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Investigating the incidence of complications caused by common national vaccinations in children and infants in Shahrood city
Fatemeh Saeedi, Mahdieh Zaki Zade , Mohammadbagher Sohrabi , Mostafa Enayat Rad , Sina Habib Zade , Mansooreh Fateh,
Volume 81, Issue 7 (October 2023)
Abstract
Background: With a national vaccination program, we have achieved success in the prevention of infectious diseases in the community especially in children. Despite this great success, the side effects of vaccination may not encourage some people in the community to get vaccinated. In this study, we investigate the prevalence of common side effects of vaccination in Shahrood city.
Methods: This study investigated the incidence of complications caused by vaccination in infants and children under seven years old in Shahrood city in a 5-year period from April 2016 to March 2020. We collected demographic and clinical information, by referring to the health centers and complications recorded after routine vaccinations such as fever, rash, diarrhea, swelling and other complications of vaccination were collected.
Results: Findings Among the 429 registered complications between 2016 and 2020, most complications were related to pentavalent and trivalent vaccines. Among the registered complications, high fever is the most common complication in both term and pre-term groups. (202 cases, 47.1%) other complications included maculopapular rash (59 cases), mild local complications (55 cases), vomiting (41 cases), and continuous screaming (36 cases), respectively. Among these, 123 cases were resolved without treatment, 297 cases were resolved with drug treatment on an outpatient basis, and only  eight cases required hospitalization.
Conclusion: In general, the vaccination program is highly effective despite having limited side effects.  Knowing this information, can increase vaccination in the country.

Management of left ventricular thrombus: diagnostic and therapeutic methods: a review article
Maryam Mehrpooya, Zahra Sadeghi,
Volume 81, Issue 8 (November 2023)
Abstract
Left ventricular thrombosis (LVT) is a very serious condition and life-threatening complication that usually occurs after acute occlusion of the left anterior descending (LAD) coronary artery followed by acute myocardial infarction with ST-segment elevation (STEMI), which leads to significant regional wall motion abnormality (RWMA). It should be noted that its diagnosis, treatment, and management are challenging now and depend on various factors such as the type of thrombus, time of percutaneous coronary intervention (PCI), and underlying disease. The preferred diagnostic method is cardiovascular magnetic resonance imaging (CMR), but transthoracic echocardiography (TTE) is routinely used for diagnostic and screening purposes also follow-up of response to treatment. It is worth mentioning that when the diagnosis of left ventricular thrombus is not clear with conventional echocardiography, contrast echocardiography is used for more resolution and detailed information. Left ventricular thrombosis can appear in both acute and chronic forms and lead to significant complications, the most important of them are stroke and systemic arterial embolism (SE). According to previous studies, vitamin K antagonist (warfarin) by keeping INR within the therapeutic range currently used to treat left ventricular thrombosis. Although the use of direct oral anticoagulants (DOAC) has brought excellent outcomes, but due to the lack of large clinical trials, the routine use of these agents is controversial, and only in case of warfarin intolerance or contraindications, DOACs can be used as an alternative. Generally, the best way to prevent left ventricular thrombosis is primary percutaneous coronary angioplasty (primary PCI) which preserves left ventricular function. Depending on the sensitivity of the diagnostic method, thrombus will likely resolve in >50% of patients by six months after the MI. On the other hand, in rare cases, surgery is indicated if a thrombosis remains despite the medical treatment especially if it is accompanied by a left ventricular aneurysm. The purpose of this narrative review is to evaluate the latest evidence in the field of left ventricular thrombosis management and to adopt the best approach for these patients.

The associated risk factors of premature rupture of membrane (PROM) and preterm premature rupture of membranes (PPROM) among pregnant women in Firooz-abadi hospital
Maryam Fakehi, Marjan Ghaemi, Nasim Eshraghi, Melina Poorkazemi, Maryam Mazloomi, Fedyeh Haghollahi,
Volume 81, Issue 8 (November 2023)
Abstract
Background: The aim of this study was to identify the associated risk factors of premature rupture of membranes (PROM) and preterm premature rupture of membranes (PPROM).
Methods: This retrospective case-control study was conducted at Firooz-abadi Hospital between 2019 and 2021. The study included 90 pregnant women diagnosed with PROM or PPROM (case group), compared with 90 women without this complication (control group) who presented to the hospital during the specified period. Demographic and clinical information of the case group was collected and compared with data from 90 pregnant women in the control group, matched for gestational age and other relevant factors. Statistical analysis was performed to assess the differences between the groups.
Results: Maternal age and weight were found to be significantly lower in the case group compared to the control group (P=0.02, P<0.001, respectively). This suggests that younger age and lower maternal weight may be risk factors for PROM and PPROM. Furthermore, the number of women with a history of PROM or PPROM was significantly higher in the Case group (P<0.001), indicating that a previous occurrence of membrane rupture increases the risk of subsequent incident. In addition, the study findings showed a significantly higher rate of smoking among pregnant women in the case group compared to the control group (P=0.04). Moreover, the occurrence of urinary tract infections during pregnancy and chorioamnionitis was significantly higher in the case group (P<0.001), suggesting that these infections may contribute to membrane rupture.
Conclusion: In conclusion, our study provides valuable insights into the risk factors associated with PROM and PPROM. It highlights that lower maternal age and weight, a history of PROM or PPROM, lower gestational age, a history of gestational diabetes mellitus and first-trimester bleeding, smoking, and urinary tract infections during pregnancy are significantly associated with an increased risk of PROM and PPROM. These findings emphasize the importance of early identification and management of these risk factors in order to prevent or mitigate the occurrence of PROM and PPROM, ultimately improving maternal and neonatal outcomes. Further research and public health initiatives are warranted to raise awareness and promote preventive measures targeting these identified risk factors.

