Payavard Salamat

Studying the Frequency of Stenotrophomonas Maltophilia from Different Clinical Samples and Determining the Antimicrobial Susceptibility Pattern of Isolates

Fatemeh Fardsanei

Background and Aim: Stenotrophomonas maltophilia is a non-fermentative Gram-negative bacillus and the third most common cause of hospital-acquired infections. Treatment of infections caused by this bacterium has not always been successful due to its high potential for multiple resistance to a wide range of antibiotics and the formation of biofilms. Obviously, accurate and timely diagnosis of bacterial agents causing hospital-acquired infections and determination of the microbial susceptibility pattern of isolates can make a significant contribution to infection control in hospitals. Therefore, the aim of this study was to determine the frequency of Stenotrophomonas in different clinical samples and to determine the biofilm production rate and microbial susceptibility of isolates.
Materials and Methods: In a cross-sectional descriptive study, non-fermentative Gram-negative isolates suspected of being Stenotrophomonas maltophilia isolated from different clinical samples from teaching hospitals in Qazvin province were collected and examined from April to March 2023. After phenotypic and molecular confirmation of the isolates using standard methods, the microbial susceptibility pattern of the isolates and the amount of biofilm production were examined using the microplate titer method.
Results: In this study, out of 50 isolates collected, the highest number of isolates were isolated from blood culture (33 isolates) and the lowest number of isolates were isolated from urine samples (1 isolate). Also, the highest frequency of samples was reported from the emergency department with 32 samples (63.8%) and the lowest frequency was reported from the ENT and oncology departments, each with 1 sample (0.8%). All isolates were 100% resistant to imipenem and meropenem due to the inherent resistance of this bacterium to carbapenems, which was a confirmation in the identification of this bacterium. The highest sensitivity to the antibiotics levofloxacin, minocycline and cotrimoxazole was observed with a frequency of 90%, 88% and 84%, respectively. The highest resistance to the antibiotic ceftazidime was observed, which was reported as 88%. In this study, 70% of the strains produced strong biofilms.
Conclusion: In this study, we saw an increase in hospital infections caused by Stenotrophomonas maltophilia in clinical samples of Qazvin hospitals. Knowledge of the frequency of opportunistic pathogens causing hospital infections and the microbial sensitivity of isolates leads to control of infections caused by these pathogens, proper treatment of infections and reduction of mortality in hospitalized patients. Fortunately, in this study, the isolates had high sensitivity to fluoroquinolone family antibiotics and antimetabolites.

Hematological Evaluation of the Interaction of Broncho T.D® and Isoproterenol in Experimental Study

Keivan Keramati

Background and Aim: BronchoT.D is an Iranian herbal drug manufactured for human consumption and has anti-cough and expectorant properties. Isoproterenol is a non selective agonist of beta-adrenergic receptors that although has been used as a drug in cases such as bradycardia, but based on the results of some studies, it has been determined that isoproterenol can also lead to tissue damage and hematological changes. The aim of this research was hematological evaluation of the interaction of BronchoT.D® with isoproterenol.
Materials and Methods: This was an experimental study. Eighteen male wistar rat were used in 3 experimental groups (each group 6 rats) including control, recipient of isoproterenol and normal saline and recipient of isoproterenol and BronchoT.D. There was no intervention in the control group. Isoproterenol was administered via twice injection and normal saline and BronchoT.D were administered five times orally. Finally, blood was collected from the rats and White Blood Cells (WBC), Red Blood Cells (RBC), Hematocrit (Hct), Hemoglobin (Hgb), Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin Concentration (MCHC) and Platelets (Plt) were measured. Statistical analysis of data was performed through one-way analysis of variance using SPSS software.
Results: In terms of WBC, the difference between the experimental groups was not significant. The isoproterenol and normal saline receiving group had a significant increase in terms of RBC, Hct, Hgb and Plt as compared to the control group. The difference between the isoproterenol and BronchoT.D receiving group was not significant in terms of RBC, Hct and Plt as compared to the control group. In terms of Hgb and MCHC, the isoproterenol and BronchoT.D receiving group had a significant increase as compared to the control group. In term of MCV, the difference between experimental groups was not significant. The isoproterenol and normal saline receiving group did not differ significantly in comparison with the control group in term of MCHC.
Conclusion: Based on the findings of this study, it can be concluded that BronchoT.D not only prevents some hematological changes caused by isoproterenol, such as an increasing of RBC and plt, but can also increase the oxygen-carrying capacity of blood through a significant increase in Hgb and MCHC. BronchoT.D probably causes such effects by counteracting oxidative stress or by directly affecting the bone marrow, although additional researches are necessary to investigate such probablities.

