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Rohullah Sakhi, Shakila Jalalzai, Zainab Ahmadi, Rowaida Almaszada, Froogh Nazanin Zarghoon, Raihana Mohammadi, Habiba Ahmad, Shakila Mazhar, Maryam Faqirzada, Mozhda Hamidi Public Health Faculty, Kabul University of Medical Sciences, Kabul, AfghanistanCorrespondence: Habiba Ahmad, Public Health Faculty, Kabul University of Medical Sciences, Ata Turk Avenue, 3rd District, Kabul, Afghanistan, Email habibaahmad241@gmail.comBackground: Menstruation is a universal, natural, unique, and physiological phenomenon. Despite the fact that menstruation is a natural fact of life, it is still considered taboo in Afghanistan and other developing countries.Objective: To assess knowledge, beliefs, and practices related to menstruation among female students of Kabul University of Medical Sciences (KUMS).Methods: A cross-sectional descriptive study design was conducted at KUMS in 2022, and a quota sampling technique was used.Results: In this study, 339 students participated out of the 346-sample size. The majority of participants (70.02%), were over 20 years of age. About (59.60%) of participants were aware of menstruation before menarche. The main source of their information was their mothers (37.50%). The average age of menarche was 13.5 years old. Above 70% of respondents had normal patterns of menstruation. More than half of them (51.90%) had dysmenorrhea. Frequent menstrual disorders were abdominal pain (58.1%), and backache (56.1%). The majority of respondents had good and acceptable knowledge of menstruation (33.6%), and (63.1%) respectively. A statistically significant relationship between knowledge and academic year was observed (P value = 0.005). The majority of respondents (92.6%) had poor menstrual beliefs. A statistically significant relationship between respondents’ age and beliefs was observed (P value = 0.004). Mother education did not affect respondents’ level of beliefs (P value = 0.4). In addition, respondents had good practice of menstruation (75%).Conclusion: In general participants had a good and acceptable level of knowledge with good practice related to menstruation. Despite the good knowledge and practice, the respondents’ beliefs related to menstruation were poorer than what was expected from medical disciplines students. Their frequent source of information was their mothers, which highlights the provision of information and education for mothers and all females.Keywords: menstruation, knowledge, beliefs, practice, female students, Kabul University of Medical Sciences

The differential strain behavior of Ta x W 1-x B solid solutions has been studied as a function of composition using high-pressure radial X-ray diffraction in a diamond-anvil cell under non-hydrostatic pressure (up to ∼65 GPa) to understand the hardening mechanisms in this family of materials. The hardness of tungsten monoboride (WB) can be increased by adding tantalum and reaches a maximum at a doping level of 50 at. % with a value of 42.8 ± 2.6 GPa under an applied load of 0.49 N. Plateaus were observed in the differential strain data for both the (020) and (002) directions, suggesting that this is the primary slip system in this material. These plateaus were modified by the addition of Ta, indicating that strengthening of the (002) and (020) planes by solid solution hardening was primarily responsible for the hardness enhancements in Ta x W 1-x B solid solutions. In contrast, the differential strain supported by the (200) plane linearly increases with pressure up to the highest pressures reached in this work (>60 GPa) and shows almost no change with metal composition. Because of the very different compression behavior in the (200) and (020) planes, change in the b/a ratio with pressure provides a unique way to visualize the onset of plastic behavior. This onset varies from ∼15 GPa for samples with 5% Ta to more than 30 GPa for the sample with 50% Ta. In addition, the ambient bulk modulus of each solid-solution sample was determined using the second-order Birch-Murnaghan equation-of-state and found to be ∼340 GPa for all phases.

