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A survey of awareness, knowledge and attitudes regarding stem cell donation among different people in the community: a systematic review study
Behjat Kalantari Khandani , Fatemeh Irannejad Parizi , Sedigheh Sadat Mousavi, Pouria Salajegheh,
Volume 81, Issue 1 (April 2023)
Abstract
Background: Stem cells play an important role in tissue regeneration and treatment of diseases. This study aimed to investigate the awareness, knowledge and attitudes regarding stem cell donation among different people in the community.
Methods: In this systematic review study, Persian keywords and English keywords such as awareness, knowledge, stem cells, embryonic stem cells, adult stem cells, cord blood stem cells and donation were selected according to MeSH database and then these selected keywords have been searched in the academic databases such as PubMed, Scopus, OVID, Science Direct, Iran Medex and SID. In addition, these selected keywords have been searched in the search engines such as Google Scholar, between January 2010 to December 2021.
Results: The results of this study found a total of twenty-five articles related to the awareness, knowledge and attitudes regarding stem cell donation among different people in the community. They were selected. In this study there were 10 cross-sectional studies, 2 descriptive-cross-sectional studies, 5 descriptive studies, 1 mixed method study, 1 semi-experimental study, 1 intervention study, 1 survey study, 1 review study, and the study type was not mentioned in three studies. Most of the studies were conducted in countries such as India, Saudi Arabia, and then United States (USA) and Turkey. Only one article was found in Iran. The results of studies have shown that the level of awareness and attitude of the majority of different people in the community towards the donation and use of stem cells is medium and low. However, most people have a good and positive attitude towards the donation and use of stem cells and mention the use of stem cells as an effective way to treat diseases.
Conclusion: Considering the importance and application of stem cells, it is suggested that managers and planners provide the necessary conditions to implement educational programs to raise the level of awareness and attitude of different people in the community towards stem cell donation.

Management of cosmetic surgery in iran: challenges and solutions
Maryam Tajvar, Parisa Pourfarokh, Najmeh Bahmanziari, Ebrahim Jaafaripooyan, Maryam Nazari , Haniye Sadat Sajadi ,
Volume 81, Issue 1 (April 2023)
Abstract
Background: Nowadays, beauty practices have attracted the attention of people following the change in lifestyle and social values. Therefore, the present study was conducted with the aim of examining the opinion of experts regarding the challenges and management solutions of the aforementioned practices in Iran.
Methods: This qualitative study was conducted through interviews with 26 policymakers and cosmetic surgery service providers in Tehran from April to September 2022. Sampling was purposeful and snowball. The interviews were semi-structured and thematic analysis was used to analyze the data obtained from the interviews. The inclusion criteria for the interviewees' entry were knowledge and experience in the subject and willingness to participate.
Results: Challenges under the four categories of service providers (improper education, non-specialist providers, moral hazards, deficiencies in the way laws are written, and the ineffectiveness of the complaint handling process), service receivers (being influenced by deceptive advertisements, low level of public health literacy and lack of mental health), the place of providing services (performing surgeries in non-standard places and non-integrated information system) and medicines, products and medical equipment (insufficient control over supply, distribution and use and price fluctuations) were categorized. Experts considered the major part of the challenges to be related to the service providers. In the category of service recipients, "being influenced by deceptive advertisements" was the main problem mentioned by the experts. Performing surgeries in non-standard places, including limited surgery centers, non-sterile places, and unauthorized places, is among the unsolved problems regarding the place of providing services. In relation to medicines, products, and medical equipment, the main problem was insufficient supply, distribution, and use supervision.
Conclusion: The main effective measure to solve the challenges is to strengthen the supervision of the health system administrator with internal and external coordination and cooperation. In this regard, it is recommended to develop educational, ethical, and legal frameworks, regulate regulatory laws, public awareness, clinical interviews and psychological counseling, especially before cosmetic surgery, and the establishment of an integrated electronic health record system.

