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Abstract Background Coronary artery disease (CAD) significantly contributes to global fatalities. Recent studies have demonstrated the crucial roles of sortilin1 (SORT1) and sestrin1 (SESN1) in lipid metabolism, as well as their involvement in the development of CAD. The aberrant expression or activity of SORT1 can consequently lead to metabolic and vascular diseases. Sestrins, including SESN1, play a crucial role in helping cells survive by maintaining metabolic balance while also reducing oxidative stress (OS). OS contributes to the progression of atherosclerosis-related diseases, such as CAD. The study aimed to compare the gene expression of SORT1 and SESN1 in peripheral blood mononuclear cells (PBMCs), alongside serum OS markers, in CAD patients and controls. Materials The case-control study included 49 CAD patients and 40 controls. The expression of the SORT1 and SESN1 genes was quantified using qRT-PCR, and the expression of the SORT1 protein was evaluated by western blotting. OS markers, including total oxidation status (TOS), total antioxidant capacity (TAC), and malondialdehyde (MDA), were measured using spectrophotometric and fluorometric methods. Results SORT1 gene and protein expressions were similar between groups. CAD patients had a non-significant decrease in SESN1 gene expression. MDA levels were significantly higher in CAD patients, whereas TOS and TAC levels did not differ significantly. Conclusion For atherosclerosis-related disorders like CAD, MDA shows potential as a non-invasive, easy-to-use, affordable, and stable biomarker. Further research is needed to elucidate the precise roles of SORT1 and SESN1 in CAD pathogenesis.

Abstract Background Nurses play a crucial role in identifying patients’ needs and assessing their clinical conditions to provide adequate and timely interventions. However, evaluating the clinical reasoning competence of nurses requires valid, specific, and comprehensive tools. The present study aimed to translate and psychometrically assess the Persian version of the Clinical Reasoning Competence Scale (CRCS) for nurses in special care units in Iran. Methods This cross-sectional, multi-axis methodological study involved 630 nurses from critical care departments in 11 Iranian hospitals. The original version of the Clinical Reasoning Competency Scale for Nurses (CRCSN) was translated into Persian using the forward and backward translation method. The psychometric properties of this scale were assessed using COSMIN criteria. Results Each item’s content validity ratio (CVR) ranges from 0.69 to 1, the Item content validity index (I-CVI) ranges from 0.82 to 1, while the S-w was 0.95. Exploratory factor analysis revealed that the items load on three distinct dimensions—“plan setting,” “intervention strategy regulation,” and “self-instruction”—with loadings ranging from 0.621 to 0.912. These dimensions collectively explain 74.32% of the variance. Confirmatory validity was affirmed without necessitating the removal or reordering of items during the exploratory phase. The scale’s reliability was established with a Cronbach’s alpha coefficient of 0.91 and a test-retest reliability coefficient of 0.92. Factor analysis was also conducted. Conclusion The Persian version of CRCSN has been found to be valid and reliable in critical care units. Therefore, nursing managers can confidently use this tool to evaluate the clinical reasoning competence of nurses. They can also implement appropriate strategies, such as educational interventions, to improve their clinical reasoning skills.

Background Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by severe social communication deficits and stereotypical repetitive behaviors. Purpose This umbrella review assessed neonatal risk factors associated with ASD using meta-analyses and systematic reviews. Methods We conducted a systematic search of international databases including PubMed, Scopus, and Web of Science for studies published through April 2022 utilizing pertinent keywords. A random-effects model was used to calculate the odds ratio (OR) and 95% confidence interval (CI). Substantial heterogeneity was considered at values of I2≥50%. A quality assessment of the included studies was performed using the A MeaSurement Tool to Assess Systematic Reviews (AMSTAR2) checklist. Results A total of 207,221 children with ASD and 22,993,128 neurotypical children were included. Six meta-analyses were included in this umbrella review. The factors of congenital heart disease (OR, 1.35; 95% CI, 1.17–1.52), macrosomia (OR, 1.11; 95% CI, 1.05–1.18), low birth weight (OR, 1.63; 95% CI, 1.48–1.81), very low birth weight (OR, 2.25; 95% CI, 1.79–2.83), small for gestational age (OR,1.17; 95% CI, 1.09–1.24), jaundice (OR, 1.74; 95% CI, 1.42–2.12), male sex (OR, 1.47; 95% CI, 1.39–1.55) and 1-minuteApgar score

Abstract Background Predicting mortality and relapse in children with acute lymphoblastic leukemia (ALL) is crucial for effective treatment and follow-up management. ALL is a common and deadly childhood cancer that often relapses after remission. In this study, we aimed to apply and evaluate machine learning-based models for predicting mortality and relapse in pediatric ALL patients. Methods This retrospective cohort study was conducted on 161 children aged less than 16 years with ALL. Survival status (dead/alive) and patient experience of relapse (yes/no) were considered as the outcome variables. Ten machine learning (ML) algorithms were used to predict mortality and relapse. The performance of the algorithms was evaluated by cross-validation and reported as mean sensitivity, specificity, accuracy and area under the curve (AUC). Finally, prognostic factors were identified based on the best algorithms. Results The mean accuracy of the ML algorithms for prediction of patient mortality ranged from 64 to 74% and for prediction of relapse, it varied from 64 to 84% on test data sets. The mean AUC of the ML algorithms for mortality and relapse was above 64%. The most important prognostic factors for predicting both mortality and relapse were identified as age at diagnosis, hemoglobin and platelets. In addition, significant prognostic factors for predicting mortality included clinical side effects such as splenomegaly, hepatomegaly and lymphadenopathy. Conclusions Our results showed that artificial neural networks and bagging algorithms outperformed other algorithms in predicting mortality, while boosting and random forest algorithms excelled in predicting relapse in ALL patients across all criteria. These results offer significant clinical insights into the prognostic factors for children with ALL, which can inform treatment decisions and improve patient outcomes.

Background and Objective: Stroke is the second leading cause of disability and mortality across the globe. The present study aimed to assess the effect of doxycycline on clinical outcomes of patients with ischemic stroke. Materials and Methods: In this double-blind clinical trial, 60 patients with ischemic stroke were selected in the first 24 hours of post-stroke and randomly assigned to two groups: intervention and control. In the intervention group, patients received 100 mg of doxycycline every 12 hours for seven days in addition to standard treatments. Both groups were followed up before the intervention, on days 7, 30, and 90 after the treatment in terms of the severity of stroke clinical outcomes using National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (mRS) tests. Results: The mean age of patients in the intervention and control groups were 68.33±12.15 and 67.40±9.99 years (P>0.05). No significant difference was observed between the intervention and control groups in terms of NIHSS and mRS scores at baseline and on the seventh day. Nonetheless, in the intervention group, the NIHSS score on days 30 (P=0.007) and 90 (P

Objectives: Children with hearing loss often undergo considerable pain and distress due to their hearing impairment, leading to challenges in engaging constructively with others. Using games, mainly through play therapy, can significantly enhance interaction and adjustment in children, especially those with hearing impairments. This research seeks to evaluate the impact of play therapy on the adaptation and self-confidence of children dealing with hearing challenges. Methods: This randomized controlled trial was conducted at a welfare center affiliated with the Hamadan University of Medical Sciences in western Iran. Sixty-two children with hearing loss were selected from the welfare center. They were then assigned to the play therapy or control group using block random sampling. The pre- and post-intervention assessments included completing demographic information, an adaptability questionnaire for elementary school children, and a self-esteem inventory. Results: The implementation of play therapy led to a significant increase in adaptability immediately after the intervention and one month later (P