Prevalence of congenital heart disease among term infants with respiratory distress: a case study in Kerman
Mohammad Mehdi Bagheri , Fahimeh Sadeghi Zarandi ,
Volume 81, Issue 8 (November 2023)
Abstract

                                                            
Background: Congenital heart diseases (CHD) as one of the most common disorders in newborns are leading cause of perinatal mortality, also one of respiratory distress syndrome causes in newborns. This study aimed to determine the prevalence of congenital heart diseases in infants with respiratory distress syndrome.
Methods: This cross-sectional study is a retrospective study that surveyed congenital heart diseases in 145 term infants who were hospitalized in neonatal intensive care unit (NICU), Afzalipour hospital, Kerman. These infants were admitted to the neonatal intensive care unit from March 20, 2012 to the end of March 20, 2015 due to respiratory distress syndrome. Information was extracted from the medical records and then were entered in the checklist. Descriptive statistics (frequency, percentage), analytical (chi-square test) and SPSS version 20 software were used to analyze the data.
Results: Out of 145 infants with respiratory distress syndrome, 123 infants had congenital heart diseases. Therefore, the prevalence of congenital heart diseases in patients with respiratory distress syndrome was 84.83%. The most infants with congenital heart diseases were male (66.67%) and weighed between 3-4 kg (47.97%). More than 69% of newborns with congenital heart diseases were born by cesarean section and most of them were receiving medical treatment (85.37%). There was a significant difference between patient outcome and congenital heart diseases (P=0.018). The difference between sex, weight and type of delivery with congenital heart diseases was not significant. In terms of the prevalence of congenital heart diseases, atrial septal defect (ASD) was the most prevalent with 14.48%. After that, patent ductus arteriosus (PDA) was the most prevalent with 11.72%.
Conclusion: Due to the high prevalence of congenital heart diseases in term children with respiratory distress syndrome, all term infants with symptoms of respiratory distress syndrome need cardiac examination, especially echocardiography to diagnose the cause. In addition, due to the high mortality of infants with congenital heart diseases with symptoms of respiratory distress syndrome, the need for more, more accurate and complete care of these infants is suggested.


Evaluating the guidelines adherence in the management of NSTE-ACS referred to shahid chamran hospital within six-month period in 2021: a brief report
Mohammad Mahdi Gholamian , Mehrnoush Dianatkhah, Mohammad Kermani-Alghoraishi, Ehsan Shirvani,
Volume 81, Issue 8 (November 2023)
Abstract
Background: The purpose of this study was to evaluate the adherence to the ESC 2020 guideline for the management of NSTE-ACS patients admitted to Shahid Chamran Cardiology Hospital affiliated to Isfahan University of Medical Sciences in 2021.
Methods: In this retrospective study which was done during April 2021 to September 2021 we reviewed the hospital documents of 239 NSTE-ACS patients, in regard to prescribed medication during the admission period in Shahid Chamran Heart Center. Guideline-adherence was evaluated according to ESC2020 guideline. Totally 18 items were evaluated including Antiplatelet (Clopidogrel, Ticagrelor, and Prasugrel) Anticoagulant (Heparin or Enoxaparin), PPI, Statin, Beta blocker, and RAAS blockers (including ACEI/ARB or MRA). In each section the selected drug and the administered dose were compared with the guideline and the guideline adherence for each part was expressed as percent.
Results: Almost complete guideline adherence was described for 12 out of 18 reviewed items (77%). However, guideline adherence in relation to the type of medicine chosen as an antiplatelet was reported to be very low, and only 1.2% of the cases received ticagrelor or prasugrel which are the guideline recommended antiplatelet agent. Additionally, most of the administered GP2b3a antagonist agents such as eptifibatide were not in accordance with the guideline (Guideline adherence 39.74%). Also, the choice of the anticoagulant agent was among the items with low guideline adherence (29.76%) and the cross-over between anticoagulants (changing heparin to enoxaparin or vice versa) which has been inhibited by the guideline was seen with high incidence in this center (78 cases).
Conclusion: The present study showed relatively high guideline adherence in the most aspects of medical management. However, compliance was reported to be low in relation to the antiplatelet selection, the choice of the anticoagulant agent, and the indication for GP2b3a antagonist use, which maybe due to the higher cost of recommended agents, and shortage of some medications and dosage forms in Iran.

