: This cross-sectional study was conducted among 270 medical students in 2019. A multi-stage random sampling was applied. A standardized self-administered questionnaire, which comprised of demographic variables and General Health Questionnaire-28, was used.Results: The mean age of the participants was 22.52±2.26 years. About 166 individuals (61.5%, CI 95%: 55.69, 67.30) showed symptoms of mental health disorders, and anxiety was the most common mental disorder with a prevalence of 16.7% in medical students. There were significant relationships between mental health and higher age (P=0.001), clinical phase students (P

Abstract Dielectrophoresis is an electric field-based technique for moving neutral particles through a fluid. When used for particle separation, dielectrophoresis has many advantages compared to other methods, like providing label-free operation with greater control of the separation forces. In this paper, we design, build, and test a low-voltage dielectrophoretic device using a 3D printing approach. This lab-on-a-chip device fits on a microscope glass slide and incorporates microfluidic channels for particle separation. First, we use multiphysics simulations to evaluate the separation efficiency of the prospective device and guide the design process. Second, we fabricate the device in PDMS (polydimethylsiloxane) by using 3D-printed moulds that contain patterns of the channels and electrodes. The imprint of the electrodes is then filled with silver conductive paint, making a 9-pole comb electrode. Lastly, we evaluate the separation efficiency of our device by introducing a mixture of 3 μm and 10 μm polystyrene particles and tracking their progression. Our device is able to efficiently separate these particles when the electrodes are energized with ±12 V at 75 kHz. Overall, our method allows the fabrication of cheap and effective dielectrophoretic microfluidic devices using commercial off-the-shelf equipment.

Abstract Objective This study aimed to determine the quality of life (QOL), in patients with endometriosis ± infertility (B and C groups) and compare those to healthy women, and also infertile groups without endometriosis as a control groups (A and D), considering the fact that endometriosis and infertility reduces the quality of life in patients. Methods The present prospective comparative study was carried out between January 2018 and September 2020. A total of 400 women were included (100 women in each group). The participants filled in a validated questionnaire of quality of life, Endometriosis Health Profile-30 (EHP-30), and a visual analog scale of pain used, at the first visit, and 3 months after the medical or surgical treatment in the endometriosis group without infertility, additionally. Results The majority of the patients were married, categorized in the middle-class of socio-economic state and housewives. They were of Persian descent. BMI was high in the infertile groups; however, the time of infertility was not different between the two groups of B and C (P = 0.054). The mean score of QOL was significantly lower in B, C, and D groups in comparison to the healthy women as the control group (A) (P

Abstract The interactions between poly (3,4‐ethylene dioxythiophene) poly (styrenesulfonate) (PEDOT:PSS) and small gas molecules are studied using non‐equilibrium Green's function formalism based on the density functional theory. The proposed method is implemented in the Tran SIESTA code to benefit from the potential application of PEDOT:PSS as a gas sensor. The results show that doping with nanoparticles can drastically improve the sensitivity of polymer‐based chemical gas sensors. Moreover, among various PEDOT:PSS doping materials, silver nanoparticles have an appropriate response to ammonia, while platinum shows the best response to carbon dioxide. The numerical results can be useful to design PEDOT:PSS‐based gas sensors.

Aluminum (Al) is a popular metal in the industry, and its usage has greatly increased recently. The dose of this metal has been proven to be toxic to rats, but its effects on the offspring of the original receivers and prevention methods to reduce this damage are unknown. Rosa damascena is a well-known plant for its high antioxidant capabilities. In this study, the protective effect of Rosa damascena extract (RDA) on aluminum-induced lesions in the brain tissue of a rat offspring was investigated. In this regard, female rats were divided into seven groups, including the control group, the sham group, the aluminum group at the dose of 100 mg/kg, the extract groups at the doses of 500 and 1000 mg/kg, and the treatment groups that received the extract and Al at the same doses. After the treatment ended, the offsprings were subjected to exploratory behavioral tests, and finally, the tissues of the brain including the cerebral cortex, hippocampus, and hypothalamus were pathologically examined. It was observed that RDA at the dose of 1000 mg/kg reduced the malondialdehyde (MDA) and acetylcholinesterase (AChE) levels significantly (P

Natural antioxidants (NAs) are promising substances, which are established as potent therapeutic agents. However, the anticancer potential of many of them is not completely known. In this research, the anticancer effect of three natural antioxidants including geraniol (Ge), citronellol (Cit), and quercetin (Qu), and their combination by estimating their cytotoxicity on the Hela cells at doses from 15.625 to 1000 µg/mL was investigated. Moreover, cisplatin (Cis) was employed as a strong competitive comparison. After estimating the IC50 value of each treatment in the MTT assay, western blot was performed with the obtained doses for further evaluation. In this regard, the expressions of caspase3, Bax, Bcl2, and p53 proteins were examined. Our results showed that the combination of these natural substances had significant cytotoxic potential by upregulating all mentioned proteins, which demonstrated the apoptosis pathway. Our findings had also the same results in both Cis-receiving and non-Cis-receiving cells regarding some indices. Consequently, it was suggested to further investigate these natural antioxidants as both main or adjuvant therapies for their anticancer potential and side-effect reduction in vivo. Overall, it can be concluded that these natural antioxidants are effective against cancer cells by upregulating the apoptosis pathway.

