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Background: The rapid advancement of digital technology and information has revolutionized teaching approaches, and evidence retrieval in medical academic settings, highlighting the necessity for adequate digital literacy (DL) among students. This research assessed DL and its components within the medical science student population. Methods: Comprehensive searching was done using the Web of Science, Scopus, Embase, and PubMed databases. Meta-analysis was conducted using CMA V.3.3. Results: Out of the 6773 identified articles, 54 studies were selected for the final synthesis. DL in medical science students has improved over the past two decades. However, there were differences in the components of DL, with computer literacy ranking the highest and search literacy ranking the lowest. Results of the meta-analysis showed that most students were skilled in using Word Processing (78%) and Presentation (68%) software, while fewer were skilled in using Spreadsheets (49%) and Email (34%). Conclusion: Medical science students have made progress in DL but there is still a gap in achieving expected competency. The COVID-19 pandemic has pushed the adoption of digital technologies for online learning, benefiting DL. This experience should guide educational practices, emphasizing online and blended learning, and integrating ICT courses into the medical science curriculum. [ABSTRACT FROM AUTHOR]

Background and Aims: Ultrasound and computed tomography (CT) scans can be used as methods to help make a more accurate diagnosis in diseases involving the omentum and peritoneum. The present study was conducted to determine etiology and CT scan pattern of peritoneal involvement and compare it with ultrasound findings. Methods: Patients referred to Ghaem and Imam Reza hospitals who had undergone CT scans and had involvement of peritoneum in abdominal CT scans were included in the study. The findings identified in the CT scan were recorded. According to the underlying cause determined by laparotomy or laparoscopy sample, each disease's most common pattern of involvement and types of patterns were examined. An ultrasound was conducted for every patient and the obtained information was analyzed. Results: A total of 101 patients were included in the study, of which 61 patients (59.8%) were female and the rest were male. The most common involvement patterns in CT scans included nodular (37.6%), mixed (21.8%), and omental cake (17.8%), respectively. In 80 patients (79.2%), CT scan findings were consistent with ultrasound, but in 21 patients (20.8%), CT scan findings were not visible in ultrasound. The most common diagnoses of the patients were colorectal adenocarcinoma and gastric adenocarcinoma (20 cases, 19.8% each), followed by ovarian and uterine adenocarcinoma (19 cases, 18.8%). Conclusion: The most common patterns of involvement of peritoneum in CT scans include nodular pattern, mix, and omental cake. The most common diseases that lead to the involvement of peritoneum are gastrointestinal cancers, uterine and ovarian cancers, and peritonitis. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, over 1.5 billion learners worldwide were deprived of access to in-person learning. Consequently, there was a significant shift towards e-learning. Social anxiety is a limiting barrier to e-learning. This study aimed to examine the level of social anxiety in e-learning environments among medical students. Method: In this descriptive-analytical cross-sectional study, 150 medical students from Mashhad University of Medical Sciences, selected through convenience sampling, completed the Social Anxiety Scale in E-Learning Environments (SASE) questionnaire. The collected data were analyzed using descriptive statistics and inferential statistics by SPSS20 software. Results: The results of this study showed that the social anxiety of students in e-learning environments was not high, with a range of (1-6). Additionally, the levels of social anxiety were higher in students without academic progress during e-learning (p=0.887) compared to students with academic progress (p=0.702), but this difference was not statistically significant. Furthermore, there was no statistically significant relationship between the level of social anxiety in e-learning environments and variables such as gender, semester, and type of study. Conclusion: Despite the lack of a statistically significant relationship between the variables of present study and social anxiety, and changes in social interaction environments, efforts to reduce the level of social anxiety among medical students and enhance learning are essential. The SASE is a valid and reliable tool for assessing social anxiety in e-learning environments. [ABSTRACT FROM AUTHOR]