Initial crohn’s disease flare-up following an anal trauma in a 2.5-year-old boy: a case report
Ali Samady Khanghah , Maryam Khalesi , Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Hokmabadi, Khashayar Atqiaee,
Volume 81, Issue 8 (November 2023)
Abstract
Background: Crohn's disease is considered a heterogeneous disorder with multi-factorial etiologies, in which the interaction of genetics and environment manifests the disease. Adverse childhood experiences can affect future physical and mental health outcomes. The rich innervation of the intestine with the Vagus nerve and hormonal interactions on the one hand and the constant contact of the digestive system with various pathogenic and non-pathogenic antigens have a proven role in autoimmune diseases and can gradually be chosen as a therapeutic goal.
Case Presentation: We are reporting a case of Crohn's flare-up after trauma in a pediatric case. A 2.5-year-old male with a through and through anal trauma was presented in Akbar Children's Hospital, Mashhad, Iran, Spring 2023 with active bleeding but conscious. He then underwent a physical examination under general anesthesia in the operating room. At the Lithotomy position, a penetrating wound at the 3 o'clock anal verge and a tear in the perineal area at 9 o'clock, which, according to the evidence of pus discharge, were seen hours after the incident which was irrigated with normal saline and Hydrogen Peroxide respectively. Due to the contamination of the area, a supportive colostomy was decided to be closed after six months. At the appointed time during the colonoscopy, the pediatric gastroenterologist noticed extensive inflammation in the distal patch of the colon, which was consistent with Crohn's disease. Histopathological studies then confirmed this diagnosis. This was even though there were no symptoms of inflammatory bowel disease in the history of the boy's illness before the accident. The patient is then treated with prednisolone, Asacol, and ciprofloxacin, and after the disease subsides, the colostomy surgery team closes the disease.
Conclusion: Trauma can be an immune-disrupting factor in the digestive system, and trying to reset the brain-gut axis can be chosen as a therapeutic goal.

The comparison of the pennation angle of knee extensor muscles in young women with pronated foot posture and normal ones
Zinat Ashnagar, Mohammad-Reza Hadian, Rahimeh Mahmoodi,
Volume 81, Issue 9 (December 2023)
Abstract
Background: Foot posture is proposed as an important factor that may affect the lower limb alignment. Variations from the normal foot posture may contribute to musculoskeletal injuries of the lower extremity especially knee joint. Considering variations in foot posture and knee joint alignment, this study aimed to assess and compare pennation angles of the vastus medialis oblique (VMO), vastus medialis (VM) and vastus lateralis (VL) in women with pronated foot posture and normal ones.
Methods: This observational, case-control study was carried out on 31 women with pronated foot posture (foot posture index: 6-12) and 31 women with normal foot posture (foot posture index: 0-5) in the age range of 18 to 35 years old.  Participants were recruited from female students of university communities using Non-probability Sampling method. Sampling was carried out from September 2019 up to February 2020 at the biomechanics laboratory of rehabilitation faculty of Tehran University of Medical Sciences. The pennation angle of VMO, VM and VL muscles was measured by using two dimensional. B-mode ultrasound imaging (USI) .A 7.5MHz linear transducer with 50mm footprint was used for the measurements. The ultrasound images were analyzed using Image J software. Three longitudinal scans were captured for each muscle pennation angle while the probe removed between each scan.
Results: The results of this study showed that there is no statistical significant difference between the pennation angles of  VMO, VM and VL in women’s foot posture compare to the normal ones (P>0.05).
However, the results of intraclass correlation coefficient (ICC) of USI measurements showed “good” intrarater reliability for VMO (ICC=0.88), VM (ICC=0.87) and VL (ICC= 0.77) pennation angles.
Conclusion: Based on the results of this study, the pennation angle of knee extensor muscles (VMO, VM, and VL), which was measured in non-weight bearing, is not different in young women with pronated foot compared to the normal ones. In addition, USI demonstrated good reliability for measuring VMO, VM and VL pennation angles.

Investigation of the frequency of resistance to fluoroquinolones in Salmonella enterica subspecies enterica serovar Enteritidis isolates isolated from hospital gastroenteritis samples
Kasra Mardani, Farhad Nikkhahi, Fatemeh Fardsanei,
Volume 81, Issue 9 (December 2023)
Abstract
Background: Salmonella enterica subspecies enterica serotype Enteritidis (S. Enteritidis) is one of the leading causes of food-borne infections associated with the consumption of contaminated food products of animal origin in humans. gastroenteritis due to Salmonella is usually a self-limiting disease and does not require antibiotic therapy. However, antibiotic treatment for salmonellosis may be lifesaving for patients with severe infections.The objective of the present study was to examine antimicrobial resistance and determine its genetic basis in recently isolated S.Enteritidis strains.
Methods: During this study, in a cross-sectional descriptive study, 44 isolates of Salmonella enteritidis from human sources were investigated between September 2021 and September 2022.. After identification of the isolates using phenotypic and molecular methods by Multoplex-PCR, antibiotic resistance testing was performed according CLSI 2023. The strains were examined for the presence of qnrA,qnrB,qnrS and gyrA resistance genes by PCR.
Results:  In a cross-sectional descriptive study, 44 isolates of Salmonella Enteritidis from human sources were investigated between September 2022 and September 2023. 100% of the strains were sensitive to imipenem and meropenem, and the sensitivity to the antibiotics ceftriaxone, ceftazidime, and cefotaxime were 93.2%, 90.9%, and 94.1%, respectively. 81.8% of isolates were sensitive to cotrimoxazole, sensitivity to ampicillin was 84.1%. Only 9.1% of isolates were sensitive to ciprofloxacin. Based on MIC results, 16 isolates had MIC between 0.002 and 0.064 and were placed in the sensitive area. 28 isolates had MIC between 0.125 and 0.5 and were placed in the area of reduced sensitivity. None of the strains resistant to disk diffusion method were resistant to MIC method. qnrA, qnrB and qnrS genes were not observed among ciprofloxacin resistant strains. All nalidixic acid resistant strains had gyrA gene.
Conclusion: In general, it was shown in this study that the resistance to the fluoroquinolone family is increasing among Salmonella Enteritidis isolates. On the other hand, we see a decrease in the sensitivity and prevalence of strains resistant to broad-spectrum cephalosporins among serovar Enteritidis, which is the drug of choice for extraintestinal infections.

