Showing 1391 results for Type of Study: Original Atricle
Rouhollah Hemmati Bushehri, Mahmoud Reza Jaafari, Ghasem Mosayebi, Ali Ghazavi, Ali Ganji,
Volume 27, Issue 6 (1-2025)
Abstract
Introduction: Nowadays, plant-derived compound is widely used in medical treatment as complementary therapies. Rosemary is one of these plants that have anti-angiogenic and anti-tumor effects. However, low solubility and low bioavailability lead to limited use of this compound. To overcome this limitation, the use of liposomes is beneficial. So, this study aimed to prepare liposomes containing rosemary alcoholic extract to obtain the best formulation with best properties to use in the antitumor study.
Methods: Liposomes were prepared by Thin-Film-Hydration method in different ratios of rosemary extract, hydrogenated-soybean-phosphatidylcholine (HSPC), Cholesterol, and mPEG2000 (F1-F6). The characterization of nanoliposomes includes size, PDI (Poly dispersity index), zeta potential, encapsulation efficiency, and release rate was measured.
Results: The results showed that the average particle size and zeta potential were 113.4 nm and -10.8 mV, respectively. Encapsulation efficiency showed a range of 60- 90%. The average release rate of the extract was about 60%. Also, the results showed that the F1 formulation was transparent, had appropriate properties, and did not precipitate. F2 formulation was not transparent. F3-F4 formulations were precipitated, and F5-F6 formulations did not achieve the appropriate size.
Conclusions: This study proved that F1 formulation in a ratio of 55:30:5 HSPC/chol/mPEG2000 is the best formulation for the preparation of nanoliposomes containing rosemary alcoholic extract to achieve the best properties for use in cancer studies.
Masoumeh Fathi, Masoumeh Davoodabadi , Fereshteh Farzan Azar, Efat Noroozi, Dr Azam Moslemi,
Volume 27, Issue 6 (1-2025)
Abstract
Introduction: Deep physical and psychological changes in pregnancy can affect women's sexual relations. This study aims to investigate the effect of psychological counseling on problem-solving skills on sexual dysfunction and satisfaction of pregnant women.
Methods: In a pre-test-post-test intervention study, 70 pregnant volunteers meeting the inclusion criteria, referring to health centers in Arak City, and with sexual function and sexual satisfaction questionnaire scores of less than 28 and 42, respectively, were randomly assigned to two intervention groups of 35 and a control group. The intervention group received six counseling sessions based on problem-solving, and both groups received routine care. Rosen's sexual performance questionnaire and Larson's sexual satisfaction questionnaire were answered by both groups before, immediately, and one month after the intervention. Data analysis was done using Chi-square, Fisher's exact test, and Repeated measure tests.
Results: The repeated measure design test showed that immediately and one month after the intervention, the average sexual performance (26.82 ± 1.61 and 28.88 ± 1.1) and sexual satisfaction (39.22 ± 2.27 and 15.15) (43.19 ± 2) compared to the control group (23.69±1.97, 22.63±2.08) (36.23±2.44, 35.06±2.46) compared to the control group (P < 0.05).
Conclusions: This study showed that counseling based on problem-solving improves the performance and sexual satisfaction of pregnant women effectively and can be included in educational protocols during pregnancy to improve the quality of sexual life.
Sara Derakhshan, Fateme Ganjeh, Korosh Rezaei, Elaheh Noroozi ,
Volume 27, Issue 6 (1-2025)
Abstract
Introduction: Diabetic foot ulcer is the most common cause of hospitalization in diabetic people, while one of the prominent sources of anxiety in patients is the time of discharge from the hospital. This study aimed to determine the effect of the SMART discharge protocol on the anxiety of diabetic foot ulcer patients.
Methods: In this semi-experimental study, 50 patients with diabetic foot ulcers Were divided equally into two control (25 patients) and intervention (25 patients) groups, randomly and based on the Inclusion criteria. In the intervention group, the SMART discharge protocol was implemented from their admission to the day of discharge. The Demographic information questionnaire and Spielberger questionnaire were used to determine patients' anxiety. The data were analyzed at two descriptive and inferential levels.
Results: There was no statistically significant difference in the mean score of anxiety for diabetic foot ulcer patients in the two groups before the intervention. In contrast, after the intervention, the mean anxiety score in the two groups showed a statistically significant difference (P = 0.0001).