Background and Objective: Influenza is one of the most common infectious diseases in the respiratory system. Preventive measures are considered one of the most important and necessary strategies to control this disease. The present study aimed to assess the factors related to the prevention of influenza among female high school students based on the protection motivation theory in Hamedan. Materials and Methods: This cross-sectional study was conducted on 303 female high school students in Hamadan. The participants were selected by multistage sampling. The data collection tool was a questionnaire designed by Sharifi-Rad et al. and completed by the self-reporting method. Data were analyzed using independent t-tests, one-way analysis of variance, Pearson correlation, and linear regression with a significance level of less than 0.05. Results: The mean age of participants in the research was 16.79±0.95 years. Only 26.10% of participants had a history of influenza vaccination. Moreover, 186 cases had information about the flu, and the Internet was identified as the most abundant source of information. Based on the results, the various constructs of protection motivation theory explained 58.30% of the variance of the intention to perform preventive behavior and 30.30% of the variance of performing the behavior in the studied students. Conclusion: In conclusion, the various constructs of the protection motivation theory have a good fit for predicting the intention and performing disease-preventive behaviors.

Background: Emergency medical personnel are among the people who play a major role in reducing the mortality and disability of the injured. This study determines the relationship between mental health and job satisfaction with professional ethics in emergency medical personnel. Materials and Methods: The present cross-sectional study included 126 emergency medical personnel in Hamadan City, Iran. The data were collected using a 3-part demographic information questionnaire, the 28-item general health questionnaire, the Barry Field and Ruth job satisfaction questionnaire and the Cadozier professional ethics questionnaire. The data were analyzed using Stata software, version 14. Meanwhile, the significance level was considered P

Abstract Introduction The constellation of pre and perinatal predictors are introduced as predictor for autism spectrum disorders (ASD), however, the information about the direction and strength of these predictors are lacking in Western, Iran. The current study aimed to determine the pre and perinatal predictors of ASD among children in this region. Methods This case-control study was conducted in Hamadan, Western Iran during January to March 2022. The study included 100 children with ASD who referred to the autism center as case group. Hundred children without ASD from registration system of health service centers were selected as control group and were matched (1:1) to cases by age and place of residency. A structured questionnaire about pre and perinatal predictors of ASD was developed by an expert panel. The questionnaire was administered by interviewing the mothers of children. Results Boy gender (OR: 3.51, 95% CI: 1.74–7.10, p-value

Background and Objectives: Phenylketonuria (PKU) is a rare hereditary metabolic disease caused by the phenylalanine hydroxylase enzyme (PAH) deficit. Delays in diagnosis and treatment have serious effects on the nervous system and reduce the IQ of these children. Materials and Methods: The current cross-sectional study was conducted on 55 children aged 5 to 18 years with a definite diagnosis of PKU who were taken care of in the Genetic Diseases Control Center, Hamadan Be'sat Hospital. The information of the patients was obtained from the file and interviews with the parents and then recorded in the checklist. For individual measurement of cognitive abilities and IQ, the Stanford Binet Questionnaire was used, and statistical analyses were performed in Stata 16 software. Results: The average age of the children was 11.08 years,52.73% of the samples were children of consanguineous marriage parents, and 29.09% had a history of PKU in the family. The average age of diagnosis was 15.09 months. The disease had been diagnosed in 47% of cases by screening. The IQ of 3.5% of the children was normal, 42% was low average, 43.5% had borderline much lower than average, and 11% suffered from mental retardation. The average age of diagnosis was 5, 15, 13, and 27.5 months, respectively. A significant relationship was found between IQ and the child's age and birth order (P

Background and Objective: Benign prostate hyperplasia is the most common benign tumor in males. An open prostatectomy procedure can be performed to treat this problem. This procedure can be performed using Pfannenstiel or lower midline incisions. The purpose of this study was to investigate the effect of each of these incisions on the operation time, postoperative pain, intraoperative bleeding, and postoperative scar. Materials and Methods: This study was conducted using a randomized clinical trial method on 62 patients who had been referred to Shahid Beheshti Hospital in Hamadan, Iran in 2022 for prostatectomy. Patients were randomly divided into two groups of L (lower midline incision) and P (Pfannenstiel incision). The required data was collected through relevant tools, and the collected data were analyzed using an independent t-test in SPSS software (version 23). Results: The results showed that there was no significant difference between the L and P groups before studying individual characteristics and the two groups were homogeneous. Based on statistical tests, there was a significant difference between group P and group L regarding the amount of bleeding in the enucleating stage, the amount of pain 24 h after the operation, and the scar score (P

Abstract The kidney cancer (KC) burden measures have changed dramatically in recent years due to changes in exposure to the determinants over time. We aimed to decompose the difference in the KC burden measures between 1990 and 2019. This ecological study included data on the KC burden measures as well as socio-demographic index (SDI), behavioral, dietary, and metabolic risk factors from the global burden of disease study. Non-linear multivariate decomposition analysis was applied to decompose the difference in the burden of KC. Globally, ASIR, ASMR, and ASDR of KC increased from 2.88 to 4.37, from 1.70 to 2.16, and from 46.13 to 54.96 per 100,000 people between 1990 and 2019, respectively. The global burden of KC was more concentrated in developed countries. From 1990 to 2019, the burden of KC has increased the most in Eastern European countries. More than 70% of the difference in the KC burden measures between 1990 and 2019 was due to changes in exposure to the risk factors over time. The SDI, high body mass index (BMI), and alcohol use had the greatest contribution to the difference in the KC burden measures. Changes in characteristics over time, including SDI, high BMI, and alcohol consumption, appear to be important in the evolving landscape of KC worldwide. This finding may help policymakers design policies and implement prevention programs to control and manage KC.

Background and Aim: Edaravone is known for its efficacy in inhibiting free radical formation, activating microglia, and promoting neurogenesis and neuroprotection following acute ischemic stroke. This clinical trial aimed to investigate the effects of Edaravone on clinical symptoms and oxidative stress factors in patients with acute ischemic stroke. Methods: In this clinical trial, fifty-two patients diagnosed with acute ischemic stroke were randomly assigned to receive either Edaravone (120 mg daily up to 3 doses intravenously) or a placebo in addition to standard treatment. Stroke severity was assessed using the NIH Stroke Scale (NIHSS) and Modified Rankin Scale (MRS) at hospitalization and three months post-stroke. Antioxidant capacity, protein oxidation, and lipid peroxidation levels were measured during hospitalization and three days later. Results: Twenty-six patients were included in each group and were matched in terms of risk factors, neurological symptom severity, antioxidant capacity, protein oxidation, and lipid peroxidation at hospitalization. At the three-month follow-up, both groups showed a decrease in neurological symptom severity, with a slightly higher reduction observed in the Edaravone group, though not statistically significant (P=0.256). A similar proportion of patients achieved an MRS score of ≤2 within three months post-stroke in both groups (23.1% in the placebo group vs. 30.8% in the Edaravone group, P=0.755). All eight deaths within the first three months occurred in the placebo group. The most common side effect was intracerebral hemorrhage (13.5%), predominantly in the placebo group. Despite higher mean antioxidant capacities in the intervention group, no significant difference was observed post-intervention. Conclusion: The study suggests that adding Edaravone to standard treatment for acute ischemic stroke may lead to improved patient outcomes. However, further research with larger sample sizes is needed to establish the efficacy of this medication.