Background: Considering that few studies have investigated the differences in clinical, laboratory, and imaging symptoms of patients with coronavirus disease 2019 (COVID-19) during different peaks of the disease in Iran, the present study compares the patients who were admitted to the COVID-19 departments of Imam Reza Hospital during the first, second, and third peaks of the disease. Methods: In this cross-sectional study, data were collected by reviewing the files of patients with a definite diagnosis of COVID- 19 based on the RT-PCR test in Imam Reza Hospital in Mashhad. The patients were divided into three groups based on the time of admission: The first peak from March 2020 to June 2020, the second peak from July to September 2020, and the third peak from October to December 2020. The variables evaluated in this study included demographic information, clinical signs and symptoms, and laboratory and radiological findings. Descriptive qualitative data were reported using frequency tables, while quantitative descriptive data were reported using measures of central tendency and dispersion. A comparison of qualitative data among the three peaks was conducted using the chi-square test, while for quantitative data, the ANOVA test was used followed by appropriate post-hoc tests. Results: A total of 561 patients with an average age of 58.90 ± 16.80 years were included in the study, of which 336 (59.9%) were male. Regarding underlying diseases, significant differences were found in age (P < 0.001), smoking (P < 0.001), diabetes (P = 0.003), high blood pressure (P < 0.001), asthma (P = 0.025), and ischemic heart disease (P < 0.001). For vital signs, significant differences were observed in heart rate (P < 0.001), respiration rate (P < 0.001), diastolic blood pressure (P = 0.010), and SPO2 (P < 0.001). In clinical characteristics, significant differences were found in fever (P < 0.001), nausea (P = 0.011), vomiting (P = 0.031), headache (P < 0.001), weakness (P < 0.001), and sore throat (P < 0.001). In laboratory characteristics, significant differences were observed in white blood cell (WBC) count (P = 0.024), neutrophil percentage (P < 0.001), lymphocyte percentage (P < 0.001), and C-reactive protein (CRP) (P = 0.001). The CT score values of the patients were significantly different between the three peaks. Patient mortality was significantly different across the three peaks. Less than 15% of hospitalized patients died in the first peak, while over 24% died in the second peak and nearly 40% of inpatients died in the third peak. In our study, the first and third surges and the second and third surges had different mortalities. Conclusions: The third and first peaks had the highest and lowest mortality rates, respectively. Underlying diseases and unstable vital signs were more common in the second and third peaks. Patients in the second peak had significantly higher CT scores compared to the other peaks. [ABSTRACT FROM AUTHOR]

Background: The demanding academic and professional environment faced by medical students renders them susceptible to mental health challenges. Tailored academic advising (AA) services are crucial in catering to the distinct requirements of medical students. This study evaluates the quality of AA from the perspective of medical students and proposes improvements in the AA approach. Method: The study comprised 250 pre-clinical year students from Mashhad Medical School. A valid AA quality evaluation questionnaire was used to measure students' perception and attitude towards AA, to evaluate the performance of students and advisors, and factors affecting its quality. Chi-square, t-test, ANOVA, and logistic regression were used for data analysis. Results: Although a majority of medical students exhibited a favorable disposition towards AA, 37% acknowledged never utilizing the AA, with only 10.4% engaging in regular consultations. The satisfaction rate with AA stood at 47%. Obstacles concerning advisor performance were identified as more prevalent reasons for student discontent, including deficiencies in advisory skills, unfamiliarity with educational protocols, low time, and low motivation. Alongside academic concerns, 36% of students sought advice for psychological issues. Logistic regression analysis showed that counselors' performance, students' knowledge, and students' positive attitudes increased the rate of students using AA. Conclusion: Enhancing AA services necessitates augmenting students' awareness regarding the available support mechanisms and upgrading the skills and commitment levels of advisors. While faculty advisors play a pivotal role in career progression, the efficiency of AA services could be heightened by incorporating an assistant psychologist alongside specialized training for faculty advisors. [ABSTRACT FROM AUTHOR]