Conclusions: According to the results of the present study, it seems that the smart discharge protocol was effective in reducing the anxiety of diabetic foot ulcer patients. Therefore, it is recommended that nursing officials and managers implement this protocol.
Zahra Zohre Vandi, Narges Babakhani, Afsaneh Taheri,
Volume 28, Issue 1 (3-2025)
Abstract
Introduction: The present study was conducted to investigate the effectiveness of acceptance and commitment-based therapy on the lifestyle of improving the health and emotional distress of women undergoing infertility treatment with the in vitro fertilization (IVF) method.
Methods: The method of this study was semi-experimental with a pre-test-post-test design with a control group and a follow-up stage. The statistical population of the study included women undergoing infertility treatment with the IVF method referring to the infertility center of Imam Khomeini Hospital in Tehran in the first six months of 2012. In this research, 27 women undergoing infertility treatment with IVF method were selected by voluntary sampling method and replaced by random method in test and control groups. The experimental group underwent acceptance and commitment therapy (10 sessions) for two and a half months. A health-promoting lifestyle questionnaire (HPLP) and an emotional distress questionnaire (Lavibond and Lavibond, 1995) were used as research tools. The data were analyzed using a mixed analysis of variance and Bonferroni post hoc test.
Results: It showed that the treatment based on acceptance and commitment to the lifestyle level improves health (Eta = 0.56, F = 19.74) and has a significant effect on the dimensions of emotional disorders such as depression (P < 0.0001, Eta = 0.58, F = 0.58). F = 34), anxiety (P > 0001; Eta = 0.59; F = 35.69), and stress (P > 0.0001; Eta = 0.61; F = 40.12) of women undergoing infertility treatment with the IVF, and has been able to lead to increase a healthy lifestyle, reduce depression, anxiety, and stress in these individuals.
Conclusions: Acceptance and commitment therapy, utilizing six psychological acceptance processes, cognitive breakdown, self under context, interaction with the present, specified values, and committed behavior, can be used as an effective treatment to reduce emotional distress in women undergoing IVF infertility treatment.
Sahar Khalvati, Tahereh Foroutan, Madjid Momeni-Moghaddam, Toktam Hajjar,
Volume 28, Issue 1 (3-2025)
Abstract
Introduction: This study aimed to investigate the effects of insulin drug therapy on the kidney structure of offspring of insulin-treated diabetic mice.
Methods: After pregnancy, female Sprague-Dawley rats were divided into control, sham, diabetics induced by streptozotocin, and diabetics receiving insulin groups. Diabetic rat offspring were sacrificed on the 10th day after natural childbirth, and the left kidneys were studied for morphometric and histological studies.
Results: The weight of children of diabetic mothers showed a significant decrease compared to children of healthy mothers (P < 0.001). The weight of the offspring of diabetic mothers receiving insulin did not show a substantial change compared to the offspring of diabetic mothers. The weight of the kidneys of the offspring of diabetic mothers showed a significant decrease compared to the control group. However, the weight of the kidneys of the offspring of diabetic mothers receiving insulin did not increase compared to those of diabetic mothers. The results of the kidney sections stained with hematoxylin-eosin and trichrome Masson showed that the offspring of diabetic mothers treated with insulin did not show a significant improvement compared to the control group.
Conclusions: Although the use of insulin is one of the momentous therapeutic ways to control blood glucose in diabetics, it cannot significantly lead to the normal health of the kidneys of the offspring of diabetic mothers under insulin treatment.
Reavan Afshar, Masoud Rahmati, Rahim Mirnasouri,
Volume 28, Issue 1 (3-2025)
Abstract
Introduction: Considering the synthesis and secretion of irisin and BDNF from muscle tissue during exercise and the possible relationship of these factors with improving muscle strength and performance, the present study aimed to investigate the effect of 12 weeks of strength training on muscle strength, body fat percentage, irisin, and BDNF in inactive middle-aged women.
Methods: In a semi-experimental study, 20 inactive middle-aged women (mean age 37.70 ± 5.91 years, weight 79.80 ± 5.82 kg) were selected and randomly assigned to two strength training groups (n = 10) and control groups (n = 10). The training group performed 12 weeks of strength training, three sessions per week at an intensity of 65 to 80% of maximum strength. Then, blood samples were taken using ELISA to measure irisin and BDNF. Independent t-test and Pearson correlation test were used to analyze the data. The significance level (P ≤ 0.05) was considered.
