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Prognostic factors of pemphigus vulgaris disease: a study on 119 patients
Halaji Z, Esmaili N, Moeineddin F, Zeinali F, Aalami L, Shams Davatchi Sh,
Volume 66, Issue 12 (5 2009)
Abstract

Background: Since the systemic steroids are introduced in Pemphigus Vulgaris treatment, the prognosis of disease improved significantly. This study was designed to evaluate determining factors in the prognosis of pemphigus vulgaris in Iranian patients.

Methods: In this study, 119 patients with documented pemphigus vulgaris who had presented to Razi Hospital from 2001 until 2003 were included. These patients had presented for the first time and treated with prednisolone and Azathioprine. Morality rate, minor and major relapses and duration of first remission had been defined as prognostic criteria and correlation between them and other demographic variables and disease characteristics were investigated.

Results: The majority of patients (84.1%) were followed for more than one year. The major recurrence and minor recurrence occurred in 28(23.5%) and 65(54.6%) of patients respectively, no case of mortality was observed. In patients who received treatment six months or less after onset of disease the frequency of major recurrence was less than the others. 18(17.8%) vs. 12(41.4%), (p=0.009). Duration of primary remission more than one year was detected in most of the patients (64.7%). In patients with less than 10 initial cutaneous lesions, period of primary remission was longer than the other patients. (p=0.009). Shorter duration of primary remission were noted in older patients (age>50) in comparison with younger patients (age≤50, p=0.04).

Conclusions: Male gender, old age, interval more than 6 months between onsets of symptoms to initial treatment and more than 10 skin lesions on admission, are associated with poor prognosis of pemphigus vulgaris.


Plasma procalcitonin level as a predictor of treatment response in ICU patients with bacterial sepsis
Mobaien Ar, Shams S,
Volume 68, Issue 2 (5 2010)
Abstract

Background: Sepsis is one of the most important causes of mortality in severely ill ICU patients. At least, a part of high mortality rate in sepsis patients is due to less specific clinical symptoms for prompt diagnosis. Recently some studies report that serum levels of procalcitonin will increase in these patients but changes of serum levels following treatments is not known. This study was designed to determin procalcitonin levels in patients with bacterial infectious disease in ICU, initially and during therapy and compare the levels during response to treatment.

Methods: This prospective cross-sectional study was conducted on ICU patients with infectious diseases, blood specimen collected on day 1 and then in days 3 and 7 of ICU admission. The semi-quantitative PCT-Q test was performed.

Results: Thirty five patients, 22(62.9 %) men and 13(37.1%) women, were enrolled in this study. 18(51.4%) patients died. Procalcitonin level in most patients in admission day was more than 10 ng/ml [16 (45.7%)] but in patients that react to treatment, decline to lower than 0.5 ng/ml [14(77.8%)]. Mean rank of procalcitonin level from 1.14 ng/ml in first day reached to 2.72 ng/ml in seventh day (p<0.0001).

Conclusions: This study showed that serum procalcitonin levels in ICU patients with bacterial sepsis significantly decrease following response to treatment. The measurement of serum procalcitonin in ICU patients with bacterial infectious diseases at first arrival day and following treatment is recommended.
The role of group A beta hemolytic streptococcal infections in patients with tic and tourett's disorders
Noorbakhsh S, Jalili B, Shamshiri Ar, Shirazi E, Tabatabaei A, Taghipour R, Modares Fathi A,
Volume 68, Issue 9 (6 2010)
Abstract
Background: Recently, many cases diagnosed as pediatric autoimmune neuropsy-chiatric disorders associated with group A beta hemolytic streptococcus infection (PANDAS) due to production of autoimmune antibodies. Object of this study was comparison the titer of antibodies against group A beta hemolytic streptococcus (ASOT, Anti-DNase B, and Anti streptokinase) between children with movement disorders (tic and tourett's disorders pediatric autoimmune psychiatric disorders) and healthy control.
Methods: A cross sectional/ cases control study in pediatric neuropsychology ward and clinics in two referral hospitals (Rasoul & Aliasghar) affiliated by IUMS had done in Tehran, Iran (2008-2010). We selected 53 children with tic disorder and 76 healthy controls (age matched children). The antibody titers (IU/ml) in their area were compared and analyzed statistically. The area under ROC, sensitivity, specificity and positive predictive value of tests calculated.
Results: Age of cases was between 4-16 years. All antibody titers had significant difference between two groups (p<0.0001 p=0.05 p=0.002 for ASOT, Anti-DNase and Antihyaloronidase respectively). ASOT (cut off level> 200IU/ml) had 75% sensitivity 84% specificity and 80% PPV Anti- streptokinase (cut off level> 332IU/ml) had 34% sensitivity 85% specificity, and 90% PPV Anti-DNase (cut off level> 140IU/ml) had 70% sensitivity 99% specificity and PPV 90%.
Conclusion: Patients with tic disorder had a significant high antibody titer against streptococcal infection in comparison with healthy children. It presents possible role for streptococcal infection in tic disorders. Treatment of streptococcal infection is achievable by using of long acting Penicillin in our country. Use of aggressive treatment like plasmaphresis etc needs future RCT studies.


