Showing 106 results for Ast
Davoud Shamsi, Mohsen Mohammadian Saravi, Khalil Ali Mohamadzadeh, Azadeh Ashrafi,
Volume 28, Issue 2 (4-2025)
Abstract
Introduction: Good governance, as one of the fundamental concepts in healthcare system management, plays a key role in enhancing the efficiency, effectiveness, and equity of healthcare services. This concept, Emphasizing principles such as transparency, accountability, participation, and legality, has been considered as a framework for improving policymaking and management in Iran's healthcare system.
This study conducted in 2024 aimed to design and present a model of good governance in the healthcare system using a mixed approach of thematic analysis and Partial Least Squares (PLS) method.
Methods: The research method included both qualitative and quantitative components. The qualitative phase, involved managers, health policy experts, specialists from the Ministry of Health and Medical Education, and academic scholars. Sampling was done using purposive and snowball sampling methods, with 17 participants selected until theoretical saturation was reached. In the quantitative phase, the Partial Least Squares (PLS) method was used for model fitting. The statistical population for this section included all experts and managers in Iran's healthcare sector, with a minimum sample size of 384 determined based on Cochran's formula.
Results: The results of thematic analysis of the qualitative data and model fitting showed that the final good governance model in the healthcare system consists of seven main dimensions: effectiveness, efficiency, equity, transparency and accountability, participation, legality, and leadership. Each dimension comprised specific components, and the importance of each was confirmed in strengthening good governance.
Conclusions: This study presents a comprehensive good governance model for the healthcare system, offering a framework for improving policymaking, management, and performance in this sector. The proposed model can be used as a strategic decision-making tool and improving management structures.
Safieh Azadi Fard, Mehdi Moradi, Mohammad Malekipooya,
Volume 28, Issue 4 (10-2025)
Abstract
Introduction: Since endurance training and a fasting diet are effective in reducing the symptoms of heart disease, this study aimed to investigate the effect of a period of endurance training with electrical stimulation on the expression of ICAM and VCAM genes in the heart tissue of obese fasting rats.
Methods: In this study, 35 male Wistar rats (8 weeks old, average weight 200 ± 19 g) were rendered obese and then randomly assigned to five groups of seven: obese control, fasting, fasting with endurance training, fasting with electrical stimulation, and fasting with endurance training with electrical stimulation. All groups except the obese control followed a 16/8 intermittent fasting protocol. The endurance training lasted 4 weeks, with 5 sessions per week, starting at 50% of maximal oxygen consumption in the first week and progressing to 65% by the fourth week. Electrical stimulation was delivered via foot shock (0.5 mA for 20 min). 24 hours after the last session, cardiac tissue was extracted under deep anesthesia. The expression levels of ICAM-1 and VCAM-1 genes in the heart were measured using real-time PCR. Data were analyzed using two-way analysis of variance (ANOVA) followed by Tukey's post-hoc test, with the significance level set at P ≤ 0.05.
Results: The results of the present study demonstrated that intermittent fasting, endurance training, and electrical stimulation—each independently—led to a significant reduction in the gene expression of vascular adhesion molecules in the cardiac tissue of obese rats (P = 0.001). Moreover, it appears that the combination of all three interventions exerts a greater effect in reducing the expression levels of these adhesion molecules in the cardiac tissue of obese rats (P = 0.001).
Conclusions: Based on the findings, the simultaneous application of endurance training, intermittent fasting, and electrical stimulation exerts a considerable impact on decreasing the expression of VCAM and ICAM in cardiac tissue. However, it is still not possible to definitively determine the directionality of the individual or combined effects of intermittent fasting, endurance training, and electrical stimulation (foot-shock stimulation) on adhesion molecules under conditions of obesity and intermittent fasting.
Maryam Mobedi ,
Volume 28, Issue 4 (10-2025)
Abstract
Introduction: Baclofen, a GABA-B receptor agonist, acts on presynaptic and postsynaptic neurons in the central and peripheral nervous systems. Baclofen withdrawal causes activation of dopamine and noradrenergic receptors. Symptoms usually develop in 1 to 3 days of cessation, including altered mental status, worsening of spasticity, fever, weakness, autonomic instability, seizures, neuroleptic malignant syndrome, neuropsychiatric manifestations, and a life-threatening state. It can be observed in patients taking oral or intrathecal baclofen following sudden discontinuation or dose reduction. Baclofen is a commonly used medicine in patients with muscle spasticity. It can also relieve gastroesophageal reflux disease (GERD) symptoms.
Case Report: Here, we report a four-month-old Iranian boy with normal neurodevelopment who was referred to the pediatric emergency department due to extreme irritability, intense crying, poor feeding, insomnia, staring, and a seizure episode. He was admitted to the pediatric intensive care unit, with initial assessment of vital signs (mild fever, tachycardia, tachypnea), laboratory tests (anemia), brain CT (computed tomography), and EEG (electroencephalogram), which were non-diagnostic. Meningitis also was ruled out. He was started on serum and antibiotic therapy and intravenous phenobarbital, but symptoms and signs did not completely improve, and the patient was irritable and his poor feeding was continued. Further history revealed GERD treated with oral baclofen for three months, which had been discontinued three days prior to admission. Baclofen was restarted at the previous dosage, resulting in rapid symptomatic improvement. The patient was transferred to the neurology department and then discharged in good general condition with oral baclofen and phenobarbital. Phenobarbital was tapered and discontinued after two weeks without seizure recurrence.