Results: Strength training significantly increased serum irisin concentration (P = 0.035) and serum BDNF concentration (P = 0.058) and also considerably decreased body fat percentage (P = 0.058) in middle-aged women. There was also a positive and significant relationship between lower body strength and serum irisin levels (P = 0.040). The Results from the Pearson correlation test indicate a significant positive relationship between BDNF and upper body strength (P = 0.038).
Conclusions: Based on the results of the present study, it seems that increased secretion of serum irisin and BDNF hormones is related to increased muscle strength following strength training in middle-aged individuals.
Hamidreza Zeraatkhah, Atye Babaii, Leila Ghanbari-Afra, Hanieh Ziabakhsh,
Volume 28, Issue 1 (3-2025)
Abstract
Background and Purpose: Emergency medical technicians (EMTs) are the frontline medical personnel who often face stressful and critical situations. Job hardiness can enhance their capacity to withstand challenging circumstances and both physical and mental pressures. Therefore, this study was conducted to identify the level of job hardiness among EMTs and its associated factors.
Materials and Methods: This study employed a cross-sectional descriptive design involving 216 EMTs from Qom University of Medical Sciences in 2024. A stratified random sampling method was utilized. Data were collected using a demographic and occupational information checklist and a job hardiness scale. Data analysis was conducted employing ANOVA, independent t-tests, and regression analyses. A significance level of less than 0.05 was deemed statistically significant.
Findings: The average age of participants was 32.26 ± 6.34 years, with over two-thirds having bachelor's degrees and working rotating shifts. The average score for job hardiness was 44.67 ± 5.30. Results from multivariable regression indicated that educational status and a sufficient number of personnel accounted for 42% of the variance in job hardiness among EMTs.
Conclusion: Findings reveal that EMTs exhibit moderate to high job hardiness. Furthermore, adequate staffing levels and higher educational attainment positively correlated with increased job hardiness scores.
Mohammad Ali Gharaat, Sajjad Karami,
Volume 28, Issue 1 (3-2025)
Abstract
Introduction: Different training methods increase performance capabilities in addition to metabolic changes in body organs. The present study aimed to compare the effect of endurance and strength training on anthropometric indicators, glucose changes, fat metabolism, and irisin levels of young male students.
Methods: Thirty-six obese students (age: 21.19 ± 2.43 years; weight: 88.59 ± 6.20 kg; height: 175.41 ± 12.96 cm; body mass index: 30.45; fat percentage: 25.73%) were randomly placed in one of control, endurance, and strength training groups (n= 12). The strength training group trained for 8 week/3 session/4 sets/10 repetitions/ from 50 to 70% of the one repetition maximum (incremental manner, every 2 weeks), and the endurance training group trained for 30 minutes of aerobic jogging with 60 to 80% heart rate maximum. Plasma irisin, glucose, insulin, insulin resistance, fat percentage, body mass index, weight, waist circumference, and hip circumference were measured. The data were analyzed by one-way analysis of variance and Tukey's test at 0.05.
Results: Body weight (P = 0.03), fat percentage (P = 0.04), and body mass index (P = 0.04) significantly decreased in the post-test of endurance training group. Irisin level in the post-test in the control group had a significant difference with endurance and strength training (P = 0.01 and P = 0.02, respectively). Insulin in the post-test of the control group was significantly different from the endurance and strength group (P = 0.00 and P = 0.00, respectively). The level of insulin resistance in the post-test of the endurance and strength group had a significant difference compared to the control (P = 0.00 and P = 0.00, respectively).
Conclusions: Eight weeks of aerobic treadmill training and strength training with free weights can improve body composition, increase irisin levels, and reduce insulin resistance in obese male adolescents.
Zohreh Salimi, Hamid Sarlak, Mojtaba Bayani,
Volume 28, Issue 1 (3-2025)
Abstract
Introduction: Pain of anesthesia injection in children is necessary and one of the most painful local anesthetics is palatal infiltration anesthesia. So, the purpose of this study was to compare the effect of needle gauge on pain and anxiety during palatal infiltration anesthesia injection in children 4-8 years.