The efficacy of botulinum toxin type A injection in the hamstring and calf muscles with and without serial foot casting in gait improvement in children with cerebral palsy
Amirsalari S, Dalvand H, Dehghan L, Feizy A, Hosseini Sa, Shamsoddini A,
Volume 69, Issue 8 (6 2011)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: The goal of this study was to compare the efficacy of botulinum toxin type A (BTX-A) injection in the hamstring and calf muscles with and without ankle serial casting in the improvement of gait in children with cerebral palsy (CP).
Methods : This double-blind prospective clinical trial was performed on 25, 2 to 8-year-old children with hemiplegic or diplegic CP in Tehran, Iran in 2010. The participants were chosen by simple randomized sampling and were matched for age, gross motor function classification system (GMFCS) and type of CP and were randomly divided into two groups: children in the first group (13) only received BTX-A injection, but the second group (12) received BTX-A and serial foot casting starting one week after the injection.
Results : Comparison of the gross motor function, right and left knee spasticities and passive ROM of both knees between the two groups before and 1, 3, 6 and 12 months after the injections were not statistically significant (P>0.1). Furthermore, comparison of the right and left ankle spasticities and passive ROM before the injections and in1 and 3-month follow-ups did not show a statistically significant difference (P>0.1), but the differences were significant in 6 and 12-month follow-ups (P<0.05).
Conclusion: BTX-A injection with serial foot casting vs. BTX-A alone was more effective in decreasing spasticity and improving passive ROM in the ankle of children with CP, but such injections in the hamstrings were not useful in these regards.


A comparative study of streptococal infection in children with PANDAS:  a case-control study
Noorbakhsh S, Ebrahimi Taj F, Shirazi E, Shamshiri Ar, Tabatabaei A,
Volume 69, Issue 10 (5 2012)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Recent evidence suggest that group A ß-hemolytic streptococcal (GABHS) infection may increase the risk of pediatric autoimmune neuropsychiatric disorders (PANDAS) composed of the clinical signs of obsessive-compulsive and attention deficit hyperactivity disorders. The objective of this study was to compare the titer of antibodies against GABHS between children with PANDS and the controls.
Methods : This cross-sectional, case-control study was done in Hazrat Rasoul Hospital, in Tehran, Iran during 2008-2010. We compared serum antibodies streptolysin O, deoxyribonuclease B, and streptokinase against GABHS quantitatively in 79 cases with PANDAS and 39 age-matched controls. The area under ROC curve, sensitivity, specificity and positive predictive value (PPV) of tests were calculated.
Results : Most cases were studied in summer (57%) and spring (23%). The three aforesaid antibodies were higher in the cases (P=0.001). Antisterptolysin O (cut-off point 195) had a 90% sensitivity, 82% specificity and a 92% PPV, (CI=95%, 0.99-0.91). Anti streptokinase (cut-off point 223) had an 82% sensitivity, 82% specificity and a 95% PPV, (CI=95%, 0.934-0.735). Anti-DNase (cut-off point 140) had an 82% sensitivity, 82% specificity and a 95% PPV, (CI=95%, 0.99-0.91).
Conclusion: The study demonstrated a possible role for streptococcal infection in PANDAS. We found a significantly higher antibody titer against GABHS in OCD and ADHD cases in comparison with healthy children. Treatment of streptococcal infection is achievable by the use of long-acting penicillin. Use of aggressive treatment schedules like plasmaphresis, IVIG, etc needs further RCT studies.


Comparison of impacts of friction massage, stretching exercises and analgesics on pain relief in primary fibromyalgia syndrome: a randomized clinical trial
Amanollahi A, Naghizadeh J, Khatibi A, Hollisaz Mt, Shamsoddini A, Saburi A,
Volume 70, Issue 10 (4 2013)
Abstract