Reihane Mohammadi,1 Alisam Aryan,2 Mir Davood Omrani,1 Sayyed Mohammad Hossein Ghaderian,1 Zahra Fazeli1 1Department of Medical Genetics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranCorrespondence: Zahra FazeliDepartment of Medical Genetics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranEmail Z.Fazeli@sbmu.ac.irAbstract: Autologous hematopoietic stem cell transplantation (AHSCT) is considered as the novel approach to improve multiple sclerosis (MS) patients with disease-modifying therapies (DMTs)-resistance. The results obtained from different studies indicate that AHSCT increases the life quality of MS patients. Several factors are known to be influenced on the successful rate of AHSCT in patients with MS. The individuals aged < 40 years with a short duration of MS disease have been demonstrated to show a better response to AHSCT administration. Furthermore, this treatment approach was more effective in relapsing remitting MS (RRMS) patients than progressive MS (PMS). Different clinical trials revealed that AHSCT with a low density conditioning regimen could be suggested as a suitable candidate approach in the management of MS. Several molecular and cellular mechanisms are known to be involved in the resetting of the immune system following the AHSCT infusion in MS patients. These mechanisms play a role in the depletion of auto-reactive lymphocytes and immune system renewal. In the present review, we discuss different clinical and molecular aspects of AHSCT application in the alleviation of MS symptoms.Keywords: autologous hematopoietic stem cells, transplantation, multiple sclerosis, molecular mechanisms, resetting immune system

Mostafa Chadeganipour,1 Rasoul Mohammadi1,2 1Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; 2Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranCorrespondence: Rasoul MohammadiAssociate Professor of Medical Mycology, Department of Medical Parasitology and Mycology, School of Medicine, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranTel +98-31-37929175Fax +98-31-36688597Email Dr.rasoul_mohammadi@yahoo.comPurpose: Aspergillosis is an important fungal disease affecting millions of individuals worldwide. The genus of Aspergillus consist of various complexes, causing a wide spectrum of diseases from superficial infections in immunocompetent hosts to life-threatening disseminated infections among immunocompromised patients. This study aimed to identify Aspergillus species by phenotypic (total isolates) and molecular tests (35 isolates), obtained from patients in Isfahan (the third-largest city of Iran) between 2010 and 2018, and determine the susceptibility of 35 clinical isolates to itraconazole (ITR), amphotericin-B (AMB), and voriconazole (VOR).Patients and Methods: Based on clinical signs, a total of 2385 suspected cases were included in this retrospective study from January 2010 to December 2018. Direct microscopic examination with potassium hydroxide, sabouraud dextrose agar with chloramphenicol, and czapekdox agar media was applied to identify etiologic agents. Thirty-five Aspergillus species collected from January 2016 to December 2018 were identified by PCR-sequencing of ITS1-5.8SrDNA-ITS2 region, and their susceptibility to ITR, AMB, and VOR was determined using E-test.Results: Based on direct microscopy and positive culture, 132 out of 2385 suspected cases had Aspergillus infection (5.5%). Fifty-four patients were male, and 78 patients were female. Patients in the age groups of 41– 50 and 21– 30 years had the highest and lowest frequencies, respectively. Aspergillus flavus/oryzae (n=54), A. fumigatus (n=24), A. niger (n=15), and A. terreus (n=12) were the most prevalent Aspergillus species, respectively. Among 35 Aspergillus species, the MIC ranges of AMB, ITR, and VOR for A. flavus/oryzae, A. niger, and A. terreus were (0.5– 4 μg/mL; 0.5– 16 μg/mL; 0.25– 8 μg/mL), (1 μg/mL, 1 μg/mL, 1 μg/mL), and (4– 4 μg/mL, 0.5– 1 μg/mL, 0.5– 1 μg/mL), respectively.Conclusion: Aspergillus infections have a wide spectrum of clinical manifestations and often occur in immunocompromised patients. Accurate identification at the species level is essential since the emergence of cryptic species is connected to different patterns of AFST that affect patient treatment outcomes. Azole-resistant Aspergillus spp. is a global concern, and the detection of the route of resistance is pivotal to prevent and control infection.Keywords: Aspergillus, causative agents, E-test, itraconazole, amphotericin-B, voriconazole