Background and Aim: The present study investigated the correlation between vertebral artery hypoplasia and fetal‐type variations of posterior cerebral arteries with stroke patterns and imaging findings in individuals with posterior circulation ischemic stroke. Methods: In this cross‐sectional study, patients with symptoms of acute ischemic stroke in the posterior circulation system referred to Ghaem Hospital in Mashhad between 2016 and 2022 were investigated. Demographic data, including age, gender, systemic diseases, history of previous stroke or transient ischemic attacks, and clinical manifestations of patients, were recorded using questionnaires and checklists from patient files. The results of imaging studies, including magnetic resonance imaging and computed tomography angiography, were also recorded. The obtained data were analyzed by SPSS statistical software. Results: Among 974 patients suffering from posterior circulation ischemic stroke, 155 patients with an average age of 60.44 ± 13.95 years were included in the study, out of which 97 patients (62.6%) were male. Unilateral vertebral artery hypoplasia on the right, left, and bilateral hypoplasia was present in 67 (43.2%), 35 (22.6%), and 5 (3.2%) patients, respectively. There were complete unilateral fetal origin on the right in 38 (24.5%), complete unilateral on the left in 12 (7.7%), partial unilateral on the right in 12 (7.7%), partial unilateral on the left in 6 (3.9%), complete bilateral in 14 (9%), and partial bilateral in 8 (5.2%) patients. There was no significant relationship between vertebral artery hypoplasia and PCA fetal‐type variants with different ischemia locations and infarct patterns (p > 0.05). Also, there was no significant relationship between the age and gender of patients with ischemia location and infarct pattern (p > 0.05). Conclusion: Despite previous evidence showing a relation between vertebral artery hypoplasia and PCA fetal‐type variants as risk factors for PC stroke, the present study did not establish a significant correlation between these factors and the location of ischemia and infarct patterns. [ABSTRACT FROM AUTHOR]

Introduction: Aluminum phosphide (AlP) poisoning, commonly known as rice tablet poisoning, is a lethal method of suicide with no known antidotes. Thyroid hormones have inotropic effects that can potentially reverse hemodynamic instability and improve cardiac output. This study investigated the effects of Triiodothyronine (T3) on the cardiac function of patients with aluminum phosphide poisoning. Methods: In this randomized clinical trial, 24 patients with confirmed ALP poisoning were recruited. The intervention group received T3 treatment in addition to standard treatment, while the control group received only standard treatment. Demographic variables, cardiac parameters, biochemical markers, and oxidative stress tests were evaluated. Results: The majority of participants were men (60%) in their thirties (intervention: 32±17.4 years; control: 30±11.6 years). Following treatment, both systolic and diastolic blood pressures had significantly higher mean differences in the T3 group compared to the control group (18.7±9.3, P=0.05 and 14.1±5.9, P=0.03 respectively). While both groups showed improvement in mean arterial pH, the intervention group exhibited a significantly greater improvement 12 hours after the administration of T3, which was significantly different from both the baseline and control groups (p=0.04, 0.009 respectively). Additionally, the intervention group had a lower QRS and QTc interval compared to admission time. Conclusion: Triiodothyronine administration has been shown to maintain a higher range of SBP, control cardiogenic shock, regulate metabolism, improve acidosis and blood pressure, and ultimately enhance recovery in patients with aluminum phosphide poisoning. Furthermore, it may have cardio-protective effects on these patients. [ABSTRACT FROM AUTHOR]

Dobutamine stress echocardiography (DSE) is a diagnostic tool for determining coronary artery disease. Considering hypotension and hypertension as important complications of DSE, we aimed to evaluate the blood pressure (BP) responses during DSE. Patients without known cardiovascular diseases who underwent DSE were included. We excluded patients who had hypertension, diabetes mellitus, a known history of cardiovascular diseases, and those taking vasoactive medications. Systolic (SBP) and diastolic (DBP) blood pressure were recorded at baseline and peak stress. We included 688 patients with an age of 57.9 ± 12.01 years. During DSE, SBP (+19.72 ± 26.51 mm Hg, p < 0.001), DBP (+5.52 ± 17.35 mm Hg, p < 0.001), and HR (+54.05 ± 22.45 bpm, p < 0.001) significantly increased from baseline to peak stress. The normal cut‐off value was measured between 101–210 mm Hg for SBP and 50–121 mm Hg for DBP. According to this normal cutoff, 11 (1.3%) and 30 (4.4%) patients had hypotensive and hypertensive SBP and 15 (2.2%) and 21 (3.1%) patients had hypotensive and hypertensive DBP, respectively. The hypotensive response was correlated with baseline SBP (r = 0.6, p = 0.001) and atropine (r = −2.18, p = 0.043), and the hypertensive response was correlated with baseline SBP (r = 0.048, p < 0.001). Baseline BP and atropine consumption were the independent variables associated with the outside‐the‐normal range of blood pressure responses. [ABSTRACT FROM AUTHOR]

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