Background: Stretching exercises and massage therapy are both suggested for pain relief in fibromyalgia syndrome. Previous studies have not proved their superiority over each other. This study compared the therapeutic effects of friction massage, stretching exercises, and analgesics on pain relief in patients with fibromyalgia syndrome.
Methods: We evaluated 129 female patients with the diagnosis of primary fibromyalgia visited at the physical medicine clinics of Baqiyatallah Hospital in Tehran, Iran during 2010- 2011. Patients were randomly divided into three groups: the first group received 400 mg ibuprofen P.O. (3 times per day) and 25 mg nortriptyline (daily) P.O. as analgesic, the second group was treated by friction massage and the third group performed stretching exercises. Patients were assessed three times (initially, after one and four weeks) by visual analogue scale (VAS).
Results: The mean age of participants was 60.46 years. The mean age in each treatment group was 46.66 years in medication group, 46.73 years in stretching group and 46.65 years in friction massage group. Changes in VAS score over 4 weeks were 2.4, 3.1 and 1.9, in the first, second, and third groups, respectively. The changes in VAS were significantly different in the first and second groups rather than the controls (P<0.05).
Conclusion: The effect of stretch exercise on pain relief was similar to analgesics, but it was more effective than friction massage. Moreover, the therapeutic effect of stretching exercise on pain relief upon four weeks was more permanent than friction massage but it was similar to analgesics.


Comparison of echocardiographic findings in infants of mothers with gestational diabetes and healthy mothers
Semira Mehralizadeh , Majid Mirmohammadkhani , Maryam Naderi Eram , Shamsollah Noripour ,
Volume 72, Issue 8 (November 2014)
Abstract
Background: Gestational diabetes is associated with increased risk of congenital heart disease in neonates. The study was performed to evaluate the cardiac parameters in neonates of mothers with abnormal glucose tolerance test (GTT) and compare them with data of normal newborn. Methods: In a cross-sectional study in Amiralmomenin Hospital, Semnan City, Iran from April to October 2013, two groups of infants were eligible for the study. Sampling was performed in succession for the infants who were eligible. Echocardiography was performed for the babies on the second day, and cardiac parameters including interventricular septal diameter, left ventricular shortening fraction and mass, left ventricular posterior wall thickness, aortic and left atrial diameter were measured. Maternal glycemic control and HbA1c were measured indicators. Analysis with the SPSS software version 16, the Student’s t-test, Mann-Whitney and Chi-square test were performed. Results: Thirty five newborn infants of mothers with impaired GTT and newborn of 33 healthy women were studied. Birth weight, maternal age and HbA1c among infants of mothers with impaired GTT were greater than the control group (P=0.003 and P=0.000 and P=0.000 respectively). Diastolic and systolic ventricular septal thickness, ratio of diastolic ventricular septal thickness to diastolic diameter of the left ventricular posterior wall, the aortic diameter and left ventricular outflow tract diameter in infants of mothers with impaired GTT were significantly increased in comparison to data of the normal group (P=0.008, P=0.034, P=0.016, P=0.017 and P=0.020 respectively). No significant difference was reported in other diameters. Conclusion: Gestational diabetes mellitus results in changes of echocardiographic findings particularly relevant in diastolic ventricular septal thickness. The increase in wall thickness especially during diastole, is associated with pathological cardiac hypertrophy. Based on the results of the present study, cardiac hypertrophy can be related to gestational diabetes. Poor control of disease may cause or aggravate the process.
Radiographic changes of lumbar spine and pelvis in chronic spinal injury
Shamsa Shariatpanahi , Soheila Khodakarim , Fateme Abolpour Mofrad,
Volume 72, Issue 9 (December 2014)
Abstract
Background: Chronic spinal cord injury has an important role in sensorimotor disor-ders which is associated with many complications and the rate of these complications should be certainly considered. The most important complications are the changes in bones and joints which come with pain and lead to increase in their motor disability. In this paper, the radiographic images were studied and the ossifications of spinal cord and pelvis were described and also the type of changes and their prevalence was eval-uated. Methods: In this study, 500 patients and veterans with spinal cord injuries who were hospitalized in Khatam-Ol-Anbia Hospital were examined. The spinal and pelvis x-ray of the patients have been studied for spinal cord ossification, the hip joint narrowing, sacroiliitis, heterotopic ossification, osteophyte and the presence of quiver in the graph. Results: Among the patients, 485 cases were males and 15 cases were females, the av-erage age was 50.26 and the mean duration of injury was 26 years. Four hundred and forty six patients were paraplegic and 54 cases were quadriplegic. There was a signifi-cant relationship between age and the number of involved vertebrae (P= 0.000), psori-asis like ossifications (P= 0.048) and large osteophytes (P= 0.037), also between the du-ration of the injury and the hip joint narrowing (P= 0.008), the number of involved ver-tebrae (P= 0.008). In addition the presence of shrapnel in the graph is correlated with large osteophytes and more heterotopic ossification. Conclusion: The most frequent cause of chronic spinal injuries of our patients has been the injury by quiver, it seems our results may not be extended to all patients with spinal cord injury. In lumbar spine radiography of the patients, osteophytes, the quiver and psoriasis like ossifications were mostly seen. In the pelvis x-rays the most changes were hip joint narrowing, sacroiliitis and the heterotopic ossification.
Evaluation of the anode heel effect on the testes dose during pelvic radiography
Vahid Karami , Mansour Zabihzadeh , Nasim Shams , Mehrdad Gholami ,
Volume 75, Issue 2 (May 2017)
Abstract

Background: Anode heel effect refers to reduction of radiation intensity in the anode side of X-ray tube. This variation in radiation intensity across the anode-cathode of X-ray tube can be benefited for decrease radiation exposure in some radiological examinations. The aim of this study was to evaluate the effect of anode heel orientation on the radiation dose received by the testes in male patients undergoing pelvic radiography.