Investigating the mean indexes of the cervical vertebrae through radiography in normal peop
Mahsa Akhavan-Sabbagh, Mohammad Ghasem Hanafi , Mozhgan Samet Zadeh , Arvin Rostami ,
Volume 81, Issue 9 (December 2023)
Abstract
Background: The study of the angles between the vertebrae and the curvatures of the spine plays an essential role in the pathogenesis of spinal disorders. Among the essential topics, the cervical sagittal parameters are widely used in evaluating cervical spine disorders and surgery. Measurement of cervical lordosis curves in healthy people is influenced by various factors. This study was conducted in order to investigate the average indexes of the cervical vertebrae in simple graphs in normal people.
Methods: In this descriptive study, using Gunya and Radiant software, radiographic photographs of the lateral view of the cervical region of 50 people (28 men and 22 women) who were referred for purposes other than problems related to neck pain were examined. Patients who were candidates for surgery and congenital disorders of the cervical spine were excluded. The study was conducted between March to April 2022. In this study, 12 cervical indexes were comprehensively measured and the scope of their changes in relation to age and gender was investigated. The measurements were conducted by an experienced radiologist.
Results:  In this study, 50 participants including 28 male (58%) and 22 female (44%) were included in the study. The mean age of participants 38.42 ± 2.1 years. After comparing the two genders, except for C0-C2/C2-C7 ratio index (4.9 in men and 2.6 in women) (P= 0.012), no significant difference was seen for other indexes (P> 0.05). After comparing the two groups, a significant difference was seen only in the T1 slope (T1S) index, which was significantly higher in people over 35 years old than in people under 35 years old (71.15 vs. 69.04) (P=0.049).
Conclusion: The evidence from this study shows that T1S increases with age and C0-C2/C2-C7 is significantly less in women than in men. These findings can be used to diagnose pathology or destructive changes in the elderly, to evaluate movement disorders, the effectiveness of treatment, and to determine the outcome.

Investigation of epidemiological and histopathological features of central nervous system tumors in the samples referred to the pathology department of a referral hospital in the east of iran in a 10-year period
Yasser Hasanzadeh, Zahra Sagheb Movafagh , Atena Sahrabeygi , Hamid Heidarian Miri , Masoumeh Gharib ,
Volume 81, Issue 10 (January 2024)
Abstract
Background: Identifying the epidemiological aspects of central nervous system (CNS) tumors is the first step in implementing management protocols to control the condition of these tumors. We aimed to examine the epidemiology and histopathology of both benign and malignant tumors of the CNS in one of the referral and university centers in the east of Iran.
Methods: This cross-sectional study was conducted on all files of patients admitted to Qaem Hospital in Mashhad City, Iran, in a period of 10 years from March 2009 to February 2018 with a definitive diagnosis of benign or malignant tumors of the CNS, including tumors of the brain, cerebellum, spinal cord, or meningeal membranes. Information sources included the patients' physical files and the hospital information system (HIS). The statistical software SPSS version 28.0 for Windows (IBM SPSS, Armonk, New York, USA) was used for the statistical analysis.
Results: In total, 775 patients with benign and 771 patients with malignant CNS tumors were included in the study. Regarding epidemiological aspects of benign tumors, the incidence rate of women was almost twice that of men (68.47% versus 31.53%), with an overall average age of 45.31±19.81 years. The most common benign tumors were meningioma (72.77%), followed by schwannoma (13.67%). Regarding malignant brain tumors, the mean age of affected patients was 36.64±19.67 years, with males accounting for 53.04% of cases and females for 46.96%. The most frequent type of tumor was glioblastoma (32.68%), followed by diffuse astrocytoma (16.47%). Both benign and malignant CNS tumors were associated with significant hospital mortality; in-hospital mortality rates for benign and malignant tumors were 10.1% and 17.5%, respectively. Tumor type and its grade were the main determinants of early death in malignant CNS tumors.
Conclusion: The epidemiological characteristics of benign and malignant tumors in our study community were similar to the reports presented in other communities. Knowledge of these characteristics provides the possibility of managing patients and reducing morbidity and mortality related to these tumors.