Mohsen Meidani,1 Sayed Hamidreza Abtahi,2 Rasoul Mohammadi3 1Department of Infectious Diseases, Isfahan University of Medical Sciences, Isfahan, Iran; 2Department of Otolaryngology, Isfahan University of Medical Sciences, Isfahan, Iran; 3Department of Medical Parasitology and Mycology, School of Medicine, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranCorrespondence: Rasoul MohammadiMedical Mycology, Department of Medical Parasitology and Mycology, School of Medicine, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, IranTel + 983137929175Fax + 983136688597Email Dr.rasoul_mohammadi@yahoo.comAbstract: Mucormycosis is an uncommon and acute fungal infection, with high morbidity and mortality. Traumatic mucormycosis mainly occurs in military conflicts, civilian trauma, and vehicle accidents. Hurricanes, tornadoes, floods, and tsunamis also play a major role in causing mucormycosis by inoculation. Herein, we presented a case of trauma-related mucormycosis in a 70-year-old diabetic male. He referred to a specialty clinic due to the auricular swelling after having fallen and having a major trauma in his ear. Pathologic examination of necrotic cartilage revealed broad ribbon like aseptate hyphae. Antifungal therapy with amphotericin B deoxycholate (1.5 mg/kg/day) was administered for 6 weeks as an initial therapy, and the patient was discharged with a regimen of posaconazole oral solution (400 mg PO bid with meals) for 8 weeks. He followed up for one year and there was no recurrence of the infection. In conclusion, traumatic mucormycosis is a rare but potentially life-threatening fungal infection. Early diagnosis and surgical excision are essential regarding the management of this critical condition. Knowing the underlying diseases is preferable to early diagnosis and timely initiation of antifungal therapy in order to improve survival rates.Keywords: traumatic implantation, mucormycosis, auricular cartilage, diabetic patient, Iran

Let R ∝ M be a trivial extension. In this note, we obtain necessary and sufficient conditions for R ∝ M to be right extending. [ABSTRACT FROM AUTHOR]

Background: Before treatment planning and dose delivery, quality assurance of multi-leaf collimator (MLC) has an important role in intensity-modulated radiation therapy (IMRT) due to the creation of multiple segments from optimization process. Objective: The purpose of this study is to assess the quality control of MLC leaves using EBT3 Gafchromic films. Material and Methods: Leaf Position accuracy and leaf gap reproducibility were checked with Garden fence test. The garden fence test consists of 5 thin bands A) 0.2 Cm width spaced at 2 Cm intervals and B) 1 Cm width spaced at 1 Cm intervals. Each leaf accuracy was analyzed with measuring the full-width half-maximum (FWHM). Maximum and average leaf transmission were measured with gafchromic EBT3 films from Ashland for both 6 MV and 18 MV beams. Results: Leaf positions were found to be in a range between 1.78 – 2.53 mm, instead of nominal 2 mm for the test A and between 9.09 – 10.36 mm, instead of nominal 10 mm for the test B. The Average radiation transmission of the MLC was noted 1.79% and 1.98% of the open 10x10 Cm2 field at isocenter for 6 MV and 18 MV beams, respectively. Maximum radiation transmission was noted 4.1% and 4.4% for 6 MV and 18 MV beams, respectively. Conclusion: In this study, application of gafchromic EBT3 films for the quality assurance of Euromechanics multileaf collimator was studied. Our results showed that the average leaf leakage and positional accuracy of this type of MLC were in the acceptance level based on the Protocols.

Laleh Mahmoudi,1 Rahim Mohammadi,1 Ramin Niknam2 1Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran; 2Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Introduction: Stress-related mucosal damage (SRMD) is described as the damage of gastric mucosa due to physiological stress that is a very common complication in critically ill patients. SRMD prophylactic medications are widely prescribed all over the world, while numerous studies have revealed that a large percentage of patients admitted to non-intensive care unit (ICU) services do not need to receive these medications. The aim of this study was to determine the frequency and type of medication errors and the economic impact of clinical pharmacist intervention on stress ulcer prophylaxis (SUP).Methods: This prospective interventional study was conducted on adult patients admitted to internal, surgical, and critical care units at two large academic medical centers over 6 months. Risk factors of stress ulcer were recorded daily during hospital stay, and appropriateness of SUP administration was assessed according to the American Society of Health-System Pharmacists (ASHP) criteria. An intervention was performed by a clinical pharmacist in the case of contradictions. The rate of inappropriate SUP and the economic impact of a pharmacist intervention were recorded.Results: In this study, 178 out of 219 (81.2%) patients received prophylactic treatments. Averagely, prophylactic therapy was compatible with standard treatment guidelines in 67.1% of cases. The implementation of ASHP guideline by a clinical pharmacist resulted in a cost saving of >18,000 USD monthly in this study, which would result in an estimated cost saving of >216,000 USD annually.Conclusion: Although treatment guidelines are available for the prophylaxis of SRMD, failure to observe these guidelines could increase the cost of treatment and adverse effects. The clinical pharmacists’ intervention in order to implement standard protocols has a significant impact on the reduction of unintended mistakes in prescribing prophylaxis, as well as significant cost savings. Keywords: acid suppression therapy, clinical pharmacy, histamine-2 receptor antagonist, proton pump inhibitor, stress ulcer prophylaxis