Methods: This is a cross-sectional study, conducted at one of the teaching hospitals of Ahvaz, Jundishapur University of Medical Science Ahvaz, Iran, from September 2015 to March 2016. In order to measure the profile of radiation intensity variation, 13 paired sets of high radiosensitive cylindrical lithium fluoride thermo-luminescent dosimeters (TLD) aligned on the cathode-anode central axis upon the table and then irradiated using routine exposure parameters. The anode of X-ray tube was positioned toward the feet for 40 patients and toward the head for 39 patients undergoing pelvic radiography. For measure the entrance skin dose (ESD), 8 TLD chips were located on the central point of the radiation field and 5 TLDs were located on the testes position to measure the dose received.

Results: Radiation intensity profile showed that radiation intensity decrease from the cathode to the anode side. Discrepancy of radiation intensity on central axis of cathode-anode was calculated about 35%. The radiation dose received by the testes was 26.74% lower for patients the anode directed toward the feet, compared to the patients in which the anode directed toward the head (FTC: 1.260±0.296 mGy, FTA: 0.923±0.167 mGy, P<0.05). There was no meaningful difference for the measured ESD of pelvis between two groups of patients (FTC: 1.256±0.315 mGy, FTA: 1.195±0.205 mGy, P=0.788).

Conclusion: In pelvic radiography, positioning of testes directed to the anode of X-ray tube can decrease the receive dose.

A review of the etiology and biomarkers of pancreatic cancer, with emphasis on the role of diabetes: review article
Akram Pourshams, Bahram Kazemi , Sima Kalantari ,
Volume 75, Issue 11 (February 2018)
Abstract
Cancer is the major cause of death in the world and the rate of mortality is higher in developed countries. Therefore, lifestyle could be effective in promoting the cancer. The pancreatic tumors, are 8th cause of mortality due to cancer, which have several types, among them ductal adenocarcinoma is the most common and includes 85% of cases. Since, it is almost impossible to diagnosis the tumor in early stages of the disease, it contributes to high rates of mortality, although if it diagnosis in early stage and the surgery performed for them only 10-20% of patients will be survived. Metastasis occurs when the tumor is smaller than 2 cm in size and because the pancreas is located in the depth of abdomen, typically, it happens after tumor is spread to other organs. A combination of medical imaging, blood tests, and examination of tissue samples are usually made for diagnosis and based on the cancer stage, surgery, radiotherapy and chemotherapy are chosen as treatment options. Some rare genetic variations can cause pancreatic cancer and about 5-10% of cases are linked to inherited genes. However, major risk factors are including age, obesity, tobacco smoking and diabetes. Smoking counts for about 25% of cases, and the diabetes is the main symptoms of pancreatic cancer, which observed in about 80% of cases. But, it is still unclear whether diabetes is a predisposing factor in pancreatic cancer, or the outcome of tumor progression. Recent studies have shown that, diabetes is unique in pancreatic cancer which is not related to common types. Currently, CA 19-9 is the only reliable tumor marker for pancreatic cancer that its frequency also increases in non-bad conditions, such as pancreatitis and obstructive jaundice, so is not sensitive and specific enough for diagnosis of this cancer. Due to researches continue to find more specific markers. In this review the etiology of pancreatic cancer, diabetes associated with this type of cancer and significant biomarkers for diagnosis will be considered.