Seasonal impact analysis on COVID-19 severity: insights from homogeneous epidemiological hospital data using the jaccard correlation coefficient
Ameneh Javanmard, Alireza Salehan,
Volume 81, Issue 10 (January 2024)
Abstract
Background: Coronaviruses were discovered in 1960. Large-sized living organisms from the Coronaviridae family, with single-stranded RNA of animal origin. Coronaviruses in humans can cause mild respiratory illness or severe respiratory illness. In 2020, the World Health Organization declared COVID-19 a global pandemic. The aim of this study is to use the Jaccard similarity coefficient to determine the similarity of COVID-19 behavior patterns in different seasons of the year.
Methods: This study used machine learning systems and similarity metrics to determine the behavior pattern of COVID-19 in different seasons of the year. The location of research was the Mousa ibn Ja'far Hospital in Mashhad, and the time was from May 2020 to August 2021. The symptoms of affected patients were compared with the compiled dataset, and the similarity of patients was prepared in a similarity matrix, and the Jaccard correlation coefficient was calculated on the data. Finally, the analysis of strains from the beginning of emergence to the latest strain was examined. The performance indicators of the algorithm in the Jaccard similarity method showed a recall metric with a value of 0.94, a precision metric with a value of 1, an F1 score with a value of 0.86, and remove accuracy metric with a value of 0.76. The most important factors in the investigation include white blood cells, platelets, RT-PCR, CT SCAN, shortness of breath, fever, SPO2, and respiratory rate.
Results: The transmission of the COVID-19 virus depends on several factors, including human interaction. The evidence of the collected data shows that people with COVID-19 have low lymphocyte count and it is very consistent with the results of recent studies. Due to the lack of a dataset, a comparative study was conducted and a dataset was collected.
Conclusion: This study, leveraging machine learning algorithms, identified a clear seasonal correlation in the spread of COVID-19. Considering geographical and seasonal variations among patients, distinct symptoms were observed in each season corresponding to the prevalent strain during that period.

Awareness, attitude and behavior toward using microwave in health care workers of shahid beheshti university
Zainab Moradi, Tayebeh Marashi, Ali Ramezankhani,
Volume 81, Issue 10 (January 2024)
Abstract
Background: In the last decade, the use of microwave ovens throughout the world, including Iran, has increased significantly. Therefore, it is important to understand the knowledge, attitude, and behavior of microwave oven use among employees of the Eastern Health Center to promote safe and responsible practices in the workplace. Assessing their familiarity and attitudes with microwave ovens, this study aims to identify potential areas for improvement and training. This, in turn, can create a safer and more efficient work environment for all involved.
Methods: In this cross-sectional study in 2022, the study population was all employees working in the health center and comprehensive health service centers affiliated with the East of Shahid Beheshti University of Medical Sciences, numbering 162 people. The research tool was a questionnaire adapted from Nadiri's thesis (2015). After collecting the questionnaires, the data was obtained by SPSS 26 software and were analyzed using Pearson's correlation coefficient, multiple regression, independent t-test, and one-way ANOVA.
Results: Although the attitude (36.35±3.579) and the behavior (61.16±6.402) towards using microwave ovens are favorable, there is still room for improvement of knowledge and awareness. Knowledge has a positive and significant effect on behavior (P=0.002, B=0.245) and attitude (P=0.001, B=0.263), which shows that improving knowledge about the safe and responsible use of microwave devices can lead to behavior. and a more favorable attitude among employees. In addition, the attitude has a strong positive and significant effect on behavior (P=0.001, B=0.417), and promoting a positive attitude toward using microwave devices can also lead to more favorable behavior. However, the relatively weak effect of awareness on attitude indicates that other factors may also play a role in determining the attitude toward using microwave devices.
Conclusion: These findings highlight the importance of educational and awareness campaigns to promote the safe and responsible use of microwave devices among healthcare workers.