Background & aim: The premature infant imposes significant tension and stress on mothers and may affect quality of mothers' sleep. Therefore, this study was performed to assess the effect of kangaroo mother care using the role-playing method on the mother-infant attachment and sleep quality of mothers of premature infants.Methods: This randomized clinical trial was conducted on 78 mothers of premature infants in the neonatal intensive care unit (NICU) of the hospital affiliated to the Hamadan University of Medical Sciences from July 2010 to September 2011. The samples were selected by convenience method, then divided into two experimental and control groups by simple random allocation method. Mothers in the experimental group learned kangaroo mother care in two 30-minute sessions using modeling and unique clothing (role-playing). Then, mothers performed 20-minute kangaroo mother care three times a day. Mothers in the control group performed kangaroo mother care through pamphlets and educational videos. Subjects completed mother-infant attachment and and sleep quality questionnaires before, after, and one week after the intervention. Data analysed by SPSS (version 22).Results: There was statistically significant difference between the two groups in the mother-infant attachment one day (P

Background and aims: COVID-19 has emerged as a novel pandemic, emphasizing the crucial role of prevention and quarantine measures. Compliance with these measures becomes particularly important for individuals in close contact with COVID-19-infected individuals. This study aimed to investigate the level of quarantine compliance among individuals who had close contact with COVID-19 patients in Hamadan province, as well as identify predictors associated with compliance. Methods: This descriptive-analytical, cross-sectional study was conducted between March and July 2022, involving 350 individuals who had close contact with COVID-19 patients in Hamadan province, Iran. A researcher-designed questionnaire was employed to gather participants’ demographic and clinical information, as well as their adherence to quarantine principles, through a 7-question assessment. The collected data were statistically analyzed using Stata software, version 16. Results: The study participants had a mean age of 40.23±12.91 years. The rate of good compliance with quarantine measures among individuals in close contact with COVID-19 patients was found was 58.66%. Adjusted logistic regression analysis revealed that men in close contact with COVID-19 patients had a 1.66 times higher chance of complying with quarantine compared to women (odds ratio [OR]=1.66, 95% CI=1.06, 2.56), P=0.025). Additionally, individuals over the age of 60 who had close contact with COVID-19 patients exhibited a 2.28 times higher chance of non-compliance with quarantine (OR=2.28, 95% CI=1.17, 4.45, P=0.015). Conclusion: Demographic characteristics could significantly influence compliance with quarantine principles among individuals in close contact with COVID-19 patients. Addressing these factors is crucial for effective health planning and patient education in the country.

Background and Objective: Considering the role of oxidative stress in the pathogenesis of ischemic stroke, antioxidant and anti-inflammatory drugs can be a potential treatment in these patients. This study aimed to investigate the effectiveness of doxycycline on the improvement of oxidative stress biomarkers in patients with ischemic stroke. Materials and Methods: This clinical trial study was performed on 48 patients with ischemic stroke who had referred to Besat Hospital in Hamadan, Iran, in 2023. They were randomly and equally assigned to the intervention (doxycycline at the rate of 100 mg every 12 hours) and placebo groups for one week. Before and after the intervention, serum levels of malondialdehyde (MDA), glutathione (GSH), total oxidant status, total antioxidant capacity, c-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were measured. Results: The study groups had no statistically significant difference in all measured biomarkers in the first 24 h after the stroke (P>0.05). In both study groups, the biomarkers of MDA and total oxidant status decreased after treatment. This decrease was greater in the intervention group, compared to the placebo group with a statistically significant difference. The total antioxidant capacity and GSH increased in both groups, and this increase was more significant in the intervention group, compared to the placebo group. In both groups, serum levels of CRP and ESR decreased, but no statistically significant difference was observed between the two groups. Conclusion: Addition of doxycycline to the standard treatment of ischemic stroke patients may reduce oxidative stress biomarkers; however, to confirm the results of this study, studies with a larger sample size are needed.

Background: To date, no study has examined domestic violence among infertile women in western Iran. Aims: This study aims to investigate the prevalence of domestic violence among infertile women in the region. Materials and Methods: A cross-sectional study was carried out at the infertility clinic in Hamadan. A total of 200 eligible infertile women, with a mean age of 31.48 ± 4.57 years, were recruited for the study. The Domestic Violence Questionnaire (DVQ) was administered to all participants. Data analysis was performed using Stata Statistical Software (version 17), with a significance level set at P ≤ 0.05. Results: This study included 200 infertile women with an average age of 31.48 ± 4.57 years. The mean duration of infertility was 1.9 ± 0.76 years. Regarding education, approximately 66% of the women and 69% of their spouses had completed high school or attained a diploma. Female-related causes accounted for 72.5% of infertility cases. Among the participants, 59.4% reported experiencing domestic violence. Emotional violence scored the highest percentage (67.5%), while sexual violence had the lowest percentage (43.63%). Statistical analysis revealed significant associations between age, spouse’s education level, frequency of sexual intercourse, and the level of violence experienced by women. Conclusion: The findings of this study reveal that 59.4% of women experienced various forms of domestic violence. Moreover, significant associations were observed between domestic violence and factors such as age, spouse’s education level, and frequency of sexual intercourse.

Background: There are many reports about the risk factors for recurrence after laminectomy surgery. Some surgeons use unilateral and bilateral fusion to provide sufficient stability to the lumbar spine. However, its strength, safety, and effectiveness in young patients are not widely known. Therefore, this study was conducted to compare surgical methods of laminectomy with unilateral and bilateral fixation and laminectomy alone without interbody fusion in young patients with lumbar spinal stenosis. Methods: 90 patients eligible for lumbar spinal stenosis surgery were selected through convenience sampling and randomly divided into three groups: laminectomy without fixation (A), laminectomy with unilateral fixation (B), and bilateral fixation (C). Pain, functional disability, quality of life, recurrent disc, adjacent segment disease (ASD), and fusion rate were evaluated and compared among the three groups six months post-surgery. The data were analyzed using SPSS version 16. Results: Six months after surgery, the mean score of functional disability in the bilateral group was significantly higher than the other groups (12.92 (3.30) vs 5.52 (1.91) and 4.30 (1.84), P 0.05) regarding fusion, recurrent disc herniation, and adjacent segment disease. Conclusions: Unilateral fixation provides the same benefits as bilateral fixation but has the additional benefits of being less invasive and minimizing the disadvantages of other investigated techniques during and after surgery.

In this present study, the association between occupational exposure to Respirable Crystalline Silica (RCS) and serum level of Clara Cell Protein (CC16) was investigated in the form of a systematic review and meta-analysis. Various databases including PubMed, Scopus, and Web of Sciences were searched until August 2022 based on Medical subject headings (MeSH) such as "CC10 protein, human" OR "Clara-cell specific 10-kD protein "OR "Clara cell phospholipid-binding protein human" AND Silicosis. Standardized Mean Difference (SMD) was used to compare the mean difference in CC16 serum levels between the silicotic and non-silicotic groups. During the initial database search until August 2022, 18 articles were found. By excluding duplicates and final screening in terms of compliance with the title and objectives, eight articles were included in our analysis. The overall effect estimate demonstrated that silicosis patients had lower serum level of CC16 (SMD:-3.58; 95% CI, from -5.14 to-2.3; I2 = 94.4% P-value

Background and Objective: Due to the growing trend of the cesarean section rate in Iran in the past years, the natural childbirth promotion program was implemented as one of the health system transformation plans in 2014. The present study aimed to assess the trend of changes in the percentage of cesarean deliveries following the implementation of this program in Hamadan province. Materials and Methods: This longitudinal study was conducted using secondary data to investigate the changes in the rate of cesarean delivery during 22 years. The data required for this study included deliveries from April 1998 to March 2019 by delivery type. The statistical analysis of this study was performed in joinpoint software (version 3.4) using the joining point regression method. Results: The percentage of cesarean deliveries in the whole province during the study period has constantly increased, from 32% in 2017 to 48% in 2019. The results of the joinpoint regression indicated an annual increase of 1.9% in the trend of cesarean section in Hamadan province. The trend has some joinpoints, none of which correspond to the timing of the implementation of the health evolution plan. Conclusion: Based on the obtained results, although the transformation plan has been able to reduce the increasing percentage of cesarean births, this amount of change was not sufficient to achieve the predetermined goals of the health transformation plan.