Assessment of serum 25(OH)D level in infants with bronchiolitis
Ahmad Shamsizadeh , Roya Nikfar , Mina Safi , Tahereh Ziaei Kajbaf , Amir Saberi-Demneh, Reza Karbalaei ,
Volume 75, Issue 12 (March 2018)
Abstract
Background: Bronchiolitis is one of the most common diseases of the lower respiratory tract in infants. Vitamin D has been shown to be protective against lower respiratory infections; however, there are limited and contradictory results in relation to serum vitamin D level and the incidence of bronchiolitis in children. The aim of this study was to compare serum levels of this vitamin in healthy infants and infants with acute bronchiolitis.
Methods: This case-control study conducted at Abuzar hospital in Ahvaz city, during October to March of 2014. Three groups of 45 eligible infants including control, low and high intensity of bronchiolitis enrolled to study. The severity of bronchiolitis classified according to scores derived from the respiratory distress assessment index. One to eight scores considered as low intensity and 9 to 17 scores considered as high intensity of bronchiolitis. Subsequently, 3 ml of venous blood sample were taken from them and the serum levels of 25(OH)D were measured by using an enzymatic kit.
Results: 60 (44.4%) infants were girls. The mean age of the control, low and high intensity of bronchiolitis groups were 11.2±5.2, 10±5.8 and 9.8±4.7 months, respectively (P=0.1). The mean of 25(OH)D concentrations in the control, low and high intensity bronchiolitis groups were 28.3±19.4, 17.7±11.7 and 13.6±5.7 nm/l, respectively. There was a significant difference in levels of 25(OH)D between the control-low intensity bronchiolitis groups (P=0.001) and the control-high intensity bronchiolitis groups (P=0.002), this difference was not significant between the two groups of bronchiolitis. There was a direct and significant correlation between serum level of 25(OH)D and age (r=0.2, P=0.005), breast milk consumption (r=0.3, P=0.001), and vitamin D supplementation (r=0.6, P=0.000).
Conclusion: In the present study, levels of 25(OH)D were significantly lower in infants with bronchiolitis than control group. In addition, 25(OH)D levels did not affect the severity of bronchiolitis.

Adjuvant effect of an acute moderate endurance exercise in herpes simplex virus 1 vaccination and its boosters on interleukin 10 cytokine and granzyme B in mice
Mahdieh Molanouri Shamsi , Afsaneh Jamali,
Volume 76, Issue 2 (May 2018)
Abstract
Background: The herpes simplex viruses cause a variety of clinical illnesses that are painful and often distressing. To control the infection, the development of an effective vaccine that prevents or reduces the primary and recurrent infections would be of great significance. With considering to immunological changes following an acute endurance exercise, the purpose of this study was to assess adjuvant effects of an acute endurance exercise in first herpes simplex virus 1 vaccine injection and its booster shots on interleukin-10 cytokine and granzyme B levels.
Methods: This experimental study was carried out in Tarbiat Modares University during May to October 2016. 32 BALB/c mice were divided into 4 groups: control, vaccine, vaccine plus an acute exercise in first injection and vaccine plus an acute endurance exercise in first injection and booster shots. Mice without or with access to acute endurance exercise were immunized intramuscularly with inactivated KOS strain of HSV-1. Two weeks after three booster shots of vaccine, interleukin-10 and granzyme B levels were determined in spleen cell culture with enzyme-linked immunosorbent assay (ELISA) method.
Results: This study was undertaken to test the hypothesis that an acute endurance exercise as an adjuvant in herpes simplex virus 1 vaccine can change interleukin-10 cytokine and granzyme B levels in mouse model. The result of this study showed significant differences between groups in interleukin-10 and granzyme B levels (P=0.001). Increasing in granzyme B levels with concurrent decreases in interleukin-10 levels was observed following using vaccine plus acute exercise in first injection of vaccine and booster shots.
Conclusion: It is suggested that exercise may stimulate parameters related to cellular immunity and hence decrease the risk of infection decreased levels of interleukin-10 in experimental group that had vaccine plus acute exercise in the first injection of vaccine and booster shots as an adjuvant was observed. These results demonstrate alternation of T helper 2 cells function and improve of cell immunity for protection against herpes simplex virus 1 infections.

The effect of kinesio taping on pain, strength and disability of neck in myofascial pain syndrome: a randomized clinical trial
Zabih Allah Rasti , Alireza Shamsoddini , Seyed Nasser Hosseini ,
Volume 76, Issue 3 (June 2018)
Abstract
Background: Tenderness, pain, muscle weakness, and limited range of motion (ROM) are symptoms of myofascial pain syndrome, which leads to restrictions on physical, occupational and social activities and ultimately reduction of productivity and quality of life. Different methods of rehabilitation are used to improve the symptoms of these patients. One of the new methods is the use of kinesio tape. The aim of this study was to evaluate the effect of kinesio tape on neck pain and disability and also muscle strength in myofascial pain syndrome.
Methods: In this single-blind randomized clinical trial, from June to November 2017 in Imam Hossein Hospital of Mashhad, Iran, thirty individuals (male and female) with Myofascial pain syndrome were divided into two groups (treatment and control), randomly by lottery. In treatment group, the kinesio tape with appropriate tension was applied directly over pain place and on upper trapezius muscle; and control group received placebo kinesio tape (kinesio taping without tension). In this study, before and three days after application of kinesio taping, numerical pain rating scale (NPRS), neck disability index (NDI) and manual muscle testing (MMT) were used to assess pain, disability and strength, respectively.
Results: To compare the effect of treatment, the mean of variables were compared with independent sample t-test before and after treatment. Pain and strength of upper trapezius were significantly different in both groups (P< 0.05), but in neck disability there was not significantly difference (P< 0.05). Then, for a closer examination, the paired t-test were used to compare the mean of disability before and after the treatment and result showed a significantly different in the treatment group and was not significantly different in the control group.
Conclusion: According to the results of this study, kinesio tape can reduce neck pain, increase the strength of upper trapezius, and ultimately reduce the disability of neck in myofascial pain syndrome. Therefore, this method can be used in rehabilitation clinics to improve the symptoms of patients with myofascial pain syndrome.