Reza Bidaki,1 Niloofar Majidi,2 Amir Moghadam Ahmadi,3 Hamid Bakhshi,4 Rezvan Sadr Mohammadi,5 Seyed-Ali Mostafavi,6 Mohammad Kazemi Arababadi,7 Maryam Hadavi,8 Afshin Mirzaei9 1Research Center of Addiction and Behavioral Sciences, Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; 2Department of Psychiatry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; 3Department of Neurology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; 4Continuing Medical Education Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; 5Department of Psychiatry, Lorestan University of Medical Sciences, Khorramabad, Iran; 6Psychiatry Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran; 7Department of Laboratory Sciences, Faculty of Paramedicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; 8Department of Anesthesiology, Paramedical Faculty, Molecular Medicine Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; 9Rafsanjan University of Medical Sciences, Rafsanjan, Iran Background and aim: Vitiligo is a chronic skin disease characterized by a total or partial loss of melanocytes from the epidermis and other tissues of the skin. It is placed in the class of secondary psychiatric disorders and can also lead to psychological problems. The main aim of this study was to assess social acceptance in vitiligo patients. Methods: This cross-sectional study was conducted on all of the patients (n=150) with vitiligo who were referred to dermatology clinics in Rafsanjan, Iran. The patients completed a social acceptability questionnaire (Marlowe–Crowne Social Desirability Scale), and information regarding their demographic characteristics was also collected. Data were gathered and analyzed with descriptive and inferential statistics using SPSS-19 software. Results: The mean age of the patients was 27.56±10.53 years and 65.9% were female. Mean score of social acceptance among the patients was 13.51±7.08. The results showed that the mean scores of social acceptance were significantly lower in women, in those with single marital status, in those with face and neck lesions, and in those with disease duration less than 5 years. Conclusion: The results showed that certain groups of patients with vitiligo are at greater risk of experiencing lower social acceptance. Keywords: vitiligo, social acceptance, skin disease, secondary psychiatric disorders

Every year, approximately one-third of the total food produced for human consumption is lost or wasted due to various reasons. This level of wastage has substantial adverse impacts on the environment, economy, and society. Numerous studies have proposed various policies to address the issue of food waste, such as incorporating technology into existing supply chains. However, concerns about their effectiveness and unintended consequences have led researchers to emphasize market-based approaches for waste reduction. The present study was carried out to estimate waste and investigate the potential for developing different marketing channels as market-based approaches to reduce waste in the leafy vegetable supply chain in Kermanshah province. To achieve this purpose, a system dynamics modelling of the waste system in the leafy vegetable supply chain was developed by using the literature review and interviews with experts and stakeholders. The tool for collecting research data was a questionnaire. The statistical population of this study is two groups including 22 experts and 728 actors in the leafy vegetable supply chain. Based on the findings, around 31,000 tonnes (39%) of leafy vegetables are wasted annually across the supply chain. The research scenarios indicate that the establishment of processing industries will effectively decrease the overall waste of leafy vegetables from around 31,000 tons to approximately 20,000 tons annually. Therefore, government initiatives and policies in the field of leafy vegetable exchange in the study area must focus on supporting businesses associated with leafy vegetable processing industries and establishing infrastructure prerequisites for these industries. [ABSTRACT FROM AUTHOR]

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