Investigating the Relationship between Learning Styles Based on the VARK Model with Gender, Performance, and Academic Semester of Anesthesia Student

Alireza Babajani

Background and Aim: Learning style refers to each learner’s preferred approach to receiving, processing, and retaining information. It is considered one of the key factors influencing the effectiveness of teaching and learning processes. This study aimed to examine the relationship between learning styles based on the VARK model and gender, academic performance, and academic semester among undergraduate anesthesia students at Iran University of Medical Sciences (IUMS).
Materials and Methods: This descriptive-analytical (cross-sectional) study was conducted during the 2022–2023 academic year using a census sampling method on 65 undergraduate anesthesia students enrolled in the 2nd, 4th, and 6th semesters at IUMS. Data were collected using the validated VARK questionnaire with a Cronbach’s alpha reliability coefficient of 98.6 Statistical analysis was performed using SPSS software, employing descriptive statistics (mean and frequency) and inferential tests (Chi-square and ANOVA). A significance level of P<0.05 was considered.
Results: Out of 60 fully completed questionnaires (32 female and 28 male students), 86.7% of students reported using a single (unimodal) learning style, while 13.3% used multiple (multimodal) styles. The predominant learning style was auditory (46.7%), followed by kinesthetic (23.3%), while visual style was the least frequent (5%). Among multimodal learners, the most common combination was auditory–kinesthetic (6.7%). In all academic semesters (2nd, 4th, and 6th), auditory style remained dominant, with no significant differences found across semesters (P=0.094). Similarly, no significant association was observed between learning styles and gender (P=0.229). ANOVA results indicated no significant relationship between learning styles and academic performance, with a mean GPA of 17.05 (P=0.345).
Conclusion: The findings indicated that most students preferred a single learning style, particularly the auditory modality, with no significant differences based on gender, academic semester, or academic performance. Identifying students’ learning styles and aligning teaching methods accordingly may enhance the teaching–learning process. It is recommended that learning style assessments be conducted at the beginning of academic programs and considered in curriculum planning. Further studies with larger and more diverse samples are suggested to evaluate the impact of learning style-based instruction on student satisfaction and academic achievement.

Analyzing Patient Satisfaction and Loyalty in a University Dental Clinic: A Structural Equation Modeling Approach

Seyed Hadi Hosseini

Background and Aim: Medical university-affiliated dental clinics, particularly those located in metropolitan areas, provide oral healthcare services to a wide range of patients with diverse demographic and socio-cultural backgrounds. The sustainability and continued effectiveness of these clinics largely depend on patients’ satisfaction and loyalty. Understanding the determinants of these two critical factors and exploring their interrelationship is essential for improving service delivery and enhancing patient retention. Therefore, the present study aimed to analyze patient satisfaction and loyalty in a university dental clinic using a structural equation modeling (SEM) approach.
Materials and Methods: This cross-sectional, descriptive-analytical study was conducted during 2023–2024 on a sample of 190 patients who visited the dental clinic of Alborz University of Medical Sciences. Participants were selected through convenience sampling. Data were collected using two standardized questionnaires: one assessing dental patient satisfaction and the other measuring patient loyalty. Structural equation modeling was employed using AMOS software, and model fit was evaluated using standard indices including the Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA).
Results: The SEM analysis revealed a significant and positive relationship between patient satisfaction and loyalty (β=0.931, P<0.001). Among the dimensions of satisfaction, hygiene and physical conditions (β=0.939), responsiveness and service delivery (β=0.847), appointment scheduling and waiting time (β=0.761) had the most substantial impact on overall satisfaction (P<0.001). Additionally, attitudinal (β=0.996) and behavioral (β=0.859) components emerged as key dimensions of patient loyalty. Model fit indices demonstrated an acceptable level of fit with the data (CFI=0.893, RMSEA=0.077).
Conclusion: To enhance patient satisfaction and foster loyalty, university dental clinics should prioritize internal operational improvements, particularly in the areas of environmental hygiene, service responsiveness, and time management. Creating a positive mental impression through these factors can serve as a foundational step in cultivating long-term loyalty, ultimately contributing to the clinic’s credibility and sustainable performance within a competitive healthcare environment.