Abstract The moral intelligence of healthcare professionals in the cardiac operating room is one of the most important aspects of professional competence. However, moral intelligence is an abstract and multidimensional concept that needs to be clarified and described based on organizational culture and environment. Therefore, there is a need to design a specific scale for measuring the moral intelligence of healthcare professionals in the cardiac operating room. This study aims to design and assess the psychometric properties of a moral intelligence scale for healthcare professionals in the cardiac operating room. The present study was a mixed method study with a sequential exploratory approach. The research was conducted in 2023–2024 in Iran. The first phase data were collected from 20 healthcare professionals and were analyzed by conventional content analysis method. In the second phase, the validity and reliability of the instrument were evaluated by involving 300 healthcare professionals in the cardiac operating room. The moral intelligence of health care professionals in the cardiac operating room was defined as moral sensitivity combined with moral commitment and moral courage for the provision of quality care that respects the principles of medical ethics. After deducing the conceptual framework, the moral intelligence scale for healthcare professionals in the cardiac operating room was developed with three dimensions: “moral sensitivity,” “moral commitment,” and “moral courage.” 11 items were removed during testing to ensure content validity. Face validity was confirmed with impact scores > 1.5 for all items. A scale was developed through factor analysis with three factors that accounted for 73.04% of the observed variance. The instrument’s reliability using Cronbach’s alpha coefficient calculation was reported as 0.94 for the entire instrument. The testretest showed no statistically significant difference between the pre and post-test scores of moral intelligence (p = 0.51). The moral intelligence scale demonstrated acceptable psychometric properties. The moral intelligence scale for health care professionals in the cardiac operating room demonstrated acceptable psychometric properties. This instrument may serve to assess the moral intelligence of healthcare professionals and determine the need for educational interventions to reduce the ethical challenges and improve the moral intelligence of this healthcare.

Abstract Background Vaccination is a primary prevention approach to preventing disease by disconnecting the transmission chain. The current study utilized a BASNEF model framework to identify factors influencing subsequent doses of COVID-19 vaccination among older adults. Methods This cross-sectional study was performed in the west of Iran in May 2022. The participants were selected via multi-stage sampling. Finally, 1120 participants contributed to the present study. The questionnaire consisted of three sections: a) Socio-demographic characteristics, b) cognitive impairments tests, and c) Questionnaire about the subsequent dose of COVID-19 vaccine uptake based on the BASNEF model. Data were analyzed using the software IBM AMOS-20 and SPSS-23 via one-way analysis of variance (ANOVA) and independent sample T-tests were used, too. The significance level of statistical tests was regarded as less than 0.05. Results The presented results of analyzing 50% of the variance of vaccination intention as the dependent variable (R square = 0.497) and 10% of the behavior variance as the dependent variable (R square = 0.104) can be explained based on the BASNEF model. The enabling factors (β = 0.636, p

Introduction: Complementary medicine presents a viable avenue for mitigating side effects after surgery. This study aimed to compare the effects of acupressure and peppermint essential oil on the quality of recovery in patients undergoing laparoscopic cholecystectomy (LC). Methods: In this clinical trial, 210 patients referred to the Besat and Beheshti hospitals in Hamadan, Iran, were included. After giving their informed consent and completing the demographics survey, they were randomly assigned to 3 equal groups of control, peppermint essential oil, and acupressure. The study primarily assessed recovery quality through a 15- item questionnaire and secondarily evaluated postoperative nausea and satisfaction. Data were analyzed using Kruskal-Wallis, Wilcoxon, and Friedman tests in SPSS 23. Results: In pre-intervention, there was no significant difference between the groups in the total score of recovery quality, nausea, and demographic data. There was a significant increase in the quality of recovery score in the acupressure group when compared to the peppermint group on the second postoperative day (P

Abstract Background Despite the widespread use of extracorporeal shock wave lithotripsy (ESWL) as a treatment for kidney stones, it is essential to apply methods to control pain and improve patient comfort during this procedure. Therefore, this study aimed to investigate the effect of acupressure at the Qiu point on pain intensity and physiological indices in patients undergoing ESWL. Methods This randomized, sham-controlled clinical trial was conducted at the Shahid Beheshti Educational-medical Center in Hamadan City (western Iran) from May to August 2023. Seventy-four eligible patients were split into intervention (n = 37) and sham (n = 37) groups. Ten minutes before lithotripsy, the intervention group received acupressure at the Qiu point, while the sham group received touch at a neutral point. The primary outcomes were pain intensity measured by the Visual Analog Scale (VAS) and physiological indices such as blood pressure and heart rate at baseline, 1, 10, 20, 30, 40, and 50 min after the intervention. The secondary outcomes included lithotripsy success and satisfaction with acupressure application. Results The analysis of 70 patients showed no significant differences in the demographic and clinical information of the patients across the two groups before the study (P > 0.05). Generalized estimating equations revealed that the interaction effects of time and group in pain and heart rate were significant at 30 and 40 min (P 0.05). Conclusions Acupressure at the Qiu point positively impacts pain in patients undergoing ESWL treatment and increases their satisfaction. However, these results for physiological indices require further studies. Thus, acupressure can be considered a simple, easy, and effective option for pain management in patients during this procedure. Trial registration [ https://en.irct.ir/trial/69117 ], identifier [IRCT20190524043687N4].

Background & Aims Providing quality nursing care has always been the main concern of nurses. Clinical competence and moral courage are effective factors in providing quality nursing care. The present study aims to determine the relationship between clinical competency and moral courage in Iranian nurses. Materials & Methods This is a descriptive-correlational study with a cross-sectional design that was conducted in 2022 on 123 nurses working in teaching hospitals affiliated to Hamadan University of Medical Sciences, who were selected using a simple random sampling method. Data collection tools were Sekarka et al.’s moral courage questionnaire, Liu et al.’s competency inventory for registered nurses, and a demographic form. Data analysis was done using descriptive statistics, independent t-test, one-way analysis of variance and Pearson’s correlation test in SPSS software, version 16. Results The mean scores of clinical competency and moral courage scores were 151.18‌±‌22.32 and 59.56‌±‌7.47, respectively, indicating a moderate clinical competency and high moral courage. There was a significant and positive (weak) relationship between moral courage and clinical competency (r=0.272, P=0.001). Conclusion Due to the moderate clinical competency of nurses, educational workshops are recommended to improve their clinical competence. Moreover, since there is a weak relationship between clinical competency and moral courage of nurses, factors other than clinical competence may be related to moral courage, which requires further studies.