Investigating the results of breastfeeding counseling in mothers referred to the breastfeeding counseling clinic of the health centers
Zeinab Khazaeeshir , Kobra Mirzakhani, Golnaz Sadat Ahmadinezhad, Fatemeh Sadat Naderi, Nahid Jahani Shoorab ,
Volume 81, Issue 1 (April 2023)
Abstract
Background: The rate of exclusive breastfeeding in Iran at the ages of 3 and 6 months is estimated to be 44% and 27%, respectively, which is still far from the optimal index of the World Health Organization until 2030 (70% in the first six months). In order to monitor breastfeeding counseling centers, which have been set up with the aim of promoting breastfeeding and supporting mothers who have problems with breastfeeding.
Methods: This is a descriptive-retrospective study and all the mothers who were referred to the Health and Treatment Center No. 2 in Mashhad between April 2019 and March 2019 were examined. This health center has two active counseling clinics and the collection of information is based on documents registered in offices and computers. The inclusion criteria for study were not having breast diseases, having an infant child, being able to read and write and living in Mashhad city. The exclusion criteria were also the unwillingness to participate in the study and the newborn suffering from diseases that are incompatible with breastfeeding. Therefore, census sampling was done. The data were analyzed using SPSS 16 software and the significance level was less than 0.05.
Results: In 42.8% of cases, mothers had started feeding combined formula with breast milk before visiting, and in 28.1% of cases, when referring to counseling milk clinics, it was reported that the baby was fed only with formula. After breastfeeding consultations and follow-ups at the end of six months, the rate of exclusive breastfeeding is 34.1% (12% increase compared to the initial reference) and combined formula feeding with breastmilk is 27.8% (a 22% decrease compared to the first visit). And feeding with powdered milk alone was calculated to be 36.5% (an increase of 8.4% compared to the first visit).
Conclusion: The positive role of breastfeeding counseling center in reducing the cases of artificial feeding is clear, and it is recommended to prepare written instructions based on the challenges in breastfeeding for breastfeeding counseling in the first month after delivery.

Evaluation of the cerebrospinal fluid analysis parameters in children with febrile seizures
Reza Abbasi, Ahmad Mokhtari, Farnaz Sadat Javanmardi ,
Volume 81, Issue 2 (May 2023)
Abstract
Background: Febrile seizures are the most common cause of seizures in children under 5 years of age. Central nervous system infections are an important differential diagnosis of febrile seizures. Apart from infections, CSF characteristics are affected by many factors including the cause, type and duration of seizures. This study was designed to determine the cerebrospinal fluid (CSF) indices, including white blood cells (WBC), polymorphonuclear cells (PMN) count, and levels of protein and glucose in the CSF of children with fever-induced seizures.
Methods: The present study is a descriptive study that evaluated the results of CSF analysis in 56 children with febrile seizures admitted to Imam Sajjad Hospital in Yasouj from March 2012 to 2013. In the present study, CSF analysis was performed in children with a diagnosis of febrile seizures. In order to collect information from a pre-designed form that includes demographic information (age and gender), degree of fever, and information related to CSF indices including WBC, PMN and levels of protein and glucose in CSF, which have been extracted and recorded, statistical methods are used in this study to express descriptive statistics such as mean, standard deviation, number, percentage, etc.
Results: 56 children with a diagnosis of convulsive fever with a mean age of 21.4±14 months were evaluated. 37.5% (21 individuals) of the study population were females and 62.5% (53 individuals) were males. Among them, 33 individuals had low-grade fever and 23 individuals had high-grade fever. In 10.7%, the number of WBCs was more than 5. The amount of protein obtained was in the normal range, between 20 and 50 mg/dl, in 57.1% of cases. However, a significant percentage (39.3%) of CSF liquid protein was below 20 mg/dl. CSF fluid glucose levels were within the normal range at 91.1%.
Conclusion: Based on the results of this study, febrile seizures may be associated with low protein levels in the CSF. However, due to the limited sample size in our study, similar studies with higher sample sizes are recommended.

Investigating the factors affecting post-laparoscopic cholecystectomy pain in patients referred to mashhad medical sciences of islamic azad university hospitals in 2021-2022
Yasamin Kaheni, Ali Mirsadeghi, Mohammad Ali Raisolsadat , Mohammad Javad Ghamari , Mohammad Barhemmat , Tooraj Zandbaf,
Volume 81, Issue 4 (July 2023)
Abstract
Background: Due to the prevalence of laparoscopic cholecystectomy, controlling common problems after this surgery is essential. This study aimed to determine the factors affecting pain after laparoscopic cholecystectomy.
Methods: In this cross-sectional study, 222 patients over 18 years old with symptomatic gallstones who underwent laparoscopic cholecystectomy from March 2021 to February 2022 in Mashhad Medical Sciences of Islamic Azad University Hospitals, were included. The amount of analgesic received after surgery was the same for all patients (Acetaminophen 1 gram intravenously every 8 hours and diclofenac 100 mg rectal every 8 hours). Demographic information of patients, body mass index, history of abdominal surgery, duration of surgery, carbon dioxide pressure, type of surgery (elective or emergency), number of surgical incisions, and pain intensity six and 24 hours after surgery (using a visual analog scale) were collected, and finally, the findings were statistically analyzed by SPSS version 26.
Results: Out of 222 patients, 179 cases were women (80.6%), and their average age and body mass index were 44.68±12.27 years and 27.08±4.7 kg/m2, respectively. In our study, 110 people (49.5%) had a history of abdominal surgery, of which cesarean section was the most common delete. Pain six and 24 hours after the operation was more common in women than in men, and surgery with three incisions was more painful than surgery with four incisions (P<0.05). In patients with a history of surgery, the pain was greater in six hours after surgery (P<0.05). Pain 24 hours after the operation in patients with gas pressure less than or equal to 14mmHg was greater than in patients with gas pressure greater than 14 mmHg (P<0.05). Pain six and 24 hours after surgery according to age, body mass index, type of surgery (emergency or elective), and duration of surgery had no statistically significant difference (P>0.05).
Conclusion: In our study, female gender, use of three incisions for surgery, and history of previous surgery were associated with more pain after laparoscopic cholecystectomy.