Survey of marital satisfaction in Iranian working women: brief report
Khadige Abadian, Zohreh Keshavarz, Hourieh Shamshiri Milani , Mostafa Hamdieh, Atefeh Aghaei, Tayebeh Mokhtarian Gilani ,
Volume 78, Issue 11 (February 2021)
Abstract
Background: Marital satisfaction is considered to be the feelings and understanding of the couple about their marital relationship and their two-way relationship. Many factors play a role in creating marital satisfaction, and on the other hand, marital satisfaction is one of the concepts that cause sexual health in a person. Sexual health has many dimensions and includes coordination and adaptation of physical, emotional, intellectual, and social aspects of sexual affairs in humans. This study was conducted to assess the marital satisfaction of working women in Iran through meta-analysis.
Methods: In this meta-analytic study, the issue of marital satisfaction amongst Iranian working women which has been published in local articles was evaluated. To find pertaining studies, Magiran, IranDoc, SID, Iranmedex, and Pubmed websites were used. Statistical society in this research consists of all studies in Iran in regard to the relationship between being a working woman and having marital satisfaction that has been accomplished since 2001-2018 and was indexed in one of the scientific informative websites.
  To access desired articles we used the English keywords of ‘Sexual dysfunction’, ‘Iran’, ‘Sexual function’, ‘Marital satisfaction’, ‘Working women’ and ‘women’ and their Persian equivalents. After the selection process of articles related to the research objectives, 10 articles were selected and assessed as final samples.
Results: Collected data indicate that the average size of  the influence of working on marital satisfaction in research samples was equal to 0.063. Point estimate based on Cohen scale shows low influence level.
Conclusion: The influence of being a working woman on marital satisfaction is not approved. Generally being a working woman can be effective on marital satisfaction at a weak level. However, regarding the impact of women’s work on marital satisfaction, research’s statistical society is also effective and should be considered. On the other hand, the positive impacts of being a working woman has become more significant over time.

The effect of auditory sensory stimulation with familiar voice on recovery from anesthesia in patients undergoing rhinoplasty
Mohammadhossein Dehghani , Seyedmohammadreza Niktabar , Amirreza Samei, Shamsodin Mohammadi,
Volume 79, Issue 1 (April 2021)
Abstract
Background: Anesthesia duration can play a significant role in post-operative complications. Therefore, the present study investigated the effect of auditory sensory stimulation with a familiar voice on anesthesia return in patients undergoing rhinoplasty.
Methods: This study was performed on 80 patients who were candidates for rhinoplasty surgery in Yazd Trauma and Burn Hospital from September-2018 to October-2019. The patients were randomly divided into two groups of 40: control and intervention. For patients in the control group, routine nursing care was performed after entering the recovery room. In addition to routine care, the patients in the intervention group were stimulated with a 15-minute pre-recorded audio. Patients' hemodynamic parameters were recorded before and after hearing stimulation. Also, the return time of the patient from anesthesia was recorded. Finally, the collected data were entered into SPSS software (Ver. 22) and analyzed using an independent sample t-test and Repeated mesasure ANOVA.
Results: The results of this study showed that from the fifth minute after auditory sensory stimulation, the mean arterial pressure (MAP) in the intervention group was significantly higher than the control group (P<0.05). So that MAP in recovery (as the last follow-up) in the intervention group with a mean of 86.85±4.11 mmHg was significantly higher than the control group with a mean of 81.88±6.68 mmHg (P<0.001). Besides, the duration of recovery from anesthesia in the intervention group was significantly less than the control group (mean time: 24.05±3.39 min vs. 34.70±70.73 min; P<0.001). Finally, nausea was observed in only 7.5% of patients in the control group and agitation was reported in 5% of the control group and 5% of the intervention group (P>0.05).
Conclusion: According to the results, the use of auditory sensory stimuli with a familiar voice can significantly decrease the duration of recovery from anesthesia. Also, it plays a crucial role in changing the SBP, DBP, and MAP of these patients to normal levels.