Background: While the traditional risk factors of atherosclerotic cardiovascular disease (ASCVD) have been well-established, the evolving role of nontraditional risk factors is not apparent. This study aimed to evaluate the association between nontraditional risk factors and the calculated 10-year ASCVD risk in a general population. Methods: This cross-sectional study was conducted using the Pars Cohort Study data. All inhabitants of the Valashahr district in southern Iran, aged 40–75 years, were invited (2012-2014). Patients with a history of cardiovascular disease (CVD) were excluded. The demographic and lifestyle data were collected using a validated questionnaire. Multinomial logistic regression analysis was used to evaluate the association between the calculated 10-year ASCVD risk and the nontraditional risk factors of CVD, including marital status, ethnicity, educational level, tobacco and opiate consumption, physical inactivity, and psychiatric disorders. Results: Of 9264 participants (mean age =52.2±9.0 y; 45.8% male), 7152 patients met the inclusion criteria. In total, 20.2%, 7.6%, 36.3%, 56.4%, and 46.2% of the population were cigarette smokers, opiate consumers, tobacco consumers, ethnically Fars, and illiterate, respectively. The prevalence rates of low, borderline, and intermediate-to-high 10-year ASCVD risks were 74.3%, 9.8%, and 16.2%, respectively. In multinomial regression, anxiety (adjusted odds ratio [aOR], 0.58; P

The rabies virus, which belongs to the genus Lyssavirus, the family Rhabdoviridae, is the causative agent of rabies, a contagious, deadly, and progressive neurological infection. This illness is commonly distributed worldwide and affects all warm-blooded animals. Regarding the zoonotic aspects of rabies, the prevalence of rabies was investigated in this study. Over 2 years, 188 samples were examined via the direct fluorescent antibody test (DFAT) and mouse inoculation test (MIT) techniques by using brain tissue samples. Our findings showed that 73.94% of samples were rabies positive. The highest number of samples belonged to cows and dogs, respectively. The positivity rate in cows was 71.88%, followed by dogs with a 57.78% infection rate. These findings suggested that despite the heavy monitoring protocols in Iran, rabies is still a prevalent disease, and it is advised that vaccinations and screening programs should be carried out more frequently with heavier observation.

Abstract Background Kawasaki Disease (KD) is the most common childhood vasculitis and cause of acquired heart disease for no apparent reason. There is some evidence indicating infectious agents as possible triggers for KD. During the COVID-19 pandemic, vasculitis has been a presentation of COVID-19 in children. We performed this study to assess the association between KD and COVID-19. We evaluated KD hospitalized children during February to September 2020 for COVID-19 (group one) and compared their demographic, clinical, laboratory, and echocardiographic findings with KD patients from the same period time in 2019 (group two). We also compared the same data in COVID-19 positive and COVID-19 negative KD patients in 2020 pandemic period in Shiraz Namazi referral hospital at southwest of Iran. Results Thirty-two patients in group one compared with 44 patients in group two. Sixty-eight percent of group one KD patients were positive for COVID-19 during the pandemic period. KD Age of onset in the group one was lower than group two (4.38 years VS 5.5 years, P-value = 0.044). There was no difference in the demographic, clinical, laboratory, and echocardiographic features of the patients during and before the COVID-19 pandemic (p-value > 0.05). Moreover, Comparing COVID-19 positive and negative the incidence of rash was higher within COVID-19 positive cases (p

Abstract Introduction It remains a matter of debate whether traditional concepts regarding the nature of food affect the development and progression of multiple sclerosis (MS).To date, there are limited studies that have investigated the association between MS and dietary patterns based on the categories of food nature (hot, cold, or balanced) defined in traditional medicine. Method This case-control study was conducted from October 2019 to February 2020. In total, 60 patients diagnosed with MS within the preceding 6 months and referred to our neurology outpatient clinic were included in our case group. The control group included 180 patients who were referred to the same center for general or orthopedic surgery. Dietary intake was assessed in both groups through a reliable and valid semi-quantitative food frequency questionnaire. Data were assessed using principal component analysis. Results The mean age of the participants was 44.9 ± 17.33 years. The analysis showed that four food patterns were distinguished (eigenvalue > 1), namely “additives and cold-natured foods”, “hot and balanced foods and nuts”, “dairy and legumes”, and “hot and balanced starches”. These food patterns explained 57.8% of the total variance. After adjusting all confounding factors, individuals in the highest quartile and medium quartile of “additives and cold-natured foods” had an elevated MS risk compared with the lowest quartile (OR = 7.21, 95%CI = 2.01–12.38 and OR = 3.37, 95%CI = 1.02–11.35, respectively). Furthermore, individuals in the highest quartile of the “hot and balanced foods and nuts” group were protected against MS compared with its lowest quartile (OR = 0.28, 95%CI = 0.08–0.90). Moreover, a protective effect against MS was seen in the highest quartile of the “hot and balanced starches” group relative to its lowest quartile (OR = 0.34, 95%CI = 0.12–0.98). No significant association was found between “dairy and legumes” and the risk of MS. Conclusion This study revealed that dietary patterns based on the traditional concept of food nature might be associated with the risk of developing MS. This represents the first work in this area, so further research is recommended.

Background and purpose: Cytomegalovirus (CMV) is one of the most important pathogens in immunocompromised patients, those who need regular blood transfusion, and renal failure patients undergoing hemodialysis. The aim of this investigation was to study the epidemiology of cytomegalovirus in hemodialysis patients in Sari, Iran. Materials and methods: This cross-sectional study was performed in 180 hemodialysis patients attending two referral centers in Sari, 2017-2018. To include the patients we considered sociodemographic characteristics, blood transfusion history and period, and duration and frequency/week of hemodialysis. Blood samples were collected from all patients and after centrifuge, serum samples were examined for CMV-specific immunoglobulin G (IgG) using enzyme-linked immunosorbent assay (ELISA). Statistical tests including Kolmogorov-Smirnov, Mann-Whitney, and Kruskal-Wallis, and descriptive analysis including proportion for qualitative data and median (quartile range 25-75) for quantitative data were used. Results: The participants were 180 patients, including 93 (51.7%) females and 87 (48.3%) males (mean age: 61.5±14.4). All patients (100%) were positive for anti-CMV IgG antibody. There were no significant relationships between antibody titer and sex, age, dialysis period, dialysis duration, dialysis frequency per week, transfusion, transplantation, or HBV and HCV status (P >0.05). Conclusion: Our findings showed high frequency of CMV-IgG positive in hemodialysis patients. Due to the possibility of CMV infection progression in immunocompromised patients, especially those who undergo hemodialysis, screening programs should be performed to prevent adverse consequences.