Background: Falling is a significant cause of occupational injuries and fatalities among farmers, and falling from trees is one of the most common causes of injury resulting in a high number of visits to health centers. Despite this, there is limited evidence on the factors associated with falling from walnut trees. Therefore, this study aimed to identify the factors that contribute to falling from walnut trees from the perspective of farmers and farmworkers.Methods: This qualitative study was conducted using conventional content analysis. Data were collected through semi-structured interviews with 20 farmers and farmworkers who had experienced falling from walnut trees as recorded in the National Accidents Record Program from September to October 2017 in Tuyserkan county, Iran. Participants were selected through purposive sampling. Moreover, data rigor was ensured through participant and external checks. All interviews were recorded and analyzed using content analysis methods.Results: Data analysis led to the extraction of six themes, including psychological factors, physical factors, behavioral and habitual factors, economic factors, factors related to walnut trees, and atmospheric agents, along with 18 subthemes for behavioral, human, and environmental factors.Conclusion: The findings of this study suggest that with appropriate interventions and training, farmers and farmworkers can be guided and assisted so as to prevent the occurrence of falling from walnut trees. In addition to educational interventions, health promotion measures such as providing safety equipment and insurance coverage can be essential in reducing injuries.

Background and Objective: COVID-19 disease has various manifestations, such as fever, sore throat, shortness of breath, body pain, and loss of consciousness. This disease may cause coagulation disorders and therefore an increase in thromboembolic events in these patients. This study examines the status of anti-phospholipid antibodies (aPL) in such patients, as one of the factors of increased coagulability. Materials and Methods: This case-control study examined anti-phospholipid antibodies (including lupus anticoagulant, anti-cardiolipin antibody, and anti-beta-2 glycoprotein antibody) in 60 patients with definite mild COVID-19. Patients were included in the study if they met the inclusion criteria. The blood samples of the studied subjects were analyzed in the unit's laboratory. The patients' sample results were compared to those of 60 healthy individuals who were matched in terms of age and gender. Results: The mean age scores of the case and control groups were 48.54±15.29 and 46.91±16.71 years, respectively (P=0.57). In case group, the Anti-β2GPI (IgG and IgM) test was positive in two patients (P=0.578 and P=0.346). The LAC test was positive in 3 patients and 2 controls (P=0.57). Anti-cardiolipin antibodies was positive in 4 patients (IgG in 1 patient and IgM in 3 patients), compared to the control group in 1 patient (P=0.004). Conclusion: According to the results of this study, the prevalence of aPL was higher in patients with mild COVID-19 than in healthy individuals. Considering the role of aPL in thrombosis, it may increase the coagulability conditions in these patients.

In recent years, the widespread use of pesticides has led to serious health concern for humans and animals. Current study was conducted to assess concentration of pesticide residues (herbicide, insecticide, fungicide, ovacide, acaricide, miticide, veterinary materials, and nematicide) in different vegetables according to the type of vegetables, pesticide, and the mainland. The literature studies regarding the concentrations of pesticides in the different vegetables were collected using international databases such as Web of Science, Scopus, and PubMed from January 2002 to October 2022. According to the results, the mean pesticide concentration in vegetables was 0.24 mg/kg and 95 % confidence interval (CI) (0.23–0.25 mg/kg). The pesticide level in vegetables was fungicide > herbicide > ovacide > insecticide > acaricide > nematicide > miticide respectively. The biggest and the smallest mean as well as 95 % CI of pesticides belong to green beans 2.57 mg/kg (2.56, 2.58 mg/kg) and Chinese kale 0.010 mg/kg (0.009, 0.011 mg/kg), respectively. Besides, if we consider the location where the vegetables are grown the pesticide concentration in different vegetables was fungicide > insecticide > herbicide > veterinary substance > ovicide > nematicide > acaricide > miticide respectively. The highest amount of pesticide concentration in Europe, Asia, and Africa was attributed to insecticide while herbicide and fungicide were reported in North America, and South America, respectively. The findings of our meta-analysis can be beneficial in risk assessment methods and can be applied by health administrators and programs designed to monitor the environment to o decrease pesticide residues in various vegetables.

Abstract Objective This cross-sectional validation work evaluated the psychometric features of the COVID-19 Media Literacy Scale (C-19MLs) in Students. Methods The study was conducted on 530 students from a medical university in Hamadan, Iran, who were recruited through a stratified cluster random sampling process in June-July 2020. Intraclass Correlation Coefficient (ICC) and internal consistency were used to assess the reliability. Moreover, CFA (Confirmatory Factor Analyses) and EFA (Exploratory Factor Analyses) were carried out to examine construction validity. CVR (Content Validity Ratio) and CVI (Content Validity Index) were used to examine the content validity. Results According to the factor analysis, it was indicated that the C-19MLs included 21 items measuring five dimensions (constructedness of credible Covid-19 media messages, contractedness of fake media coronavirus messages, fake media coronavirus messages, audience, with three questions in each factor; format, represented lifestyles in fake media coronavirus messages with six questions in each factor) for an explanation of 58.4% of the prevalent variance. The average scores for the CVI and CVR were respectively 0.94 and 0.77. According to confirmatory factor analysis, the studied model had an appropriate fitting to the data; the relative chi-square (x2/df) = 2.706

Background and aims: Long-term stress can lead to forgetfulness of nursing care and reduce the quality of nursing care. Therefore, this study aimed to determine the relationship between nursing stresses and missed nursing care during the COVID-19 pandemic. Methods: The present study was a cross-sectional study. This study included 268 nurses from various hospitals in 2022. Sampling was done by stratified quota method. Kalish and Williams’ Forgotten Nursing Care and French’s nursing stress questionnaires were used to collect data. Data were analyzed using Stata 14 at a significance level of 0.05. Results: The study showed a significant relationship between the expression of nursing stress and forgotten nursing care (P≤0.001). Average stress scores for nursing care and forgotten nursing care were obtained as 137.90±36.70 and 32.71±8.72, respectively. Conclusion: Most nurses reported much stress. Considering the positive correlation between nursing stress and forgotten nursing care, nursing managers are suggested to reduce missed nursing care with stress reduction workshops.

Introduction. Disability to recognize emotional and mental states from other people’s facial expressions is acknowledged as one of the major developmental-behavioral problems in autistic children. Therefore, this study aimed to investigate the effect of traditional and computer emotional facial training on the recognition of facial emotional states in children with autism and mother-child relation and parental competence in mothers of autistic children. Material and Methods. The present was clinical trial study. The children in the both groups were trained during 10 sessions. In traditional group children training using 40 images related to four situations as happiness, sadness, anger, and fear. The children in the computer group trained with the Let’s Face It software. These questionnaires were completed one day before and one day and one week after performing the intervention. The data were analyzed using SPSS software. Results. Findings showed that emotional state training has improved the identification of emotional states (p = 0.01), mother-child relation (p = 0.001) and parental competence (p = 0.001) in the both groups. There was also a statistically significant difference between the scores of identifying face emotional states (p = 0.01), mother-child relation (p = 0.001) and parental competence (p = 0.001) in the both groups. But training in traditional group was effectiveness than computer grope. Conclusion. Teaching emotional face to children with autism improved the recognition of emotional states by these children, and subsequently improved the mother-child relationship and motherly sense of competence in the mothers of these children.