Complications of trans-obturator mesh surgery in the treatment of stress urinary incontinence; A 10 Year Review
Shahnaz Barat, Goldis Ola , Zinatossadat Bouzari, Azita Ghanbarpour, Hoda Shirafkan,
Volume 81, Issue 6 (September 2023)
Abstract
Background: Urinary stress incontinence occurs due to weakness of the urethral sphincter and/or weakness of the pelvic floor muscles. The purpose of this study is to investigate the complications of TOT surgery in the treatment of women with stress urinary February.
Methods: This is a cross-sectional study that was conducted on women suffering from stress urinary incontinence who underwent TOT surgery in Rohani and Mehregan Hospitals of Babol between March 2010 and February 2019. In order to record early complications, the medical records available in the clinic were referred to for the examination of patients one week and two months after the operation. The late complications of the operation were also investigated at the time of entering the study. Also, satisfaction with the procedure was scored using a visual scale (score 0 to 100). SPSS version 26 software was used in this study. Also, the significance level is less than 0.05.
Results: The study included 59 patients, the majority of whom were housewives (91.5%), had an education level below high school (74.6%), and were menopausal (71.2%). The average age of the participants is 54.92±9.40 years. The most common postoperative complications were Dyspareunia (20.3%), lower urinary symptoms (13.6%), and incontinency (10.2%). Also, the rarest complications were intraoperative injury to the urethra or bladder (1.7%), mild Vaginal erogenous (1.7%), pain at the operation site (3.4%), and need for adjuvant treatment (3.4%). In response to the question of whether you would recommend this surgery to others who have the same problem, 53 people (83.89%) responded positively. The average level of patients' satisfaction with the operation (on a scale of 0 to 100) was 88.64±23.44. According to the T-test, there is a statistically significant relationship between the incidence of postoperative complications and the level of patient satisfaction (P<0.001).
Conclusion: Dyspareunia is the most common and complications during surgery such as damage to the urethra are the rarest complications of TOT surgery.

Evaluation of Fragmented QRS complex and conduction abnormalities and its association with disease severity in systemic sclerosis patients, a case-control study
Reza Atef Yekta , Hoda Kavosi , Pouria Esavand, Monir Sadat Hakemi , Abdolvahhab Baradaran, Zahra Tamartash,
Volume 81, Issue 8 (November 2023)
Abstract
Background: Systemic Sclerosis (SSc) is an autoimmune disease with multi-organ involvement mostly due to fibrosis and ectopic or excessive collagen fibers production in organs. Myocardial fibrosis is the main finding of cardiac involvement in patients with systemic sclerosis. In recent studies, the presence of Fragmented QRS complexes (FQRS) has been shown in the surface electrocardiogram in relation to fibrosis.
Methods: The present study is a case-control study during March 2019 to February 2020 that was conducted in 148 patients with scleroderma referred to the Rheumatology clinic in Shariati Hospital and 101 non-ischemic individuals in the control group matched by age and sex with the patient group. All the medical records were reviewed and those who were low risk according to 10-year atherosclerotic cardiovascular disease (ASCVD) risk assessment were selected as case groups. Data of ECG were evaluated for availability of FQRS or conductive abnormalities and calculating PR, QRS, QT, QTc and Tp-e intervals.
Results: Of the 141 patients with systemic sclerosis, 127(85.81%) were female and 21(14.19%) were male. In the control group, 81 women (80.2%) were present. 61(41.2%) of patients with scleroderma and 8(7.9%) of the control group in this study had FQRS changes in their electrocardiogram. In this study, QRS, QTc and Tp-e intervals were significantly higher in patients with systemic sclerosis compared to those in the control group. The frequency of FQRS, LAHB and LPHB in patients with systemic sclerosis was significantly more than control group. The relationship between PR, QRS, QTc, Tp-e intervals with age, length of disease onset and the severity of skin involvement was assessed. There was a significant correlation between PR-interval and age. Furthermore, there were a correlation between QRS interval and Rodnan skin score, Pulmonary Artery Pressure and Finger to Palm. It is also a meaningful correlation between QTc interval and Rodnan score.
Conclusion: The FQRS finding in electrocardiogram in patients with systemic sclerosis, which has no obvious cardiac symptoms, may indicate myocardial fibrosis and predict future cardiac disorders.