Introduction: Bedside teaching plays a crucial role in acquiring essential clinical skills. Therefore, the main aim of this study is assessing the validity and reliability of the Persian version of German bedside teaching (BST) instrument. This instrument was specially developed for evaluation of bedside teaching.Methods: The present cross-sectional study was conducted on 150 last year medical students, using convenience sampling. The Persian version of the bedside teaching (BST) was used for datagathering. To calculate the reliability of the questions, Cronbach’s alpha was used and to determine the construct validity of the questionnaire, confirmatory factor analysis was used. All analyseswere performed in LISREL 10 and SPSS 21 software.Results: Cronbach’s alpha indicated excellent reliability for each subscale (α=0.77–0.85). All of the value of the questions are more than a significant number of 1.96 and concluded to be significant. There was an acceptable fit between the hypothetical model and the data and all comparative fit indices (CFI, NFI, RFI, IFI) showed good model fitness. BST is a valid and reliable instrument for the assessment of clinical teaching at bedside. It has 18 items with 5 point Likert scales.Conclusion: The findings suggest that the Persian version of the BST questionnaire is a valid and reliable tool for the evaluation of teachers and providing feedback in a clinical setting. However,more studies should be conducted in other cities in Iran.

Space frame structures that are made up of a huge number of members are often used on a large scale, hence their accurate evaluation is important to achieve the optimal design. On the other hand, the use of space Frames and 3D truss structures has become more popular due to its time efficiency. Also, these types of structures can carry loads in longspan buildings and are used in large-scale structures such as halls, hangars, passenger stations, etc. In this study, a novel evolutionary algorithm, named ETLBO, has been proposed for the optimization of space frame design in real-size structures. Despite the existing methods in the literature, the ETLBO method can be used for large-scale space frame structures due to its high speed with sufficient accuracy. At first, four optimization algorithms Particle swarm optimization (PSO), Genetic Algorithm (GA), Differential Evolution (DE), and Teaching–learning-based optimization (TLBO) under structural problems have been evaluated. The results show that the TLBO algorithm performs better in solving problems and has been better in most problems than other algorithms. So, we have tried to improve this algorithm based on a machine learning approach and combination operators. Algorithm improvement is created by adding a crossover operation between the new solution and the best solution in the teacher phase. This change causes a sudden movement and escapes from the local minima for the algorithm. Enhanced algorithm results show that convergence speed and optimal response quality have improved. Finally, using this algorithm, several new practical examples have been optimized.

Background: Behçet’s disease (BD) can negatively impact the quality of life (QoL) of the affected patients. The present study aimed to assess the QoL of BD patients using the Leeds BD-QoL and compare its results with the WHOQOL-BREF questionnaire.Methods: In the present cross-sectional study, 179 BD patients and 304 healthy individuals (the control group) were recruited in Shiraz, 2017. The Persian version of the Leeds BD-QoL and WHOQOL-BREF questionnaires were used to assess the QoL of patients with BD. The QoL in the patient and control groups was compared after controlling the effect of some variables (age, sex, marital status, and educational level) using the multiple linear regression analysis. Spearman’s correlation coefficient was calculated for the Leeds BD-QoL and WHOQOL-BREF scores. Disease activity was measured using the Behçet’s Disease Current Activity Form. All the statistical analysis was performed using SPSS software (version 21.0). PResults: The mean of the Leeds BD-QoL total score in the patient group was 12.3±8.7. The control group had significantly higher scores in the WHOQOL-BREF total score and the physical health and psychological health domains compared with the patient group; mean difference of 10.24, 10.8, and 4.62, respectively (PConclusion: BD patients had a lower QoL than healthy individuals, specifically in the physical health and psychological health domains. An increase in disease activity and severity was associated with a reduced QoL. The Persian version of the Leeds BD-QoL questionnaire had an acceptable correlation with the WHOQOL-BREF questionnaire.

Background: There is a close association between problematic Internet use (PIU), sleep quality, and mental health problems. To evaluate which mental health problem is more associated with coexistence of both PIU and poor sleep quality, we hypothesized a model in which PIU influences sleep quality directly and also through the mediation of three different mental health problems. Methods: A total of 402 medical students completed the Persian versions of the Internet Addiction Test, 21-item Depression Anxiety Stress Scale, and Pittsburgh Sleep Quality Index. A maximum likelihood structural equation model was used to assess the hypothesis. For assessment of the indirect effects, bootstrapping was conducted. Results: PIU predicted poor sleep quality through indirect pathways by the mediation of mental health problems (P < 0.001). Poor sleep quality were associated with depressive symptoms (P < 0.001), anxiety (P = 0.035), and stress (P < 0.001); however, the direct pathways from stress and anxiety to poor sleep quality were not statistically significant (P > 0.05). Conclusion: Findings extend our previous knowledge about the interrelationships between PIU, sleep disturbances, and mental health problems by unveiling the key role of depressive symptoms.

Digitalization and the emergence of the Internet have resulted in escalating access to information and communication. Given the circumstances that soaring access to information amounts to the intensification of misinformation and disinformation, a set of critical skills to navigate and critically assess the information is necessary. This paper outlines the significance of these skills, and provides a perspective on metaliteracy as a supplement to media and information literacy, and argues that the ability to conceptualize, access, comprehend, analyze, and use information is crucial in achieving inclusive, pluralistic, and participatory knowledge societies.

Helminthic infection is the major cause of the sheep’s reduced productivity. In this study, a total number of 240 fecal samples of sheep from stationary flocks of four different zones of Mazandaran province (Amol, Babol, Sari, and Nowshahr cities) were examined each season, out of which 53.33% of animals were affected by the helminthic infections. The most prevalent infecting parasites were the Trichostrongylidae (46.61%), followed by the Fasciola (9.96%). In addition, the Strongyloides had the lowest proportion with only 2.39%. The other detected parasites included Chabertia (5.98%), Cooperia (3.19%), Nematodirus (3.19%), Trichuris (5.58%), Toxocaridae (4.78%), Haemonchus (4.78%), Ostertagia (5.58%), Oesophagostomum (4.78%), and Dicrocoelium (3.19%). The nematodes had the highest percentage with 86.85%, whereas the trematodes followed them with 13.15%. No significant difference was observed between the infection level in females and males, with 56.9% and 43.94% rates of infection, respectively. Significantly lower infection was observed in winter compared with the other seasons. Trichostrongylidae was the dominant genus across all seasons. It was also noted that winter had the lowest percentage of helminthic infection significantly. The eggs per gram of feces was also estimated, and it showed that a significant number of sheep are infected with a moderate number of parasites. In a conclusion, even though livestock farmers have been using antiparasitic drugs in their livestock in recent years, parasitic infection still exists in livestock. Thus, a proper implementation of helminthic infection control programs in this area should be employed as the key element for reducing the high prevalence of livestock helminthic infection.