Hygiene protocols during the coronavirus pandemic for athletes: biref report
Amir Hossein Ahmadi Hekmatikar, Sadegh Amani Shalamzari , Mahdieh Molanouri Shamsi ,
Volume 79, Issue 4 (July 2021)
Abstract
Background: Long-term and intensive physical exercise can change the function of different cells in the immune system in athletes, predisposing them to viral infections such as coronavirus disease (COVID-19). The purpose of this brief report was to provide protocols related to the immune system in athletes to prevent infectious diseases.
Methods: To examine immune system responses to sports activities, articles were collected from all databases: Science Direct, PubMed, Scopus, Web of Science, Springer, Google Scholar, SID, and the most recent articles were selected.
Results: High-intensity and long-term physical exercise can be effective in suppressing immune responses. Therefore, moderate-intensity exercise can be an effective strategy. Maintaining the function of the immune system in athletes was dependent on nutritional strategies, sleep control, stress management, and strict adherence to proper exercise principles and health protocols. Athletes are more prone to viral infections in the early hours after strenuous, prolonged physical exercise; and they should be limited in contact with people who may increase their risk of infectious diseases. We should mention that moderate-intensity physical exercise can improve the function of immunoglobulins, anti-inflammatory cytokines, neutrophils, natural killer cells, cytotoxic T cells, and immature B cells. Maintaining social distance, especially immediately after strenuous exercise, is also recommended for athletes due to the increased risk of infectious diseases. The immune system has been considered an effective part of sports activities in athletes in recent years. The prevalence of viral diseases such as COVID-19 has not been and will not be for the first and last time in life. Therefore, using questionnaires and initial monitoring (adherence to diets, corona testing, adherence to health protocols) can be the first step.
Conclusion: Finally Due to the pandemic of coronary heart disease and its unknowingness, providing some health and nutrition guidelines for starting exercises and sports competitions to prevent the transmission of this disease is on the agenda of this article.

Investigating gender differences in research performance of Iranian medical faculty members: a scientometric study
Ahmad Sofi-Mahmudi , Erfan Shamsoddin, Bita Mesgarpour, Shahin Akhondzadeh, Payam Kabiri,
Volume 79, Issue 7 (October 2021)
Abstract
Background: Gender differences in scientometric indicators among medical faculty members in Iran was investigated.
Methods: The Research performance of the faculty at all universities and institutes of medical sciences in Iran was assessed using the Iranian Scientometric Information Database (ISID) on June 12, 2021. Selected variables in our study were name, gender, university, degree, academic rank, type of faculty, the total number of articles, the total number of citations, self-citation percentage, h-index, citation per article, international cooperation percentage, and the number of research collaborators. The Kruskal-Wallis test was used. The extracted data were analyzed using R v4.0.1 statistical software.
Results: A total of 21064 faculty members in 77 universities and institutes of medical sciences were registered in the ISID database, of which 12093 (57.4%) were men. Men faculty members outnumbered women in all academic ranks, except for the “instructor” rank (1134 female instructors against 835 male). In both sexes, most faculty members were assistant professors. There were more articles (346837 vs. 146024) and citations (5177060 vs. 1639246) by men than women. Among the 1789 faculty members with zero articles, 902 (50.4%) were men. One-hundred-and-fifty-four people were among ESI's top researchers' list, with a majority of men (124 people equal to 80.5%). The medians of all the scientometric indicators were higher in men than women. Men had a higher number of articles, the number of citations, h-index, citation per article, percentage of international articles, and co-authors, however, women had lower self-citations (1.56% vs. 2.51%). In all academic ranks, men had higher scientometric indicators. The only exception was the associate professors’ self-citation, in which women’s citations were higher than that of men (3.5 vs. 3.3). The highest mean h-index was in men with a Ph.D. in Pharmacy (13), men with a Ph.D. by Research (12) and women with a Ph.D. by Research (8.5), respectively.
Conclusion: Gender differences were evident in research performance in Iran. Women faculty members of medical sciences in Iran generally had lower scientometric indicators.

The percentage of otitis types in patients being reffered to ENT clinic: a brief report
Ayeh Shamsadini, Maryam Amizadeh, Keramat Mozaffarnia, Nafiseh Fakharpour,
Volume 79, Issue 8 (November 2021)
Abstract
Background: Otitis is the most common infectious disease of the ear with internal and external cranial complications. If the infection is in the middle ear, it causes otitis media. If the infection is in the external ear, it’s along with otitis externa (OE). Different types of otitis media include acute otitis media (AOM), chronic otitis media (COM) and Otitis media with effusion (OME). This study aimed to investigate the different types of otitis and its symptoms.
Methods: This cross-sectional study was conducted from March 2019 to February 2020 for 200 patients who have been referred to the ENT center of Shafa hospital, Kerman, Iran. Sampling was conducted with ease and no need for specified sampling distribution. The type of otitis was written in a questionnaire by the physician after the examination. The present research investigated types of otitis along with its symptoms. Also, their demographic information was determined.
Results: This study was done among 200 patients. 106(53%) participants were diagnosed with external otitis and the most common symptoms include discharge from the ear, inflammation and pain of the ear. 53 patients (26.5%) had acute otitis media with the most common symptoms of tympanic membrane color change and otalgia. 22 patients (11%) were diagnosed with chronic otitis media. So, perforation of the tympanic membrane and otorrhea were considered as the most common symptoms for these patients. 9(9.5%) of participants had otitis media with effusion that aural fullness and reduction of hearing were the most common signs. In this research, most of the patients were between the age of 11 to 30.57% of patients in this study were men and 43% were women. Most of the patients were between the age of 30-40 and the least number of patients were over the age of 70. Among the 200 patients, most of them lived in cities and provinces rather than villages. 67.5% of patients didn’t have an academic certificate.
Conclusion: Considering the high prevalence of otitis among patients with ENT disorder, it was recommended that otitis should be recognized and cured.