Identifying the Health Information Needs of the Elderly in Public Libraries: A Systematic Review

Nosrat Riahinia

Background and Aim: With the increasing elderly population and their specific needs, access to health information in public libraries has become increasingly important. Public libraries can play a crucial role in providing reliable health information and enhancing health literacy among the elderly. This study aimed to identify the health information needs of the elderly in public libraries based on global experiences.
Materials and Methods: This study was conducted as a systematic review using the Kitchenham and Charters framework. Relevant articles were retrieved from three major citation databases—PubMed, Scopus, and Web of Science—covering the period from 2010 to 2024. Relevant keywords were used for searches, and reference lists and citations of the retrieved documents were examined to ensure comprehensive coverage. Inclusion criteria consisted of research articles related to the health information needs of the elderly in public libraries. Ultimately, 40 English-language articles were selected and analyzed. The extracted data were coded and categorized qualitatively.
Results: The findings indicated that the health information needs of the elderly in public libraries could be classified into four main categories: (1) Information Needs, including access to diverse health information resources, primary health information, public health and prevention information, and self-care and personal empowerment resources; (2) Educational Needs, encompassing information literacy, health information literacy, and educational events; (3) Social and Cultural Needs, including cultural and recreational activities, social and communication needs, social participation, and reducing social exclusion; and (4) Library Services and Facilities, comprising appropriate physical spaces, assistive reading technologies, and mobile and remote library services.
Conclusion: With the growing elderly population, public libraries face a critical responsibility in promoting the health and well-being of this demographic. The findings of this study reveal that the health information needs of the elderly extend beyond mere access to resources; they encompass educational, social-cultural, and library service dimensions. Therefore, it is essential to move beyond traditional information dissemination approaches and adopt a comprehensive, multilayered, and participatory framework—one that positions libraries as active institutions in enhancing public health among the elderly.

Promoting Interoperability Program in Electronic Health Record Roadmap: A Scoping Review Study

Fatemeh Bahador

Background and Aim: Today, with the digitalization of many healthcare processes, healthcare organizations strive to implement electronic health records (EHR) as effectively as possible. In this regard, the Meaningful Use (MU) program of EHRs was introduced in the United States. However, due to the existing challenges in this program and in order to accelerate the adoption of EHRs and reduce barriers, the Promoting Interoperability (PI) program was introduced by the Centers for Medicare and Medicaid Services (CMS). This study was conducted with the aim of reviewing the various dimensions of the PI within the EHR roadmap and examining strategies to overcome the obstacles of the MU program.
Materials and Methods: This scoping review was conducted in 2024. To assess the PI program, relevant articles were searched on PubMed, Scopus, and Web of Science databases, as well as electronic documents from CMS, without any time restrictions until March 2024. The searches employed the primary keywords “EHR,” “Meaningful Use,” “Promoting Interoperability,” and their synonyms. Additionally, a manual search was performed using the Google Scholar search engine to ensure comprehensive retrieval of all pertinent literature. Subsequently, articles and documents meeting inclusion criteria were selected, and their main characteristics were extracted.
Results: The review revealed that the PI program introduces substantial changes in EHR program requirements, objectives, and scoring methods. The core objectives of this program include: 1. electronic prescribing, 2. health information exchange, 3. provider-to-patient information transfer, and 4. public health and clinical data exchange. Furthermore, the program emphasizes additional requirements to enhance the quality of implementation, promote better sharing of EHR data, and improve clinical quality.
Conclusion: The Promoting Interoperability program has the potential to enhance patient health outcomes and reduce healthcare costs. Moreover, it is expected to gain increasing significance for hospitals as they adopt innovative healthcare delivery and payment models.