Paracetamol (AKA acetaminophen) is a widely used drug and is used for mild to moderate pains, such as mild osteoarthritis, toothache, headache, and pain caused by minimally invasive surgeries. Despite being a harmless drug in lower doses, acetaminophen can be toxic to the liver and kidneys if overdosed and even results in death. In this study, the therapeutic effects of Solidago canadensis L. extract (SCE) were investigated. 48 adult male Swiss albino mice (20–30 grams) were randomly divided into six groups of 8. The control group was gavaged with normal saline every 12 hours for 6 days. The second group received paracetamol at a 500 mg/kg intraperitoneally (i.p) dose on the sixth day. The third, fourth, and fifth groups were gavaged doses of 125, 250, and 500 mg/kg of SCE every 12 hours for six days, respectively, and on the sixth day, we received paracetamol at a dose of 500 mg/kg i.p. The sixth group only received SCE every 12 hours at a dose of 1000 mg/kg via gavaging for six days. On the seventh day (24 hours after paracetamol injection), blood samples were collected to measure the serum level of creatinine, uric acid, blood urea nitrogen (BUN), total protein, albumin, alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and total and direct bilirubin, and liver and kidney tissues were also sampled for histopathological examination. It was observed that paracetamol caused a considerable increase in the ALT, AST, ALP, uric Acid, and BUN levels (P

Ruminant parasites are found in all parts of the world, including the tropical and subtropical regions. Mazandaran province (northern Iran) is one of the areas prone to the activity of gastrointestinal parasites in ruminants. This study was performed in 2020, in order to identify common parasites of cattle gastrointestinal tract, the percentage of the infection, the effect of seasons, and livestock on the amount of infection and determine the severity of infection. In this study, seven genera of gastrointestinal parasites including Strongyloides, Haemonchus, Ostertagia, Cooperia, Trichostrongylus, Oesophagostomum, and Chabertia were identified among 240 cattle. Overall, 34.58% of cows were infected with different kinds of parasites. Based on the average percentage of livestock infected with gastrointestinal parasites across different seasons, winter had the lowest percentage (18.33%) compared to other seasons, which has a statistically significant difference (P

Introduction: Cancer patients are more prone to dental caries. Exposure to chemotherapy and/or radiation therapy, leads to hypofunction of salivary glands and consequently increases dental caries. A considerable number of cancer survivors are exposed to a heavy economic burden imposed by the disease. Aim: To study the effects of Socio-economic Status (SES) on oral health and the utilisation of Oral Healthcare (OHC) services among female cancer survivors in Iran. Materials and Methods: A cross-sectional study was conducted from June 2019 to October 2019 on 200 female cancer patients. Proportion of dental caries, OHC services utilisation, and SES were assessed in participants older than 18 years, who visited Shiraz cancer clinics at Shiraz, Iran. The data on OHC utilisation and SES among individuals were collected using the questionnaires by face to face interviews and oral examinations. Pearson’s Chi-squared test, the independent samples t-test, and binary logistic regression were used for statistical analyses. Results: Total of 200 female cancer patients were included and the median age was 49 years. Filled Teeth (FT) and Decayed, Missing and Filled Teeth (DMFT) (Poisson Regression (PR): 1.64, p-value

Indo-Iranian medicine dates back to a couple of centuries ago. The Gurkanies’ movement from Iran and Transoxiana to India introduced the Persian language to India, and the scientific language changed from Arabic and Sanskrit to this language. Iranian medicine has had a remarkable influence on the Indian Subcontinent, a sign of which is the elevated medical literature written in this language. Hakim Mohammad Azam Khan was born in 1813 AD. His ancestors were great sages of Khorasan (in north east of Iran) and then migrated to Afghanistan and India. Since he lived in the late 19th AD century, he had access to many Iranian traditional books. He provided rich sources of traditional medicine for the next generation by publishing traditional medicine books and traditional pharmacology. He wrote great books such as the Exir Azam (a comprehensive medical encyclopedia), Romouz Azam (a general book on medicine), Qarabadin Azam (Pharmacopeia). With his profound 19th century orientalist approach that emphasized safeguarding the Persian language, he created numerous works in the field of medicine, making him the most serious custodian of Indo-Iranian medicine in India. The present study reviews the scientific life of a contemporary famous author of Indo-Iranian medical literature written in Persian Language.

A microfluidic-based gas sensor was chosen as an alternative method to gas chromatography and mass spectroscopy systems because of its small size, high accuracy, low cost, etc. Generally, there are some parameters, such as microchannel geometry, that affect the gas response and selectivity of the microfluidic-based gas sensors. In this study, we simulated and compared 3D numerical models in both simple and serpentine forms using COMSOL Multiphysics 5.6 to investigate the effects of microchannel geometry on the performance of microfluidic-based gas sensors using multiphysics modeling of diffusion, surface adsorption/desorption and surface reactions. These investigations showed the simple channel has about 50% more response but less selectivity than the serpentine channel. In addition, we showed that increasing the length of the channel and decreasing its height improves the selectivity of the microfluidic-based gas sensor. According to the simulated models, a serpentine microchannel with the dimensions W = 3 mm, H = 80 µm and L = 22.5 mm is the optimal geometry with high selectivity and gas response. Further, for fabrication feasibility, a polydimethylsiloxane serpentine microfluidic channel was fabricated by a 3D printing mold and tested according to the simulation results.