Investigating the correlation between the frequency of single nucleotide polymorphisms in the IFNAR2 gene with the severity of the Covid-19 disease
Mahnaz Safari, Pooneh Rahimi, Akram Sadat Tabatabaee Bafroee,
Volume 81, Issue 8 (November 2023)
Abstract
Background: Understanding the complex processes of the immune system in dealing with the covid-19 infection, which is probably related to polymorphisms in cytokine and chemokine genes, can explain the pro-inflammatory condition of patients. Accordingly, in the present study, the correlation between the frequency of single nucleotide polymorphisms in the pro-inflammatory IFNAR2 gene and the severity of the disease of COVID-19 was investigated.
Methods: This research was reviewed by the ethics committee of the Pasteur Institute of Iran and was approved by this committee with the ethics code IR.PII.REC.1400.042. and continued from December 2021 to November 2022. This study was conducted on 954 patients with COVID-19, who were divided into two groups: those who recovered and those who died. COVID-19 infection in all 954 volunteers has been confirmed through rtReal Time-PCR of oropharyngeal or nasopharyngeal swabs.After taking blood samples from patients and extracting DNA, IFNAR2 gene was amplified using specific primers. Then RFPL method and Cac8I restriction enzyme were used to investigate rs2236757 polymorphisms in IFNAR2 gene. Genotype of people was determined according to the pattern of formed bands. The results were statistically analyzed using SPSS software.
Results: Calculation of genotypic frequency of rs2236757 polymorphism in IFNAR2 gene showed that in general 21% of cases had AA genotype, 47% GA genotype and 32% GG genotype. The allelic frequency of this polymorphism showed that 56% of cases had G allele and 44% had A allele. In investigating the correlation of rs2236757 polymorphism in IFNAR2 gene with the severity of the disease of Covid-19, the OR value for the GG genotype was equal to 1, which indicates the absence of the role of this polymorphism in the severity of the disease. On the other hand, A allele was significantly more in recovered people than in deceased people, and the value of OR<1 also confirmed this issue.
Conclusion: The results showed that rs2236757 in the IFNAR2 gene is related to the reduction of disease severity, which indicates the important role of genes related to inflammatory responses, as well as the role of genetic variants of these genes in the severity of COVID-19.

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.

Mohsen Sadat Shahabi , Ahmad Shalbaf ,
Volume 82, Issue 2 (May 2024)
Abstract
Background: Major Depressive Disorder (MDD) is one of the most prevalent and disabling mental disorders in the world. Due to the life quality decline caused by this disease and its growing nature, timely detection and treatment is of paramount importance. In the present study Electroencephalogram (EEG) signal utilized for the precise detection of MDD using Artificial Intelligence (AI) Methods.
Methods: In this analytic study, which is done in Shahid Beheshti University of medical Sciences in 2023, fifty eight subjects were investigated using an experienced psychiatrist that 30 subjects diagnosed as MDD and 28 determined to be healthy. Nineteen channels EEG signals in resting state with eyes closed situation acquired for five minutes from all of the participants including 36 men and 22 women with the average age of 39.3 years. The EEG signals were preprocessed to remove contaminating signals from brain-originated signals. The EEGLAB package in MATLAB utilized to re-reference channels to the average reference, apply a band-pass filter between 1 and 40 Hz and to remove non-brain components of the signal using Independent Component Analysis (ICA). The cleaned data segmented to the three seconds windows with 50 percent overlapping. These segments were used as the input to the AI models. Deep Learning (DL) models utilized in the present study were EEGNet, ShallowConvNet and DeepConvNet which were developed based on the deep convolutional models for the classification of healthy and MDD brain signals. The main difference between these models laid in the number of specific convolutional layers and the model complexity.
Results: MDD and Healthy signals classification has been done using EEGNet, ShallowConvNet and DeepConvNet models and accuracy of 92.3%, 83.2% and 92.2% were achieved, respectively. Also EEGNet acquired the highest sensitivity of 98.9% and specificity of 79.1%.
Conclusion: The detection of MDD patients using EEG signals with high accuracy and generalizability is possible and proposed AI models can be utilized in the clinical settings as assistant tools.