Methods: This triple-blind cross-over clinical trial study was performed on 60 children 4-8 years candidates for pulpotomy and SSC treatment of both maxillary first molar teeth. Based on the sequence of using 27- and 30-gauge needles, children were treated during 2 sessions. The anxiety level of children during palatal infiltration local anesthesia was measured using pulse rate (PR) and the pain level of patients was measured using SEM and FPR (objective and subjective criteria).
Results: Anxiety during palatal anesthesia injection with gauge 27 was higher than gauge 30 (treatment effect < 0.001). In subjective and objective criteria, the injection pain in the palatal mucosa with a 27-gauge needle was higher than 30-gauge needle (treatment effect < 0.001). There was no significant difference between earlier and later injection of palatal infiltration with different gauges during treatment sessions (P < 0.05) and according to 0.021 for the period effect, it can be said that the period of receiving two needle gauges had an effect on the average heart rate difference.
Conclusions: The pain of injection in the palatal mucosa with a 27-gauge needle is higher than with a 30-gauge needle, and the use of a 30-gauge needle in the palatal injection of children 4-8 years causes less discomfort than a 27-gauge needle.
Ebrahim Mohammadi, Laya Hooshmand, Arash Masumi,
Volume 28, Issue 1 (3-2025)
Abstract
Introduction: Novel antidiabetic medications are employed to manage glycemic control and mitigate the long-term complications of type 2 diabetes. This study aimed to investigate the prevalence of adverse events, including hypoglycemia, associated with these novel antidiabetic agents in a cohort of patients with type 2 diabetes.
Methods: This cross-sectional analytical study was conducted on 157 patients with type 2 diabetes mellitus attending the Endocrinology Clinic at Imam Khomeini Hospital, Urmia, during the summer of 2024. A convenience sampling method was employed to recruit participants. Data on demographics, the incidence of hypoglycemia, and reported adverse drug reactions were collected from all eligible patients through a structured interview. Subsequently, patients were stratified into three treatment groups based on the specific novel antidiabetic medication they received.
Results: In patients receiving sitagliptin, the most prevalent adverse events included arthralgia and rheumatic problems (26.31%), dermatological manifestations (36.84%), and allergic reactions (21.06%). Nausea (52.94%) and abdominal pain (17.65%) were the most frequent adverse events observed in patients treated with liraglutide. Polydipsia (28.72%), weakness and lethargy (26.6%), and dry mucous membranes (27.66%) were commonly reported in patients receiving empagliflozin. Hypoglycemia was observed predominantly in male patients aged 51-55 years receiving sitagliptin.
Conclusions: The findings of this study demonstrate a low incidence of hypoglycemia among patients treated with modern antidiabetic medications. Prevalent short-term adverse events observed included gastrointestinal disturbances, allergic reactions, and dermatological manifestations.
Fateme Tahsinin, Ali Heidarianpour, Elnaz Shokri,
Volume 28, Issue 1 (3-2025)
Abstract
Introduction: Being overweight is associated with increased cortisol secretion, along with heightened anxiety and depression. This study aimed to compare the effect of six weeks of concurrent moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) with HIIT training alone on body composition, plasma cortisol levels, and anxiety and depression levels in overweight male students.
Methods: In this semi-experimental research, 27 overweight students were selected and randomly divided into three groups 9: MICT+HIIT concurrent training, HIIT training, and a control group. The MICT )15 minutes of exercise per day at 60-65% of maximum heart rate with an additional 5 minutes every two weeks). The HIIT (3 minutes of running at 70-75% of maximum heart rate, followed by 3 minutes of active rest at 50% of maximum heart rate, with three repetitions in the first two weeks, four repetitions in the second two weeks, and five repetitions in the final two weeks).
Results: Both types of training protocols resulted in reductions in weight, body mass index, cholesterol, low-density lipoprotein, cortisol levels, anxiety, depression, and an increase in high-density lipoprotein (P < 0.05). There was no significant difference between the two types of exercise in terms of effectiveness on these variables; however, only peak oxygen consumption and triglycerides were associated with better changes in the MICT+HIIT group.
Conclusions: For overweight male adolescents aiming for weight loss and improved mental health, HIIT alone is sufficient, and adding MICT does not provide additional clinical benefits.