The present cross-sectional study aimed to evaluate Attention-deficit hyperactivity disorder (ADHD)symptoms in terms of gender and age. Based on convenience sampling, the data records of 1,184children and adolescents with ADHD were gathered from various Child and Adolescent PsychiatryClinics affiliated to Shiraz University of Medical Sciences (Shiraz, Iran). During 2010-2015, thepatients had been interviewed face-to-face for ADHD diagnosis in accordance with the Diagnosticand Statistical Manual of Mental Disorders 4th Edition (DSM-IV) diagnostic criteria. The collecteddata were re-analyzed using parent-reported ADHD symptoms measured with the DSM-IV clinicalsymptoms checklist. Statistical analysis was performed using SPSS software with the Pearsoncorrelation test, Chi-square test, and t test. PThe mean age of the participants was 9.29±2.55 years, 904 (76.40%) of whom were boys. The mean total score of hyperactivity-impulsivity in girls and boys was 2.63±2.77 and 3.19±8.17, respectively. The mean total score of inattention in girls and boys was 3.40±1.97 and 3.28±2.00, respectively. Ageand gender were not associated with the symptoms of inattentive ADHD. The symptoms associatedwith hyperactivity-impulsivity had a significant association with age (Pstatistically significant association with gender were frigidity (P=0.001), often running about (P=0.03),and often difficulties with playing or leisure activities (P=0.005). The most common symptoms ofinattentive ADHD in both boys and girls were “inattention to details or making careless mistakes”(47.6% and 54.3%, respectively) and “fails to finish work” (43.0% and 40.1%, respectively).In contrast with the hyperactivity-impulsivity, the severity of inattention was not associated withage. The results of the present study indicated that while the ADHD screening questions for inattentioncould be the same for both genders, they should be different for hyperactivity-impulsivity.

Purpose: To estimate the pooled prevalence and incidence of diabetic retinopathy (DR) in Iran and to investigate their correlations with the Human Development Index (HDI), healthcare access (i.e., density of specialists and sub-specialists), and methodological issues. Methods: Electronic databases such as PubMed, Embase, Scopus, Web of Science, Google Scholar, and local databases were searched for cohort and cross-sectional studies published prior to January 2018. Prevalence and incidence rates of DR were extracted from January 2000 to December 2017 and random effects models were used to estimate pooled effect sizes. The Joanna Briggs Institute critical appraisal tool was applied for quality assessment of eligible studies. Results: A total of 55,445 participants across 33 studies were included. The pooled prevalence (95% CI) of DR in diabetic clinics (22 studies), eye clinics (4 studies), and general population (7 studies) was 31.8% (24.5 to 39.2), 57.8% (50.2 to 65.3), and 29.6% (22.6 to 36.5), respectively. It was 7.4% (3.9 to 10.8) for proliferative DR and 7.1% (4.9 to 9.4) for clinically significant macular edema. The heterogeneity of individual estimates of prevalence was highly significant. HDI ( P < 0.001), density of specialists ( P = 0.004), subspecialists ( P < 0.001), and sampling site ( P = 0.041) were associated with heterogeneity after the adjustment for type of DR, duration of diabetes, study year, and proportion of diabetics with controlled HbA1C. Conclusion: Human development and healthcare access were correlated with the prevalence of DR. Data were scarce on the prevalence of DR in less developed provinces. Participant recruitment in eye clinics might overestimate the prevalence of DR.

Context: Dysmenorrhea is a common problem in women. Objectives: This study aimed to summarize the results of all relevant clinical trials to draw a conclusion regarding the effect of Foeniculum vulgareon primary dysmenorrhea (PD). Methods: In this study, we searched 19 databases (including Medline/PubMed, Scopus, ISI Web of Science) for the effects of Foeniculum vulgareon primary dysmenorrhea up to November 2016. The reference lists of the reviews and related articles were consulted to identify eligible articles. Studies investigating combinations of fennel and other products, without a control group, addressing premenstrual syndrome (PMS) and bleeding as the primary outcomes, and not being a randomized clinical trial (RCT) were excluded. A meta-analysis was performed to obtain a pooled estimate of effectiveness. The methodological quality was assessed using the modified Jadad scale. The registration number of this study is 95-01-65-11733. Results: Our search identified nine relevant articles for inclusion. The meta-analysis showed favorable effects of Foeniculum vulgareon primary dysmenorrhea for fixed effect (n = 727, OR = 0.573, 95% CI: 0.414 to 0.793, P = 0.001) and random effect (n = 727, OR = 0.141, 95% CI: 0.027 to 0.742, P = 0.021). The analysis also revealed a remarked heterogeneity (Q value = 198.318, P = 0.000, I 2= 95.96, τ 2= 6.065). Conclusions: We found that the fennel extract is effective for primary dysmenorrhea. However, due to the heterogeneity of various findings, we were unable to find the effective dosage and concentration of this herbal medicine. We recommend multicenter clinical trials worldwide for evaluating the effectiveness of fennel in primary dysmenorrhea.

Background: Insomnia is a prevalent disorder leading to psychological problems such as anxiety and depression. Methods: This study investigates the effect of a combination of herbs (Melissa officinalis L. and Nepeta menthoides Boiss. & Buhse) on anxiety and depression for insomniacs and on insomnia severity. This study is a double-blind randomized placebo-controlled clinical trial. A total number of 67 participants met the inclusion criteria who were diagnosed as cases of insomnia. The patients were randomized into the herbal treatment or placebo groups. The herbal treatment group received a combination of Melissa officinalis and Nepeta menthoides Boiss. & Buhse. The primary outcomes were insomnia, depression and anxiety. We used per-protocol analysis. Results: The all outcomes of herbal treatment were significantly improved compared with placebo in the ISI, BAI and BDI scores after four weeks’ treatment (p value: 0.008, 0.005 and

Attention to the history of medicine (HM) has been increasing enormously among the scientific community. History of Culture and Civilization of Iran and Islam (HCCII) is taught in medical schools as a required course. However, data on medical students' level of knowledge and attitude about HM is limited. This is a cross-sectional survey conducted between 2016 and 2017. A multi-stage random cluster sampling was done in which 230 medical students were asked to fill a standardized self-administered questionnaire. Univariate statistical tests and ordinary multivariable linear regression were applied. Medical students' knowledge level was 50.8%, which is considered fair and weak. Interestingly, the knowledge score of those who attended only in HCCII course did not differ significantly from those who did not attend this course (P = 0.163). The results showed that knowledge scores were considerably greater in those who participated in related volunteer workshops than those who did not (P = 0.0001). The mean score of attitude toward HM was significantly higher in female subjects than male subjects (P = 0.028). Moreover, data indicated that attendance at the HCCII course and workshops was not associated with improvement in attitude. According to the outcomes, the authors recommend revising the content, teaching method and structure of the HCCII course curriculum.