Factors affecting the interest of specialized assistants to continue studying in subspecialized fields: a brief report
Ghazal Mansouri, Fatemeh Nouri Koohbanani , Fatemeh Karami Robati , Robabe Hosseinisadat,
Volume 82, Issue 2 (May 2024)
Abstract
Background: Choosing a specialty in medicine is an important decision for the individual. It is also important decision for the health system. This study aimed to investigate the factors affecting the interest of specialized assistants to continue studying in subspecialized fields.
Methods: This descriptive cross-sectional study investigated the factors affecting the interest of 261 specialized assistants to continue their studies in subspecialized fields from March 2021 to March 2022. All the specialized assistants of Kerman University of Medical Sciences (KMU), whose assistantship continued until the end of March 2022, were included in the study by census method. The data collection tool was a 4-part questionnaire. 1) demographic information including 13 questions (age, gender, marital status, city where the family lives, place of residence to complete the residency course, specialized field, level of education, grade point average, parents' education, parents' occupation and having first-degree relatives with subspecialized degrees), 2) the willingness or unwillingness to continue studying in subspecialized fields and the field of interest, 3) the reasons for the assistants' interest in continuing their education, included 14 questions, and 4) the reasons for the assistants' lack of interest in continuing their education, included 14 questions.
Results: The average age of the assistants was 31.53±3.90 years old. Most of the assistants were women (57.9%). 57.5 percent of the assistants were interested in continuing their studies in subspecialized fields. The most important reason for residents' interest in continuing their studies was "increasing practical-clinical knowledge" (80.1%). The most interest in continuing education was observed in internal assistants (17.33%). The assistant's age, specialist field and having first-degree relatives with a subspecialist degree had a significant relationship with the interest of the assistants to continue studying in subspecialist fields.
Conclusion: The results showed that a significant percentage of assistants were interested in continuing their studies in subspecialized fields. Age, the assistant's specialty and having first-degree relatives with a subspecialist degree had a significant effect on this interest.

Investigating the incidence and severity of pruritus in intrathecal fentanyl injection in opium-addicted patients in lower limb orthopedic surgeries: a double-blind randomized clinical trial study
Seyedeh Roya Mousavi , Parvaneh Ebrahimzadeh, Sepideh Yazdanpanah , Nasim Alsadat Mousavi, Mansour Deylami ,
Volume 82, Issue 4 (July 2024)
Abstract
Background: Today, addiction is a major problem in modern society, which affects the management of patients during anesthesia. In patients with long-term use of opioids, higher doses of opioids are needed to create analgesia and control pain during and after surgery. Also, addicted patients have more resistance to local anesthetic drugs when they are used to perform peripheral and central nerve blocks. Therefore, many drugs are added to local anesthetics to enhance their analgesic properties, one of the most common of which is narcotic compounds. Itching caused by opium may be generalized and often occurs shortly after injection. Therefore, this study aims to investigate the amount of itching caused by intrathecal injection of fentanyl in opium addicts who undergo elective orthopedic surgeries of the lower limbs with spinal anesthesia. have been taken, designed and established.
Methods: This study was a double-blind clinical trial conducted on 68 patients who were candidates for elective lower limb orthopedic surgeries under spinal anesthesia and referred to 5 Azar Hospital in Gorgan in 2023. Patients were divided into two groups using random numbers table, Intervention (a group of addicted patients who received intrathecal marcaine together with fentanyl for spinal anesthesia) and control (a group of addicted patients who received only intrathecal marcaine for spinal anesthesia). Pruritus, nausea and vomiting were measured in both groups. Data analysis was done using descriptive statistics and inferential statistical tests.
Results: In terms of age, gender, and BMI, there was no statistically significant difference between the intervention and control groups. There was no statistically significant difference in the incidence of nausea and vomiting between the two groups. The incidence of itching was zero in the bupivacaine group and 17.6% in the fentanyl and bupivacaine group, of which 3% required anti-itch medication for treatment.
Conclusion: The results of this study showed that due to the low incidence of pruritus in the group using fentanyl along with bupivacaine, its use is beneficial in people with drug addiction.

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