Introduction: The occurrence of nausea and vomiting following anesthesia and surgery is a prevalent and distressing issue, ranking second only to pain. In this study, the effects of ginger and ondansetron in mitigating these symptoms in patients who underwent cesarean section surgery were compared. Methods: This double-blinded randomized clinical trial included 150 eligible patients who were randomly assigned to one of three groups: ginger, ondansetron, and control. The ginger group was given one 1000 mg ginger capsule, the ondansetron group was given one 16 mg ondansetron capsule, and the control group was given one placebo capsule. Participants took their designated capsules with 30 mL of water one hour before their scheduled surgery. Nausea intensity and vomiting frequency were assessed throughout the surgical procedure and at post-operation intervals of 0.5, 1, 2, and 4 hours. Results: Compared to the control group, the ginger group had significantly less severe nausea during the surgery (P=0.03) and one hour after surgery (P=0.01). The ginger group also had significantly fewer vomiting episodes during the surgery (P=0.007) and half an hour after surgery (P=0.001). There was no significant difference between the ginger and ondansetron groups regarding the severity of nausea and the number of vomiting (P>0.05). Conclusion: The administration of ginger was found to be successful in alleviating the severity of nausea and vomiting both during and after spinal anesthesia for cesarean section procedures. It could be a viable alternative to ondansetron.

Background and Objective: Appendectomy is one of the most common surgical procedures with various clinical complications affecting wound healing. The type of skin closure is a critical surgical stage to prevent infection and dermal scarring. Therefore, administration of proper skin suturing can lead to complete wound healing and reduction of appendectomy-associated complications. In this regard, the present study was designed to compare the quality of the wound healing process and related complications in Simple Semi-Plastic (SSP) and Continuous Sub-Cuticular (CSC) dermal suturing procedures. Materials and Methods: This triple-blind clinical trial study was conducted on 73 appendectomy patients randomly categorized as the cases with SSP (n=38) and CSC (n=35) suturing procedures. Demographic data, wound-associated characteristics (e.g., width of scar, color, odor, patency, necrotic tissue, wound warmth, granulation and epithelialization tissues, volume and color of wound secretion, and color of wound-surrounded tissues) were totally assessed using a pre-designed checklist. Visual Analogue Scale (VAS) index was also used for assessing level of pain. All the collected data were applied on 2nd, 10th, and 30th days post-surgery. The obtained data was analyzed in SPSS software (version 23). Results: According to the results of the present research, no significant differences were detected in the terms of demographic characteristics, wound-associated complications, healing-related factors, and changes of wound-surrounding tissues between the SSP and CSC groups (P>0.05). The width of scar was significantly higher on the 2nd and the 10th days after suturing in SSP group than CSC group (P

Background and Objective: Burn pain during therapeutic procedures causes anxiety in patients. Spiritual health and resilience are factors affecting anxiety. The present study aimed to determine the relationship between spiritual health with resilience and wound pain anxiety in burn patients. Materials and Methods: In this cross-sectional study, 213 patients were selected by random sampling method. Demographic information, Polotzin and Ellison's spiritual health questionnaire, Connor-Davidson Resilience Scale, and Burns Specific Pain Anxiety Scale were used to collect data. T-tests and one-way analysis of variance were used to analyze the collected data. Data analysis was performed using SPSS software (version 21). Results: The findings showed that most patients were male (62.91%) with an average age of 38.21 ± 12.72. The average scores of spiritual health, wound pain anxiety, and resilience were 73.63 ± 21.20, 52.83 ± 16.18, and 58.24 ± 13.51, respectively. Although a significant relationship was found between spiritual health and resilience and between resilience and wound pain anxiety, no significant relationship was seen between spiritual health and wound pain anxiety. Conclusion: Burn patients suffer a lot of pain during procedures such as dressings. Considering the relationship between spiritual health, burn pain anxiety and resilience, educational workshops are suggested to increase spiritual health, resilience and better tolerance during hospitalization.

IntroductionHealthcare professionals have a critical role in ethical decision-making around end-of-life care. Properly evaluating the ethical decision-making of health care professionals in end-of-life care requires reliable, tailored, and comprehensive assessments. The current study aimed to translate and assess psychometrically a Persian version of the ethical decision making in end-of-life care scale for Iranian adolescents in the final stages of life.MethodsThe present study investigates the methodology and multicenter research. 310 healthcare professionals who treat/care for adolescents at the end of life were selected from 7 cities in Iran. The original version of the end-of-life care decision-making scale was translated into Persian using the forward-backward translation method, and its psychometric properties were evaluated using COSMIN criteria.ResultsExploratory factor analysis revealed that the factor loadings of the items ranged from 0.68 to 0.89, all of which were statistically significant. Furthermore, three factors had eigenvalues greater than 1, accounting for 81.64% of the total variance. Confirmatory factor analysis indicated a proper goodness of fit in the hypothesized factor structure. The internal consistency reliability of the tool was assessed in terms of its homogeneity, yielding a Cronbach's alpha coefficient of 0.93.ConclusionThe Persian version of the End-of-Life Care Decision-Making Scale demonstrates satisfactory validity and reliability among healthcare professionals working with adolescents in the final stages of life. Therefore, nursing managers can utilize this tool to measure and evaluate ethical decision-making in end-of-life care for adolescents in the final stages of life and identify the most appropriate strategies, including educational interventions, to improve ethical decision-making in end-of-life care if necessary.

Background and Objective: Moral distress is a harmful factor in nursing and nursing care. Ethical courage helps nurses to perform nursing care. The present study aimed to determine the relationship between moral distress and moral courage of nurses working in selected hospitals of Hamadan University of Medical Sciences during the Covid-19 pandemic. Materials and Methods: This cross-sectional study was conducted with the participation of 204 nurses working in selected educational hospitals by random sampling method. Data were collected by the self-report method using a demographic checklist, as well as Corelli Moral Distress and Sekerka Moral Courage questionnaires. The data were analyzed in SPSS software (version 21) using independent t-test, ANOVA, and regression analysis. A P≤0.050 was considered statistically significant. Results: The results demonstrated that the majority of nurses were male (55.40%) with a mean age of 41.96±9.53 years, working in the emergency department (43.20%), with 5-10 years of work experience (51.38%), and contract employment (57.45%). Moral distress was significantly correlated with gender, place of service, and work experience; moreover, moral courage and age were significantly associated (P≤0.050). Nevertheless, no significant relationship was detected between moral distress and the type of employment. Moral courage was not correlated with the type of employment, work experience, gender, and place of service (P≥0.050). There was a significant negative relationship between moral distress and moral courage (R=-0.863, P≤0.050). The results of the adjusted regression model illustrated that with each unit increase in the moral distress score, the moral courage score decreases by 0.33. This relationship was statistically significant (β=-.033, P

Background and Objective: In the last decade, cross-linking (CXL) has been widely used for treating people with progressive keratoconus. The present study aimed to compare corneal aberrometry parameters before and after CXL in patients with keratoconus. Materials and Methods: In this cross-sectional study, 67 patients with keratoconus referred to Farshchian Sina Medical Education Center, Hamadan, Iran, who underwent CXL surgery at Mahdia Surgery Center, were selected. The results of refractometry and aberrometry before the surgery and six months after the CXL, were examined and compared. Data were extracted from patients’ medical records and analyzed in SPSS software (version 26). A P-valuec less than 0.05 was considered statistically significant. Results: The mean age of patients was 22.28 ± 5.03 years, and 65.7% were male. Mean aberrometry parameters before and six months after the treatment for K1: 44.33 and 44.04 (P=0.003), K2: 48.01 and 47.91 (P