An ethanol gas sensor based on carbon nanofibers (CNFs) with various densities and nanoparticle functionalization was investigated. The CNFs were grown by means of a Plasma-Enhanced Chemical Vapor Deposition (PECVD), and the synthesis conditions were varied to obtain different number of fibers per unit area. The devices with a larger density of CNFs lead to higher responses, with a maximal responsivity of 10%. Furthermore, to simultaneously improve the sensitivity and selectivity, CNFs were decorated with gold nanoparticles by an impaction printing method. After metal decoration, the devices showed a response 300% higher than pristine devices toward 5 ppm of ethanol gas. The morphology and structure of the different samples deposited on a silicon substrate were characterized by TEM, EDX, SEM, and Raman spectroscopy, and the results confirmed the presence of CNF decorated with gold. The influence of operating temperature (OT) and humidity were studied on the sensing devices. In the case of decorated samples with a high density of nanofibers, a less-strong cross-sensitivity was observed toward a variation in humidity and temperature.

BACKGROUND: Due to the rapid advancement of medical knowledge, promotion in research is necessary to have the best clinical practice. Research Self-efficacy (RSE) is the researcher's confidence in their ability to conduct a specific study. The Evidence-Based Practice (EBP) represents how to improve the quality of care and treatment of patients. RSE and EBP are the cornerstones of successful research and then efficacious medical practice.This study aims to evaluate RSE and acceptance of EBP and their correlation among medical students. MATERIALS AND MEHODS: This is a cross-sectional study designed on 600 clinical students at the medical school of Shiraz, using a census method in 2020. Students were invited to fill out the standardized Phillips and Russell's questionnaires about RSE (4 domains, 33 questions) and Rubin and Parrish's questionnaire of EBP (10 questions). The gathered data were analyzed through the SPSS at α = 0.05 using descriptive statistics, t-test, Chi-square, and multiple linear regressions. RESULTS: There was a positive correlation between EBP and RSE score (P < 0.05). The results of linear regression test showed that all variables had a significant effect on our response variables and their effect were significant (P < 0.05). The highest mean score in RSE was shown in the subscale of writing skills (52.54). The lowest score was observed in the subscale of quantitative (student's subjective assessment of their ability to work with statistically related data and formulas) as well as computer skills (35.61). CONCLUSIONS: Students who participated in a research project, workshop, or Master of Public Health program got a higher RSE and EBP. Due to the positive correlation between RSE and EBP, we conclude that trained physicians who can research independently and use research evidence can find the best treatment approach for patients. These finding support the importance of integrating research education in medical curriculum to increase RSE and finally improvement of EBP among medical students.

The Concepts of General and Special are crucial issues in jurisprudence and statutes, that is, many provisions in statutes lay down on this basis. There is a well-known maxim which states that no General exits unless it is limited with a Special.The question of whether the general phrase is acceptable after narrow phrase and whether the ambiguity of special conveyed to general as well as fulfillment of suspicious via practical rules in subjective suspicious and in generality rule in non-suspicion at narrow phrase, is subject to great controversy and debates. This article deals with this issue by conducting a comparative study and considering the reasoning on which courts’ judgments are based. Then, it proposes some jurisprudential solutions for the purpose of convergence and finally, it concludes that there is obvious difference between collective general and floated general phrase and in subjective suspicion the wholly evidence, the wisdom as an independent source have value and no difference among other verbal specials.

BACKGROUND Chronic constipation is one of the most common gastrointestinal disorders. It has negative effects on the patients’ quality of life, and their productivity, and results in a high economic burden on the healthcare services. The aim of the present study was to estimate the prevalence of chronic constipation and its associated factors in pars cohort study (PCS). METHODS A cross-sectional study was conducted on the baseline data of the PCS. Data gathering was done by structured questionnaire and physical examination. A total of 9264 subjects aged between 40 and 75 years were enrolled in the PCS. Diagnosis of chronic constipation was done using Rome IV criteria. Multivariable binary logistic regression was applied for data analysis. RESULTS A total of 752 (8.1%) participants were diagnosed as having chronic constipation (9.3% of female and 6.7% of male participants). Older age (OR: 1.55, 95% CI: 1.31-1.83), physical activity (OR: 0.56, 95% CI: 0.46-0.68), opium consumption (OR: 2.06, 95% CI: 1.63-2.60) , anxiety (OR:1.38, 95% CI: 1.15-1.65), depression (OR: 1.22, 95% CI: 1.01-1.48), back pain or arthralgia (OR:1.38, 95% CI: 1.14-1.67), insomnia (OR: 1.62, 95% CI: 1.36-1.93) and gastroesophageal reflux disease (OR: 1.51, 95% CI: 1.28-1.78) were associated with the prevalence of constipation in the multivariable analysis. CONCLUSION Chronic constipation was a common problem in the PCS population. Decreasing modifiable risk factors associated with constipation such as opium consumption and physical inactivity can reduce its prevalence and decrease burden of the disease.

This paper explores the style of the book "Favayed Al-afzaliyeh" authored by Ali Afzal Qatea Qazvini. He is one of the renowned and prolific physicians of the Safavid era, who despite medical profession and writing several valuable books, has been paid less attention by researches. Among his writings, "Favayed Al-afzaliyeh" is the Encyclopedia of Medicine and Pharmacology. According to many researchers, this book is the most important, most detailed and most comprehensive medical treatises of the Safavid era. In this paper, the stylistic features of "Favayed Al-afzaliyeh" are studied from the viewpoints of thought, literature and language. The result of this study shows that the above-mentioned book is a moral and advisory work in addition to mentioning comprehensive medical issues; according to its scientific structure, it has excellent literary traits. Linguistic features of this work, despite a relatively long period from Khorasani style, is yet adaptable to it. Of course, this does not mean that style of "Favayed Al-afzaliyeh" is devoid of the linguistic features of its own era.