Costs of services covered by the global payment system in Tehran University of Medical Sciences
Jalal Saeedpour , Mehdi Rezaei , Shamsi Ekhteyar, Sara Akhavan Rezayat , Soheila Damiri , Faezeh Fartaj, Maryam Radin Manesh ,
Volume 80, Issue 4 (July 2022)
Abstract
Background: In Iran, a combination of three methods of budget payment, fee for service and case-based payment (known as the global payment system) is used to reimburse the cost of hospital services. The aim of this study was to investigate the costs of 90 services of the Global Hospital Reimbursement System at Tehran University of Medical Sciences.
Methods: This descriptive cross-sectional applied study was performed from March  2017 to March 2019 in the hospitals of Tehran University of Medical Sciences. The billing and record data of all patients whose services were reimbursed on a global payment system basis were extracted from hospital information systems. Data were analyzed using descriptive statistics (frequency mean. std deviation, maximum & minimum) in SPSS 21 and Excel 2016.
Results: During two years in TUMS, the costs of services provided to 143,866 patients have been reimbursed based on the global payment system., which had a cost of 2300 billion rials. 80% of the total services and costs were related to 10 services. 78.46% of the cases were related to two specialized groups of ophthalmology and obstetrics and gynecology. 83.17% of the total costs of services reimbursed globally at the TUMS were related to these two specialized groups. The average cost per service was about 16 million Rials, but varied greatly for different services, ranging from about 1.8 million Rials to 67 million Rials. On average, for a global service, the share of each of the cost subgroups of diagnostic services, hoteling and nursing services, medicine and consumables, operating room and surgery, physician's visit and consultation, respectively 3.1%, 11.6%, 21.4%, 49.9% and 13.9%.
Conclusion: Managers need to focus on high-frequency and high-cost services to reduce the cost and financial losses for services that are under the global payment system. Depending on the specific cost pattern of each service, the strategies adopted to control the costs of that service should also be different.

Successful cesarean section in a woman with coronavirus and scleroderma: a case report
Shamsi Zare, Payman Rezagholi,
Volume 80, Issue 7 (October 2022)
Abstract
Background: The incidence of adverse perinatal outcomes including increased risk of miscarriage, preeclampsia, preterm birth and stillbirth is higher in pregnant women with coronavirus. Pregnant women who are infected with the coronavirus have placentas that are abnormal compared to the placentas of healthy women. Examples of these adverse effects have been observed before and include reduced fetal growth, pre-eclampsia, premature birth and stillbirth. Scleroderma is an uncommon connective tissue disease and its most obvious manifestation is skin fibrosis. Patients may also have involvement of visceral organs, as a result, their digestive system, kidney and heart are affected. Scleroderma also exacerbates miscarriage, fetal growth retardation, intrauterine fetal death, and preterm delivery. Pregnant women with these problems need special measures, so this study was performed to report a successful cesarean section in a woman with coronavirus and scleroderma.
Case presentation: The patient was a 31-year-old pregnant woman with a gestational age of 29 weeks who presented to Sanandaj Besat Hospital in November 2021 with symptoms of shortness of breath and dyspnea. HRCT-positive, PCR-positive, bilateral pleural effusion, and pulmonary dilatation corona were diagnosed. Due to 3 liters of vaginal bleeding and diagnosis of Décollement 60% and severe preeclampsia underwent emergency cesarean section. The live baby was born weighing 1300 g with Apgar 7. During surgery, he received 3 units of FFB and 3 units of Cryoprecipitate. Microcalcifications and fibrin thrombi were reported in the pathology of intermittent nodules. The diagnosis and treatment of this patient has significant points that are mentioned below.
Conclusion: Complications of pregnancy and childbirth in pregnant women infected with Corona virus include an increase in premature birth and an increase in the rate of cesarean section. Pregnancy in women with scleroderma at the right time and careful delivery monitoring will increase the probability of successful pregnancy outcome and all patients need counseling.

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