Conclusions: After four months of follow-up, the patient was in normal condition. To the author's knowledge, no cases of seizures after discontinuation of baclofen have been reported in Iranian infants under six months of age with GERD.
Mehtab Farahani, Fatemeh Mehrabi, Mohammad Ali Mardom, Abdollah Abolfathi, Zahra Borzabadi Farahani, Fatemeh Rafiei,
Volume 28, Issue 4 (10-2025)
Abstract
Introduction: The purpose of this study was to investigate the effect of education based on the self-efficacy model on coping strategies and hope in breast cancer patients undergoing chemotherapy.
Methods: This study was conducted on 62 breast cancer patients undergoing chemotherapy. The intervention group received four training sessions on chemotherapy side effects and management strategies based on the self-efficacy model, while the control group received routine care without additional training. Demographic questionnaires, the Billings and Moss Coping Skills Questionnaire, and the Schneider Hope Scale were completed by both groups immediately before and after the intervention. Data were analyzed using appropriate statistical tests.
Results: The average hope in the intervention and control groups was low before and after the intervention. It remained low in the control group but showed a significant increase in the intervention group (P < 0.05). Statistical tests showed that there is a significant relationship between the average total life expectancy and their age, economy and education (P<0.05). Before the intervention, both groups demonstrated low use of coping strategies. After the educational intervention, the control group maintained low usage while, the intervention group showed substantially increased use of coping strategies.
Conclusions: Self-efficacy training intervention increased life expectancy and coping strategies in breast cancer patients undergoing chemotherapy.
Mehri Rostamnejad, Javad Khalatbari, Mohammadreza Zarbakhsh Bahri,
Volume 28, Issue 5 (12-2025)
Abstract
Introduction: Breast cancer is one of the chronic diseases that is closely related to psychological factors. The present study was conducted with the aim of investigating the mediating role of perceived social support and self-compassion in the relationship between coping styles and quality of life in breast cancer patients (after mastectomy surgery).
Methods: The research method was a correlational description. The statistical population of this study was women diagnosed with breast cancer and mastectomy who were referred to the hospitals of Mazandaran province (Sari and Babol) for follow-up treatment. According to Klein (2014), the sample size of 480 people was selected purposefully. Data were collected using the Quality of Life Questionnaire (European Organisation, 2006), the Coping Strategies Questionnaire (Lazarus & Folkman, 2001), the Perceived Social Support Questionnaire (Zimet et al., 1988), and the Self-Compassion Questionnaire (Eris, 2000). Structural equation modeling (SEM) was used to analyze the data.
Results: The results of the research showed that there is a relationship between coping styles mediated by perceived social support and self-compassion with quality of life in breast cancer patients. The lower limit of the confidence interval for the two variables of self-compassion and perceived social support as a mediating variable between coping styles and quality of life is 0.4687 and its upper limit is 0.6523.
Conclusions: Based on the findings, it is recommended to pay attention to the variables of perceived social support, self-compassion, coping styles, and quality of life in breast cancer patients.
Mahsa Soltani, Elham Shojafar, Ali Asghar Ghafarizadeh, Azam Moslemi, Maryam Baazm,
Volume 28, Issue 6 (1-2026)
Abstract
Introduction: Sperm cryopreservation is a crucial method for preserving fertility in patients with asthenoteratozoospermia. However, this process can lead to a reduction in sperm parameters due to the production of free radicals and damage to the cell membrane. Various substances are added to the cryopreservation medium to prevent cellular damage. In this study, platelet-rich plasma (PRP), which contains growth factors and bioactive molecules, was used to improve sperm parameters after freezing.
Methods: Semen samples were collected from 20 men diagnosed with asthenoteratozoospermia. The samples were randomly divided into five groups: control (no PRP), PRP50, PRP100, PRP200, and PRP400. Homologous PRP was prepared and added to the respective groups. The sperm samples were cryopreserved in liquid nitrogen. Twenty days after freezing, samples were thawed and subjected to a comprehensive evaluation of viability, motility, morphology, malondialdehyde (MDA) levels, and DNA fragmentation using specific assay kits. The findings were evaluated using one-way analysis of variance followed by Tukey's post hoc test.
Results: The results of this study demonstrated that cryopreservation led to a significant decrease in all sperm parameters in the control group. The addition of PRP at concentrations of 50 and 400 among the concentrations used resulted in a significant increase in total motility, progressive and non-progressive motility, sperm viability, and a decrease in immotile sperm, DNA fragmentation, and MDA levels compared to the control group (p<0.05).
Conclusions: Cryopreservation and subsequent thawing can have detrimental effects on the biological properties of sperm samples. Therefore, the dose-dependent addition of platelet-rich plasma as a cryoprotectant may offer a promising approach to mitigate the negative impacts of freezing on samples from men with asthenoteratozoospermia.