The impact of high-intensity interval training (HIIT) combined with berberine supplementation on hematological parameters in middle-aged men with pre-diabetes: a randomized controlled trial
Mehdi Nikseresht, Valiollah Dabidi Roshan , Khadijeh Nasiri,
Volume 81, Issue 10 (January 2024)
Abstract
Background: Exercise programs can lead to different physiological adaptations, but the effects of low-volume, low-frequency HIIT protocols with varying interval structures have not been thoroughly investigated. This study aimed to explore the impact of HIIT with high compression (HC) and low compression (LC), with or without berberine (BBR) supplementation, on hematological parameters in pre-diabetic men.
Methods: This semi-experimental study was conducted between October and December 2021 at Mazandaran University. Fifty-four overweight/obese men with a mean age of 48.6±6.6 years, a body mass index of 30.7±7.3 kg/m², and a body fat percentage of 34.4±4.3% were randomly and equally divided into one of six groups: HC, LC, HC+BBR, LC+BBR, BBR, and control. The HC group (2:1 work-to-rest ratio) and LC group (1:1 work-to-rest ratio) underwent training programs comprising 2-4 sets of 8 exercises at an intensity of 80-95% of their maximum heart rate twice a week for 8 weeks. Hematological responses to Bruce's incremental exercise test were measured before and after the intervention. Data were analyzed using a two-way ANOVA with Bonferroni's post hoc test, with a significance level set at P<0.05.
Results: Baseline hematological indices showed no significant differences between pre-diabetic and non-diabetic groups (all, P>0.05). Following the 8-week intervention, there were significant decreases in white blood cells (WBCs) in the LC and LC+BBR groups, and in lymphocytes across all intervention groups except BBR (all, P<0.05). Additionally, hemoglobin and hematocrit levels showed significant reductions in the HC and HC+BBR groups (both, P<0.05). However, in response to Bruce's incremental exercise test, a significant decrease in WBCs was observed in the LC and LC+BBR groups, with reductions of 18% and 25%, respectively (both, P<0.05).
Conclusion: The LC protocol, even without berberine supplementation, seems to provide better immunological benefits and result in less hemolysis compared to the HC protocol, as evidenced by reductions in white blood cell counts.

Mobile applications as a new way to health: a systematic review
Negar Heidari , Fatemeh Rajati , Mojgan Rajati, Paria Heidari,
Volume 81, Issue 11 (February 2024)
Abstract

                                                                  
Background: Management of chronic diseases, such as hypertension and diabetes, requires a comprehensive long-term care plan. Adherence to self-management behaviours is crucial in improving health outcomes and quality of life for individuals living with these conditions. The research highlighted in this review study aimed to explore the potential of mobile health technology in enhancing primary and secondary prevention of chronic diseases. By providing personalized interventions, mobile applications can play a significant role in supporting individuals in the self-management of their hypertension and diabetes, ultimately leading to better disease control and improved overall well-being.
Methods: The present study is a systematic review of research examining the impact of mobile application interventions on the self-management of hypertension and diabetes. The review analyzes studies published between July 2013 to March 2023, retrieved from the PubMed and Scopus international databases using keywords such as Mobile Health, mHealth, adherence, Hypertension, High Blood Pressure, and Diabetes.
Results: A total of 1398 abstracts were found, of which 12 articles met the inclusion and exclusion criteria for this study. The research indicates that mobile health (mHealth) applications have significant potential to optimize healthcare processes and facilitate improved access to health information. These digital tools can combine various treatment methods with attractive, user-friendly solutions that allow patients to actively monitor a range of health indicators, such as diet, body weight, blood pressure, mood, and sleep patterns. By enabling this type of continuous self-monitoring, mHealth apps can empower individuals to take a more active role in managing their well-being. Additionally, these applications can facilitate greater collaboration between healthcare providers, patients, and their families, thereby enhancing the overall coordination and accessibility of care. As such, mHealth technologies can be effectively leveraged in conjunction with traditional medical services to improve health outcomes and expand access to critical health information.
Conclusion: The present study found a significant increase in mobile health app usage. To understand the real, long-term impact of this technology on health, further longitudinal studies are needed. Comprehensive research is crucial to guide the development of effective digital health interventions that can improve individual and population outcomes over time.


Evaluation of obstacles to receive tissue plasminogen activator in patients with acute ischemic stroke in Imam Khomeini Hospital of Urmia
Hamidreza Mehryar, Payman Atabaki, Abass Riyahi, Mohammad Reza Amiri Nikpour,
Volume 81, Issue 11 (February 2024)
Abstract
Background: The emergence of thrombolytic drugs has opened new horizons in the treatment of patients with acute ischemic stroke, and this study was conducted with the aim of evaluating the barriers of receiving tissue plasminogen activator in patients with acute ischemic stroke in Imam Khomeini Hospital of Urmia.
Methods: This descriptive-analytical, cross-sectional study was conducted from April 21, 2015 to March 19, 2016 on patients with acute ischemic stroke referred to the emergency department of Imam Khomeini Hospital in Urmia using census sampling method. To collect data, a checklist containing demographic information was used. After collecting the data, it was entered into SPSS 18 and analyzed with the help of descriptive statistics.
Results: In this study, the results showed that out of 100 patients, most of the participants were male (58%)58 and the rest were female, and the average age was 63.71±17.3 years, and 86% were in the age range of 18-80 years, which was the appropriate age to receive or thrombolytics. and the rest were over 80 years old. The fastest visit time was 25 minutes and the latest was 10080 minutes (168 hours). Among these 40 people, only four people (40%) were in the golden time period of thrombolytic drug, i.e. Three hours from the onset of symptoms to the final evaluation. Among the four people who were placed in the golden time, in 50% of the cases there was a history of taking anticoagulants, in 25% a history of head injury, in 50% of the blood sugar less than 50 and finally 1 person (25% of the people placed in the golden time) that is, 1% of all patients were eligible to receive rtPA. About 24% of patients had NIHSS<4 and 2% had NIHSS>25, and the average number obtained was 10.
Conclusion: The most important obstacle in the timely initiation of thrombolytic therapy is the delay in visiting the emergency room. Therefore, public education in order to improve the level of general awareness of the society can be effective in reducing this time delay.