Background: Infertility adversely affects quality of life (QoL). The present study aims to evaluate QoL and its associatedfactors among infertile couples.Materials and Methods: In this cross-sectional study, the Fertility QoL (FertiQoL) instrument was used to measureQoL among 501 volunteer couples who attended the Infertility Clinic at the Mother and Child Hospital, Shiraz, Iran.We used an additional questionnaire to assess participants’ demographic and clinical characteristics. The relationshipbetween the scores of QoL to the sociodemographic and treatment data was analysed.Results: The subjects with lower income levels had lower relational, mind/body, emotional, and total core scores. Femaleparticipants without academic education had lower scores in the emotional subscale, while the male participantsshowed lower scores in emotional, mind/body, relational, social, and total QoL domains. Subjects who had undergoneany type of treatment, including pharmacological treatment, intrauterine insemination (IUI), intra-cytoplasmic sperminjection (ICSI), and in vitro fertilization (IVF) showed significantly lower scores in the environmental domain. Participantswith lower infertility duration obtained significantly greater QoL scores. Finally, tolerability, emotional, andenvironmental domains were significantly more desirable when the infertility problem was related to a male factor.Conclusion: Infertile couples with shorter duration of infertility and male etiology have higher QoL. Lower academiceducation, lower income levels, or prior unsuccessful treatments are associated with lower QoL.

Background:Spontaneous bladder rupture is a rare condition, and almost all the reported cases in the world have been preceded by bladder dysfunction, radiotherapy, urinary tract obstruction, pelvic surgery, inflammation, and malignancy. Case report: In this study, we present the case of a 39-year-old woman (G: 4, P: 1, Ab: 2) who was in week 38 of pregnancy and attended our hospital with the onset of labor pain. She gave birth to a 3200 g infant through normal vaginal delivery. The patient attended with severe abdominal pain and oliguria four days after delivery. Ultrasonography showed massive abdominal fluid and bladder rupture. Conclusion: Regarding the rareness of bladder rupture during vaginal delivery, we introduced a case of bladder rupture following delivery. This case is important for midwives and gynecologists to gain more information about normal vaginal delivery complications to accelerate diagnostic and therapeutic interventions.

BACKGROUND Prevalence of gastroesophageal reflux disease (GERD) is increasing worldwide. We aimed to estimate the prevalence of GERD in Pars Cohort Study (PCS) and to find its correlates. METHODS We used the baseline data from PCS. PCS was conducted in the district of Valashahr in Fars province in southern Iran from 2012 to 2014. 9264 inhabitants who were 40-75 years old, and agreed to participate were enrolled. Data were collected by a structured questionnaire and simple physical examination of all participants. RESULTS Generally, 58.50% (95% CI 57.49 - 59.51) of the participants had GERD and 25.10% (95% CI 24.22 - 25.99) experienced it at least weekly. Approximately, 32.0%, 52.0%, and 24.4% of the participants reported heart burn sensation, regurgitation, and both symptoms, respectively. Being female (OR: 1.45, 95% CI 1.27 - 1.65), being older (OR: 1.20, 95% CI 1.06 - 1.36), being divorced/ widowed/separated (OR: 1.38, 95% CI 1.01 - 1.91), and lower education (OR: 1.43, 95% CI 1.02 -2.03) were associated with frequent GERD. CONCLUSION GERD is common in PCS and its prevalence is close to that in western countries. Being female, higher age, being divorced/widowed/separated, lower education, history of hypertension, anxiety, insomnia, and non-cigarette tobacco smoking were associated with frequent GERD. We are going to investigate the causal relationship between these risk factors and GERD in the next stages of PCS.

Background: A Premature infants undergo multiple painful procedures during treatment; thus, it must be tried to limit complications caused by diagnostic and treatment procedures using simple and practical methods. This study was performed to evaluate the effect of spike lavender lakhlakhe on pain intensity due to phlebotomy in hospitalized premature infants.Methods: This single-arm, randomized clinical trial was performed on 30 infants chosen through convenience sampling method. Each newborn was considered as its own control. For the test group, one drop of pure (100%) spike lavender lakhlakhe was taken by a standard dropper and diluted with 4 ml of warm distilled water by the research assistant. This mixture was stirred at 2-3 cm distance of the newborns’ nose from 60 minutes before until 2 minutes after phlebotomy, such that it could be smelled by the newborns. In both groups, heart rate and blood oxygen saturation were measured by a standard portable device, and the corresponding data was recorded in data collection sheets. Moreover, the infants’ facial expression changes were recorded by a camera and the intensity of pain was measured by Premature Infant Pain Profile before and after the procedure. Finally, the data was analyzed by paired comparison analysis test in SPSS, version 17.Results: Comparison of mean pain intensity caused by phlebotomy in the control and test groups showed a significant difference (7.667±0.311 vs. 4.882±0.311; P

Background: The present study aimed to study the quality of doctor-patient relationship, and measure the extent of relationship between the dissatisfaction with the doctor-patient relationship and the usage rate of traditional and complementary medicine among the people who visited the non-conventional medical centers in Shiraz city, Iran. Methods: This was an analytical cross-sectional study in which 800 people who visited six non-conventional medical centers in July 2016 were enrolled; having gained their satisfaction, they were studied by method of complete enumeration. The data were collected using a researcher-made questionnaire. Validity and reliability of data were confirmed and analyzed through SPSS software. Findings: 61 percent of visitors were dissatisfied with the quality of doctor-patient relationship to mediocre extent. There was a significant correlation between the dissatisfaction extent of visitors for doctor-patient relationship and the usage rate of traditional and complementary medicine in that the high dissatisfaction extent was accompanied with the high consumption rate of traditional and complementary medicine. Conclusion: The usage rate of the traditional and complementary medicine is in relation with the dissatisfaction extent of medical behavior. Thus, providing the doctor-patient relationship is not improved, high dissatisfaction and high consumption of non-conventional medicine will be seen. Therefore, it is to take action to improve the doctor-patient relationship by means of education, and culturalization; in addition, it is to pay more attention to parties’ rights in order to avoid the consequences of excessive and without doctors’ leave usage of traditional and complementary medicine.