Abstract Background Child laborers are often defined as work that deprives children of their childhood, their potential and their dignity, and that is harmful to physical and mental development. Child laborers are one of the most vulnerable groups in domestic violence. Domestic violence severely affects the physical and mental health, and consequently affects substance dependence and resilience to suicide of these children. Accordingly, it is essential to examine domestic violence, substance dependence, and suicidal ideation in working children. Objectives the present study aimed to investigate the relationship between exposure to domestic violence and substance dependence and suicide resilience on the other among child laborers in Iran. Methods This study employed cross-sectional research. 600 child laborers were selected via convenience and snow ball sampling from one rehabilitation and welfare center and three charity organization societies in the west of Iran, from January to August 2022. They completed questionnaires. Data were analyzed by SPSS software version 22 and with using descriptive statistics (frequency, percentage, mean and standard deviation) and ANOVA, independent t-test and the multiple linear regression model with a backward strategy. Results Findings showed that exposure to domestic violence has a strong and direct correlation with substance dependence (r = 0.94, p

Background: Hyperemesis gravidarum (HG) is an infrequent and severe occurrence of nausea and/or vomiting during pregnancy, with a prevalence ranging from 0.3% to 2%. Until now, no meta-analytic study has been undertaken to assess the correlation between pre-pregnancy body mass index (BMI) and the likelihood of HG. Consequently, this meta-analysis was carried out to examine the connection between BMI and HG risk. Methods: For this systematic review and meta-analysis, we conducted a thorough search of electronic bibliographic databases such as PubMed, Web of Science, Scopus, and Science Direct until May 2022. The outcomes were presented utilizing a random-effects model. Heterogeneity was assessed using the chi-square test and I2 statistic. Potential publication bias was examined using Begg’s test. Additionally, we evaluated the quality of studies using the Newcastle Ottawa Scale. Results: In total, seven studies were included in the present meta-analysis such as six cohort studies and one cross-sectional study. In this meta-analysis, 3,573,663 participants were involved. Based on the results, the underweight was a risk factor for HG (odds ratio (OR) = 1.91, 95% confidence interval (CI): 1.21, 2.61). There was not significant association between overweigh and HG (OR = 1.23, 95% CI: 0.96, 1.50). In addition, there was not significant association between obesity and HG (OR = 0.88, 95% CI: 0.42, 1.34). Heterogeneity was seen among the included studies. Conclusions: An apparent association between pre-pregnancy BMI and the risk of HG has been observed. However, further investigation is necessary, as the mechanisms and the connection to GDF15 are not yet clear. The most supported public health advice is to attain a healthy BMI before conception. Additionally, the oversight of confounding variables should be taken into account, highlighting the need for comprehensive consideration in future studies.

Objectives: Stroke patients often experience poor sleep quality and spiritual health due to complications and limitations. In this situation, implementing spiritual care may reduce these problems. Therefore, this study aimed to examine the effect of a spiritual care program on sleep quality and spiritual health of Muslim stroke patients. Methods: This was a two-group randomized clinical trial conducted in Hamadan, Iran, in 2021, with 117 stroke patients. The samples were selected by convenience sampling and assigned to experimental (N = 59) and control (N = 58) groups based on random permutation blocks. The data were collected using the demographic information form, the Pittsburgh Sleep Quality Index, the Paloutzian and Ellison Spiritual Well-Being Scale, and the Modified Rankin Scale before and one month after the intervention. The experimental group received five daily sessions of spiritual care for 45–60 min based on standard and local methods, including patient orientation and identification of spiritual needs, religious care, supportive spiritual care, and beneficial evaluations. Data were analyzed by chi-square test, Fisher's exact test, independent t-test, and paired t-test at 0.05 significance level in SPSS 21. Results: The socio-demographic characteristics were similar between the groups (p > 0.05). At baseline, there was no significant difference in sleep quality and spiritual health between the experimental and control groups (p > 0.05). However, after the intervention, the sleep quality and spiritual health of patients in the experimental group improved significantly compared with the control group (p

Introduction: So far, no study has been conducted in Iran on the effect of COVID-19 on neonates. Therefore, the present cross-sectional study has been evaluated to determine the clinical manifestations and outcomes in neonates infected with COVID-19 in the west of Iran. Materials and Methods: The present cross-sectional study was conducted among neonates infected with COVID-19 in six provinces of Hamadan, Kermanshah, Kurdistan, Ilam, Zanjan and Lorestan, located in the west of Iran, from 1 March to 1 July 2020. In these neonates, the polymerase chain reaction test was positive. The data were collected by a checklist and were analysed using SPSS Statistics Software. Result: During the study period, 16 neonates infected with COVID-19 were identified including Kurdistan Province with five cases, Hamadan Province four cases, Kermanshah with three cases, and Lorestan and Zanjan provinces with two cases. Neonate gender of them had equal distribution. Two (15.38%) of them needed CPR after delivery. The delivery method for 9 (56.25%) was vaginal, and one of them died during the study period. The medical care used for these neonates was as follows: 87.5% were hospitalized in the intensive care unit and antibiotics were used for 68.75%. 12.5% underwent COVID-19-specific treatment, and for 25%, a ventilator was used. The laboratory findings in neonates infected with COVID-19 showed that in 18.75%, blood urea nitrogen has increased. 46.15% of neonates reported lymphocytopenia. The blood haematocrit and haemoglobin decreased by 31.35% and 56.25%, respectively. Conclusion: The coronavirus disease 2019 has occurred among neonates, but they seemed to have a milder disease course and better prognosis than adults. Findings showed that there is a possibility of vertical intrauterine transmission from pregnant mothers to newborns.

Introduction: Because COVID-19 with extrapulmonary manifestations is likely to lead to the development of musculoskeletal disorders in susceptible individuals due to immunological mechanisms, it is possible to see more frozen shoulder cases during the COVID-19 pandemic. Therefore, this study was performed to evaluate the relationship of frozen shoulder and COVID-19. Materials and Methods: This study was a cross-sectional study from September 2020 to February 2021; patients who were referred to our shoulder clinic with stiffness and shoulder pain and diagnosed with adhesive capsulitis (AC) were evaluated for COVID-19 involvement. Shoulder range of motion was assessed as passive range of motion of forwarding flexion, internal rotation and external rotation in the arm at the side and 90° abduction. The visual analogue scale was also used to assess pain intensity. SPSS software was used for analysis, and Chi-square test was used for qualitative data analysis and a t-test was used for quantitative data. Results: Seventy-two patients with frozen shoulders were included in the study; the results showed that AC occurs at a younger age in patients with COVID-19 infection (P < 0.039); the mean age of all patients was 52.73 ± 8.68. The severity of pain was higher in patients with COVID-19 (P = 0.012). Furthermore, regarding the duration of referral in terms of months, it was shown that people with COVID-19 were referred in a shorter period after the onset of shoulder symptoms and there was a significant difference in terms of referral time and pain between the two groups (P < 0.01). Regular activity had a lower rate in patients with COVID-19 infection and the difference was significant in patients with and without COVID-19 (P < 0.029). Conclusion: Due to younger age, greater pain and faster visit of patients with a frozen shoulder after COVID-19, it is recommended to look for frozen shoulder in all COVID-19-infected patients by a complete clinical examination. This is more important in patients without regular physical activity.