A guide for conducting exploratory factor analysis in medical science research using SPSS: a brief report
Jafar Hassanzadeh, Haleh Ghaem Maralani , Fatemeh Jafari , Aboubakr Jafarnezhad,
Volume 81, Issue 11 (February 2024)
Abstract
Background: It is necessary to examine different dimensions of psychometrics in different sciences, and paying attention to the accuracy and precision of the results can lead to the construction of reliable and valid tools; In this article, exploratory factor analysis has been done using SPSS software, version 26.
Methods: This research was a brief report that was conducted between 30 January 2023 to 10 October 2023. Reliability means reproducibility and continuity of results in the same conditions, and validity means matching the test with the purpose for which it was designed. Validity includes face, content, criterion and construct validity. To determine construct validity, various methods are used including: convergent validity, divergent validity, internal consistency and factor analysis. Factor analysis is a method that aims to simplify a complex set of data and allows researchers to find a specific pattern among many variables and complex relationships between them which includes exploratory factor analysis and confirmatory factor analysis. Exploratory factor analysis is a statistical technique that is used to estimate hidden factors or variables and reduce the large number of variables.
Results: exploratory factor analysis is a statistical method that is used by reducing the number of variables and exploring the underlying structure of a large set of variables with the aim of discovering factors or hidden variables, and its basic assumption is that any variable may be related to any factor. It tries to use factor loadings to discover the factorial structure of the data and by identifying the basic structures, grouping the factors by considering the common meaning of the variables.
Conclusion: Reliability means repeatability and validity of the degree of accuracy of the results which are measured through different methods. Exploratory factor analysis uses construct validity measurement methods to simplify the data and provide more reliable and valid tools, so it is very important to pay attention to the accurate and correct measurement of the results in the validation of health system tools.

Application of bone cements based on ceramic and polymer in orthopedic surgeries: a review article
Naeemeh Kalali, Sogand Mirshah, Mohammad Hossein Ebrahimzadeh , Bibi Fatemeh Kalalinia, Ali Moradi, Azar Gharib, Nafiseh Jirofti ,
Volume 81, Issue 12 (March 2024)
Abstract
For over 50 years, bone cement has been used to strengthen artificial joints like hip, knee, shoulder, and elbow joints. The main purpose of bone cement is to fill the space between the prosthesis and the bone. This absorbs the forces on the joint by creating an elastic area. Besides ensuring the long-term stability of the artificial implant, it also improves the damaged bone. Polymeric bone cement consists of a polymer matrix known as polymethyl methacrylate (PMMA) and a liquid monomer called methyl methacrylate (MMA). When these two components are mixed, a free radical polymerization reaction occurs, leading to the cement's hardening at the place of use. The properties of bone cement, such as mechanical strength, biocompatibility, and handling characteristics, can be adjusted by combining the effective polymerization parameters. However, there are some challenges, such as heat generation during polymerization.
Ceramic bone cement is a composite material of ceramic particles dispersed in a polymer matrix, including calcium phosphate and calcium sulfate. The ceramic particles provide strength and bioactivity, while the polymer matrix enhances the transport properties of the cement. This combination results in a mechanically stable, bone-conductive, and biocompatible cement. Moreover, ceramic bone cement can be engineered to release therapeutic agents, such as antibiotics or growth factors, to prevent infection and foster bone regeneration. Ceramic bone cement is a promising alternative material for bone cement in joint replacement. However, more research and development are required to optimize the properties of bone cement and overcome the challenges associated with its use. With continued advancements in biomaterials, ceramic and polymer bone cement could revolutionize the field of orthopedic surgery and improve patient outcomes. Recent research has focused on developing new bone cement with improved properties like bioactivity, antibacterial activity, and drug delivery capabilities. These developments aim to enhance the performance of bone cement and remove the current limitations in orthopedic applications. In this review study, we will focus on the types of bone cement, their mechanical, biological, and structural properties, and how to optimize them.

Relationship between maternal early pregnancy body mass index (BMI) and weight gain during pregnancy with pregnancy outcomes: a cross-sectional study
Lida Saeed, Niusha Bahmanpoor, Robabe Hosseinisadat, Fatemeh Karami Robati ,
Volume 81, Issue 12 (March 2024)
Abstract
Background: One of the factors affecting the outcome of pregnancy is the primary body mass index (BMI) and the amount of weight gain during pregnancy. This study aimed to check the relationship between mother's initial body mass index and weight gain in pregnancy with pregnancy outcomes.
Methods: This cross-sectional study was conducted on 455 pregnant women referred to Afzalipour Hospital in Kerman, Iran, from August 2021 to August 2022. These pregnant women were included in the study through easy and accessible sampling. The mother's initial weight was recorded through the mother's health card. The height of the mother was measured using a standard meter and the final weight of the mother before delivery was measured using a standard scale available in the department. Other information of the mothers was extracted from their records. Weight gain during pregnancy and initial body mass index were calculated and divided into four categories, less than normal, normal, overweight and obese. Maternal-fetal complications were included in the information registration form. Descriptive and analytical statistical methods and SPSS version 24 software were used to analyze the data.
Results: The average age of women was 27.56±6.82 years. Body mass index of more than 40% of them (44.4%) was normal (19.8-26) and more than 45% of them were overweight 11.5-16 (45.5%). There was a significant relationship between initial body mass index and weight gain during pregnancy (P=0.001), gestational diabetes (P=0.001) and newborn weight (P=0.019). There was also a significant relationship between weight gain during pregnancy with premature birth (P=0.001), vaginal delivery (P=0.001), gestational diabetes (P=0.001) and newborn Apgar (P=0.001).
Conclusion: High body mass index of the mother and weight gain during pregnancy can cause complications in the mother and the fetus. Therefore, prenatal care should be done more carefully and health care providers should place mothers who have abnormal body mass index and inappropriate weight gain in pregnancy in the high-risk group and under special care to minimize maternal and fetal complications.