Comparative Analysis of Biochemical Parameters Across Different Stages of Kidney Disease: From Early Kidney Disease to Dialysis-Dependent Renal Failure

Nasrin Dashti

Background and Aim: This study investigated the biochemical profiles of individuals with different stages of kidney disease, including those with kidney disease without hemodialysis, chronic kidney disease without hemodialysis, and individuals with renal failure undergoing hemodialysis treatment, to clarify the role of mineral markers, inflammation, and kidney function in the complications of this disease.
Materials and Methods: This case-control study was conducted with 180 participants aged 18 to 81 years in Iraq. Participants were divided into four groups: the case group (including individuals with kidney disease not on dialysis, chronic kidney disease not on dialysis, and kidney failure treated with dialysis) and the control group, which included healthy individuals. Blood levels of urea, creatinine, calcium, phosphorus, vitamin D3, parathyroid hormone (PTH), high-sensitivity C-reactive protein (hs-CRP), and cystatin C were measured.
Results: The results showed that the levels of blood urea, calcium, vitamin D3, cystatin C and hs-CRP were significantly different between the different groups. The mean creatinine in the non-dialysis kidney disease group (3.98±1.77 mg/dL) and non-dialysis chronic kidney disease (4.59±1.63 mg/dL) was different from the dialysis kidney failure group (11.03±3.35 mg/dL) (P=0.001), but there was no significant difference between the two groups of kidney disease without dialysis and chronic kidney disease without dialysis. The phosphorus concentration was significant in all groups (P=0.001) and the highest value was observed in the dialysis kidney failure group. The PTH level was not significantly different between the two groups of non-dialysis, but there was a significant difference compared to the dialysis kidney failure group (P=0.001). Cystatin C was not significantly different in the two non-dialysis groups, but was significantly higher (P=0.001) compared with the renal failure group on dialysis (7.06±1.61 mg/dL).
Conclusion: This study demonstrated that regular monitoring of biochemical biomarkers is essential for the timely diagnosis and effective management of kidney disease. It also highlights the importance of paying attention to metabolic and inflammatory abnormalities in patients with kidney disease (especially in patients on dialysis), including extensive changes in biochemical, hormonal, and inflammatory factors levels that often occur due to severe impairment of kidney function and the dialysis process.

Determining Data Elements for a Personalized Self-Care Fitness Application for Women

Sahba Kazemipour

Background and Aim: The World Health Organization defines physical inactivity as engaging in less than 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity per week for adults, which is recognized as a serious global health challenge with dangerous consequences for public health. Global statistics indicate that this issue is more prominent among women; in Iran, 61.9% of women do not engage in sufficient physical activity. The adoption and expansion of health-related technologies indicate their high potential in supporting self-care. This study aims to identify the necessary data elements for designing a personalized self-care fitness mobile application for women.
Materials and Methods: This descriptive study was conducted in two phases: literature review and data element needs assessment. In the first phase, relevant data elements for creating a personalized self-care fitness application for women were identified through scientific articles in databases and library resources, and a data elements checklist was prepared. In the second phase, based on the checklist, a questionnaire was designed by the researcher. Its validity was confirmed by the research team, and its reliability was calculated with a Cronbach’s alpha coefficient of 91.3%.
Results: The aforementioned questionnaire was provided to 20 physicians from the sports medicine department at Mahdi Clinic, Imam Khomeini Hospital Complex, Tehran, to thoroughly evaluate the proposed data elements in terms of their importance, measurability, and relevance. In total, 49 data elements were identified across seven sections: demographic information, health information, disease information, inappropriate behavioral habits, anthropometric data, reports, and lifestyle. Of these, 4 elements were removed due to incompatibility with the study objectives and low importance scores. Additionally, to facilitate future analyses, the remaining elements were re-categorized into 6 groups.
Conclusion: In this study, the key data elements required for designing and providing exercise programs specifically for women were identified and determined. This process aimed to enhance the level of physical activity and address the specific needs of women, thereby establishing a scientific and precise foundation for developing programs tailored to the physical and psychological characteristics of this group.