Background To our knowledge, this is the first meta-analysis of the association of not breastfeeding and the risk of autism spectrum disorder (ASD) based on observational studies. Purpose This meta-analysis aimed to evaluate of the association of not breastfeeding and the risk of ASD. Methods Three databases (PubMed, Web of Science, and Scopus) were systematically searched until December 2021. Heterogeneity was determined using the chi-square test and its quantity was measured using the I2 statistic. The Begg line regression test was used to assess publication bias. A random-effects model was used to analyze the data. Seven studies were included in this meta-analysis. Results The total study population included 3,270 individuals. According to the random-effects model, the estimated odds ratio of the risk of ASD associated with not breastfeeding was 1.81 (95% confidence interval, 1.35–2.27; I2=0%). Conclusion The results of the included studies were homogeneous. Our findings showed that not breastfeeding is a risk factor for ASD. These results suggest the importance of breastfeeding in decreasing the risk of ASD in children.

Abstract Aim The aim of this study was to investigate the relationship between identity crisis and suicide resilience and quality of life in adolescents with burns in Iranian society. Design A cross‐sectional study. Methods Four hundred thirty adolescents with burn in three hospitals were selected via convenience sampling. They completed questionnaires online. Data were analysed by SPSS software version 22. Results Findings showed a strong and inverse correlation between identity crisis with suicide resilience (r = −.92, p

Objectives: The disability to recognize facial emotions is one of the behavioral problems in autistic children. This study was designed to evaluate the effect of education on the promotion of face recognition. Methods: This single-blind clinical trial study was conducted on children with autism. The participants were allocated with random sampling to the two groups. Autistic children in the intervention group were educated in 10 sessions with 40 facial emotions images, each session lasted 20 min. Autistic children in the control group underwent routine teaching. The assistant researcher completed the Benton questionnaire for each child before and after the study. The obtained data were analyzed with SPSS software, version 22. Results: This study showed that education on facial emotions has good effects on the recognition of facial expressions by children with autism. In addition, a significant difference is identified between the two study groups in identifying facial emotions (P

Objectives: The periodontal disease during pregnancy is considered to be significant because not only does it affect the tissues supporting the teeth, but also it is connected with systemic conditions such as adverse pregnancy outcomes. The present study aimed at assessing periodontal disease in pregnant women and other relevant demographic factors. Materials and methods: This is a cross-sectional, descriptive-analytical study that was conducted among 275 pregnant women visiting the health centers in Arak, Iran, in 2021. Cluster random sampling method was used to select the samples. The demographic information was gathered and periodontal statues was examined using the Community Periodontal Index of Treatment Needs (CPITN). The data were analyzed by SPSS18 software, using logistic regression. Results: According to the results, 55.4% of the pregnant women had periodontal disease (CPI>0). Bleeding on probing (BOP), dental calculus, and periodontal pocket depth (PPD) between 4 and 5 mm were observed of 17.5%, 36.4%, 5.1% of women, respectively. No periodontal pocket deeper than 6mm was observed. Brushing frequency was the main predictor for gingival health, and the women with under diploma education (OR: 2.26, 95% CI: 1.14-4.48) and having one or more children were (OR: 1.40, 95% CI: 1.02-1.94) more likely to have periodontal disease than women with academic education or having no children. Conclusion: According to the findings, pregnant women were not in good health condition in terms of periodontal disease. Considering the demographic and behavioral differences, designing the health promotion programs during pregnancy is recommended.

Background: The present study examines the various complications and impurities of alcoholbased hand sanitizers during COVID-19 among health workers in Hamadan City, Iran.Methods: This cross-sectional study was conducted on 178 healthcare workers in different hospitals affiliated with the Hamadan University of Medical Sciences. The inclusion criteria included health personnel working in hospitals dedicated to the care and treatment of patients with COVID-19 in Hamadan City. A researcher-made questionnaire was used to collect data. Afterward, to evaluate the quality and impurities of the alcohol-based hand sanitizers used by healthcare workers, various samples were collected and analyzed using gas chromatographymass spectrometry (GC-MS). Stata software version 14-2 was used to analyze the data.Results: The highest and the lowest percentages of ethanol in washing solutions and gels were 68.24% and 60.71%, respectively. Among them, the frequency of using gel, solution, and spray was 93.82%, 42.13%, and 49.44%, respectively. Skin and breathing sensitivity were the most common symptoms in 44.38% and 27.68% of the health workers, respectively. Skin dryness (50%) and sore throat (25.84%) were the most common complications observed in skin and respiratory symptoms among health workers, respectively.Conclusion: Our findings implied that the prevalence of various complications related to the use of alcohol-based hand sanitizers is high among health workers, which highlights the role of using appropriate alcohol-based hand rubs with suitable formulations in the hospital environment to reduce the adverse health effects caused by their long-term and extensive use among health workers.

Abstract Aim The aim of the present study was to investigate the burden of care, coping styles and involvement in the care of mothers of autistic children in the pandemic of COVID‐19 in Iranian society. Design A cross‐sectional study. Methods A total of 134 mothers completed questionnaires online. Data were analysed by descriptive statistics (frequency, percentage, mean and standard deviation) and independent t‐test, ANOVA and multiple linear regressions. The significance level was considered p

IntroductionMothers with disabled children are among the most critical groups exposed to domestic violence. Although domestic violence strongly affects these mothers’ physical and mental health, it subsequently affects their drug addiction and resilience to suicide. Based on this, it is crucial to investigate domestic violence, drug addiction, and resilience against suicide in mothers with disabled children. This study investigated the relationship between domestic violence, substance dependence, and resilience against suicide in mothers with disabled children in Iranian society.MethodsFrom January to April 2023, a cross-sectional study was conducted in central and western Iran with the participation of 267 mothers with disabled children. The mothers of disabled children were selected through convenience and snowball sampling. Then they completed questionnaires included domestic violence, substance dependence and resilience against suicide. The collected data were analyzed using SPSS version 22 with descriptive statistics, such as prevalence, percentage, mean, and standard deviation, and expository measurements, including ANOVA, independent t, and regression tests.ResultsThe study revealed that there was a strong direct correlation between domestic violence and substance abuse (r = 0.89, p

Background: One of the most common endocrine disorders in women during reproductive age is polycystic ovarysyndrome (PCOS). This study aimed to evaluate sexual functioning among women with PCOS in a sample of a region’spopulation in the west of Iran.Materials and Methods: This study was a cross-sectional study that was conducted on 130 women with PCOS whoreferred to three clinics of gynecology, infertility, and dermatology affiliated with Hamadan University of MedicalSciences, Iran, from September to November 2020. The measurement tools included demographic characteristics,hirsutism score, and sexual function was assessed using the female sexual function index (FSFI) questionnaire.Results: In total, 60% of patients had reported sexual dysfunction related to lubrication, satisfaction, and pain as domainsof sexual dysfunction. The number 109 (83.85%) of them had hirsutism and these patients had a lower score forlubrication (3.7 ± 1.47 vs. 4.47 ± 1.71, P=0.03), orgasm (3.2 ± 1.34 vs. 3.95 ± 1.37, P=0.02), satisfaction (3.4 ± 1.29vs. 3.71 ± 1.33, P=0.03), and FSFI score (22.56 ± 5.78 vs. 25.42 ± 5.51, P=0.04). Women with higher education hadreported higher scores of FSFI and its domains. Rural participants had a higher arousal score (3.93 ± 1.4 vs. 3.37 ±1.28, P=0.04). Moreover, housekeeper women had higher scores regarding desire, pain, and total FSFI score.Conclusion: Our results showed that there was a significant association between hirsutism and FSFI scores, differentdomains, including lubrication, orgasm, and satisfaction.