Investigation of the relationship between the dietary inflammation index and the dietary phytochemical index with non-alcoholic fatty liver diseases
Parastoo Beknejadi, Davoud Vahabzadeh, Esmaeil Yousefi Rad , Somayeh Saboori , Koroush Ghanadi , Mehdi Birjandi,
Volume 81, Issue 12 (March 2024)
Abstract
Background: The increasing prevalence of non-alcoholic fatty liver disease (NAFLD) in recent years has raised concerns about its significant risks for public health. According to previous studies, a diet with low phytochemicals and high inflammatory index is related to non-alcoholic fatty liver disease. In this study, we intend to investigate the relationship between inflammatory diet and phytochemical diet with NAFLD.
Methods: In this case control study, 112 newly diagnosed patients with NAFLD referred to the Shahid Rahimi Hospital clinic in Khorramabad between January 1400 and April 1401 and 112 healthy individuals without NAFLD and any other chronic diseases as the control group, with the range 23-59 years old were selected. General information, demographics, physical activity level and food intake were collected using general information questionnaire, physical activity questionnaire and valid semi-quantitative food frequency questionnaire (FFQ). The energy received between the people of the two groups was adjusted. People's diet was divided into two anti-inflammatory and pro-inflammatory groups based on the DII index based on the score quartiles.
Results: The results showed a significant relationship between DII score and NAFLD in the crude model (OR: 2.22, 95% CI: 1.04 -4.73), model I (adjusted for energy and age classification) (OR: 2.4, 95% CI:1.07-5.58), model II (adjusted for model I+physical activity, sex, education) (OR:2.77, 95% CI:1.14-6.77) and model III (model II+BMI) (OR: 2.16, 95% CI: 0.81-5.71) and DPI score and NAFLD the crude model (OR: 0.69, 95% CI: 0.32-1.47), model I (adjusted for energy and age classification) (OR: 0.56, 95% CI: 1.29-5.58), model II (adjusted for model I+physical activity, sex, education) (OR:0.58, 95% CI: 0.23-1.44) and model III (model II+BMI) (OR: 0.65, 95% CI: 0.24-1.75).
Conclusion: The results obtained from this study showed an inverse relationship between following an anti-inflammatory diet and the risk of NAFLD. However, there was no correlation between receiving a diet with a high phytochemical index and NAFLD.

Evaluation of emergency department crowding of Imam Khomeini hospital in Urmia based on EDWIN index in 2020
Hamidreza Mehryar, Mohammad Rafiei,
Volume 81, Issue 12 (March 2024)
Abstract
Background: Overcrowding in the emergency department is considered as a problem of the public health system, and the present study was conducted with the aim of evaluating the overcrowding in the emergency department of Imam Khomeini Hospital in Urmia based on the EDWIN index.
Methods: This descriptive-analytical study was carried out cross-sectionally from March 21, 2019 to March 19, 2020, using a simple random sampling method in patients referred to the emergency department of Imam Khomeini Hospital in Urmia. Which was used to collect information from the demographic information checklist and the EDWIN index was calculated. Then the information was entered into SPSS18 software and analyzed with the help of descriptive and analytical statistics.
Results: In this study, the results showed that in terms of the frequency of triage level, 5.4% was level one, 65.6% was level two, 26.3% was level three, 2.7% was level four and there was no disease in level five. In terms of shift, 22.5% visited the hospital in the morning shift, 27.6% in the evening shift and 49.9% in the night shift. The average EDWIN index was 2.7±0.75 on holidays and 5.9±4.6 on non-holiday days. Although emergency room congestion was more on non-holiday days, this difference was not statistically significant (P=0.15). Also, the average of EDWIN in the morning shift was 2.5±2.3, in the evening shift it was 0.71±2.16 and in the night shift it was 9.7±5.8 and even though the average of EDWIN in the night shift was higher than in the evening and night shifts, this difference was not statistically significant (P=0.06).
Conclusion: The results of the present study indicated that on most of the investigated days, the emergency room was evaluated as crowded based on the EDWIN criteria. Also, there is no significant difference between the busyness of the emergency room according to the holiday or working day, as well as the morning, evening and night shift.

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