Background: According to the World Health Organization viewpoint, social well-being is an important dimension of health along with physical and mental aspects. Evaluation of social well-being is necessary in students, especially in medical sciences students due to future responsibility as health care professionals. The present study attempted to investigate the level of social well-being, five domains of it (like actualization, integration, contribution), and some related factors in the school of nursing and midwifery students. Methods: This cross-sectional study was carried out between Julys to December 2015 and comprised 346 students in the school of nursing and midwifery in Shiraz University of Medical Sciences, Shiraz, Iran. Social well-being, socio-demographic status and physical activity were measured by valid questionnaires. Univariate linear regression analysis, multiple imputation method, ANOVA and independent sample t-test were used as different statistical methods. The P values less than 0.05 were considered as statistically significant. Results: The mean score of social well-being was 50. The minimum and maximum scores of social well-being were 20 to 100. Married students had higher social well-being than single students in univariate linear regression (Beta: 2.111, 95% CI: (0.387 to 3.738), P=0.017). Also, social integration had higher scores in married students (P=0.015). Social actualization was higher in male students (P=0.015); on the other hand, social contribution was higher in female students (P=0.026). Conclusion: The results of our study showed that social well-being status of students in this research was not satisfactory. Designing and conducting programs for promotion of social well-being, for example preparing facilities for marriage of students, can be helpful. Evaluation of social well-being in students of other schools with multicenter studies seems to be useful.

Background: Genital warts are the most common viral sexually transmitted disease affecting 1% of the population. A prospective, open-label controlled trial was performed to compare topical 5% potassium hydroxide (KOH) solution with CO2 laser in the treatment of female genital warts. Methods: Seventy patients were enrolled in the study after convenience sampling. Right-sided lesions of the patients were treated by CO2 laser every 3 weeks. The left-sided lesions of the same patients were treated by topical 5% KOH solution twice a day using a toothpick with cotton wrap on the tip. The patients were visited at 3, 6, and 9 weeks after initiation of the treatment and followed up for 6 months after the last visit. Results: Out of seventy patients, sixty three completed the study and were analyzed. A total of 56 KOH treated-patients (88.9%) showed complete response. On the other hand, 56 laser-treated patients (88.9%) presented complete clearing of the lesion. There was not any difference in response to both modalities of treatment. Complications of KOH solution and CO2 laser were 24% and 19% respectively (P>0.05), but serious adverse events were not observed. The patients under KOH treatment displayed a recurrence rate of 11.1% (7 cases), while the same patients with CO2 laser therapy demonstrated a recurrence rate of 7.9% (5 cases) (P=0.54). Conclusion: Topical 5% KOH solution was as effective as CO2 laser in the treatment of female genital warts. There was not any serious complication in the application of KOH solution. This could be used as a new treatment for genital warts.

Introduction: Integration of public health and medical education has been thought to have an important role in medical students’ training. Shiraz University of Medical Sciences has developed an MD/MPH dual degree educational program for the talented volunteer students. The aim of this study was to assess the students’ viewpoints about various aspects of Shiraz MD/MPH program. Methods: This cross-sectional study was conducted on Shiraz undergraduate medical students, who were enrolled in MD/MPH program. A self-structured questionnaire in Persian consisting of 4 parts was used; it included demographic factors including 16 questions which evaluated the students’ perspective of the goals, content, skill development, applicability and meeting their expectations; 7 questions evaluating the self-reported increase of knowledge; and 3 multiple choice questions to assess the students’ motivations and opinions on the impact of the program on their future career. Descriptive statistics was used for data analysis. Results: All MD/MPH students (89) with a mean age of 21.4±1.34 participated in this study. Forty one of the students (46.1%) were male and 48 (53.9%) female. Overall, 86.1% of them had positive views about the goals of the program; also, 83.5%, 81.2% and 81.9% of them reported a positive viewpoint about the contents, the applicability and development of specific skills, and meeting their expectations, respectively. The students’ most frequent motivation was “learning how to research systematically” (73%). The majority of the students reported this program to be moderately to highly effective in increasing their knowledge in the provided courses. Conclusion: The students had a positive view about almost all of the aspects of the MD/MPH program; this may be indicative of the program being successful in delivering the goals, increasing the students’ knowledge and skills, and meeting their expectations to date. Students’ enthusiasm for the educational program may lead to their motivation for better learning and thus in the program’s success.

Introduction: Accurate seating of abutments on implants is an important factor for long term success of implant supported restorations. Among different methods of evaluating abutment seating, radiography is most commonly used, while some clinical factors such as angulation of radiography film and radiography tube can adversely affect its diagnostic value. Aim: To evaluate diagnostic value of digital periapical radiographs in terms of sensitivity, specificity and accuracy of gap detection at implant-abutment connection with different angles of X-ray projection when using a zirconia abutment. Materials and Methods: In this in vitro study radiographs were made of three different implant connections (internal tri-channel, external hex and internal hex with platform switching) to which zirconia abutments were fastened, once with and once without using a spacer between implant and abutment. Radiographs were taken at different projection angles of -20, -15, -10, -5, 0, +5, +10, +15, and +20. Then 10 prosthodontists were asked to assess all the radiographs, two times for each one with an interval of 10 days. Sensitivity, specificity and accuracy indices were calculated for each system. Results: Findings showed that sensitivity of gap detection in all study groups was amongst acceptable range (85-100%). In general external hex connection system showed better results (95-100%) while the platform switching internal hex system had the weakest results (85-100%). Conclusion: Angle of X-ray projection is better to be between -10 to +10 when evaluating complete seat of zirconia abutments on implants especially if a platform switching system is used.

Background: Acute kidney injury (AKI) is a common problem in critically ill patients and is independently associated with increased morbidity and mortality. Recently, serum cystatin C has been shown to be superior to creatinine in early detection of renal function impairment. We compared estimated GFR based on serum cystatin C with estimated GFR based on serum creatinine for early detection of renal dysfunction according to the RIFLE criteria. Methods: During 9 months, three hundred post trauma patients that were referred to the intensive care unit of a referral trauma hospital were recruited. Serum creatinine and serum cystatin C were measured and the estimated GFR within 24 hours of ICU admission was calculated. The primary outcome was the incidence of AKI according to the RIFLE criteria within 2nd to 7th day of admission. Results: During the first week of ICU admission,21% of patients experienced AKI. After adjusting for major confounders, only the patients with first day's serum cystatin level higher than 0.78 mg/l were at higher risk of first week AKI (OR=6.14, 95% CI: 2.5-14.7, P