Parto Hekmatpou, Parnian Hekmatpou, Farideh Jalali Mashayekhi, Sahar Bayat, Milad Gholami,
Volume 28, Issue 1 (3-2025)
Abstract
Introduction: Oculocutaneous Albinism is a hereditary disease with an autosomal recessive pattern. The incidence of this disease is about 1 in every 17 thousand births. Most of the affected people in Iran are the result of consanguineous marriages. White hair, fair skin, and reduction of iris pigments are the main manifestations of this disease. Also, exposure to sunlight increases the susceptibility of these patients to skin cancer. This study aimed to investigate the genetic cause of a person with Oculocutaneous Albinism by whole exome sequencing.
Methods: A 6cc peripheral blood sample was obtained from a child with oculocutaneous Albinism with an autosomal recessive inheritance pattern. DNA extraction and whole exome sequencing were performed. After analyzing the exome sequencing data, the pathogenic mutation was identified. Then, the Sanger sequencing method was used to confirm and segregate.
Results: The affected case showed homozygous pathogenic mutation (NM_000372.5): c.286dupA p.(Met96AsnfsTer73) in exon 1 of the TYR gene. Oculocutaneous albinism IA was determined according to the mutated gene. Also, the parents of the affected person were heterozygous for the mutation.
Conclusions: The mutation causing oculocutaneous albinism was identified in the affected person using the high-efficiency whole exome sequencing method and then confirming the mutation through Sanger sequencing. Considering the parents' consanguineous marriage of the parents, this finding can be used for preventive measures in the future.
Zahra Juodi, Zahra Fakur, Ali Aagayar Makouii, Rasool Gareaghaji Asl,
Volume 28, Issue 1 (3-2025)
Abstract
Introduction: One of the most common problems in newborns is apnea of prematurity. Given the importance of preventing apnea in very premature infants, the present study was designed and conducted to investigate the preventive effect of caffeine on reducing the frequency of apnea events in very premature infants.
Methods: This randomized, double-blind, controlled clinical trial was conducted on premature infants hospitalized in the neonatal intensive care unit of Shahid Motahari Hospital in Urmia. Infants were randomly divided into two intervention and control groups. The intervention group received intravenous caffeine at an initial dose of 20 mg/kg and a maintenance dose of 5 mg/kg for 14 days. In contrast, the control group received an equal volume of normal saline intravenously for the same period. Apnea events, cyanosis attacks, and bradycardia were recorded by the researchers in a standard checklist.
Results: Of the 50 infants in each group, 2% of the caffeine and 4% of the control group required prolonged oxygen therapy, respectively. Also, 6% of the caffeine group and 4% of the control group experienced intraventricular hemorrhage. In addition, 4% of the caffeine group and 2% of the control group required surgery to close the patent ductus arteriosus, and 14% of the caffeine group and 18% of the control group experienced apneic events. However, there was no statistically significant difference between the two groups regarding the incidence of apneic events (P = 0.58). Ultimately, 20% of the caffeine group and 14% of the control group died.
Conclusions: Although the findings of the present study were not statistically significant, they indicate a decrease in the frequency of apnea events in the group of premature infants receiving caffeine compared to the control group.
Hadis Tahmasbi Arashloopour, Daryoush Khajavi, Fardin Faraji,
Volume 28, Issue 2 (4-2025)
Abstract
Introduction: Multiple sclerosis (MS) is the most common neurological disorder in young adults and balance problems due to MS may result in disturbances in upright posture, limitations in walking and turning, and ultimately falls in patients. The aim of this study was to investigate the effects of a combined physical exercises and cognitive-behavioral stress management intervention program on static, dynamic balance and balance confidence in PwMS.
Methods: The statistical population included MS patients (aged 20–60 years with Expanded Disability Status Scale [EDSS] scores of 2–4) referred to the Arak MS Association. Thirty participants were selected via convenience sampling and randomly assigned to experimental and control groups. Participants underwent pretests using the Timed Up and Go (TUG) test, single-leg stance test, and the Activities-Specific Balance Confidence (ABC) Scale. Then, they participated in the combined motor and cognitive intervention program, and finally performed a post – test. Data were analyzed by Independent and Paired Student T-tests.
Results: According to the results, the mean score of the experimental group in the TUG test (P ≤ 0.002), and standing on one-foot tests increased significantly in the post-test (P ≤ 0.001). There were no significant differences in mean ABC scores between the experimental and control groups on the post-test (P ≤ 0.153).
Conclusions: The findings suggest that a combined motor and cognitive intervention program can effectively improve agility, dynamic and static balance in people with MS. Improving balance confidence may require a longer duration of training due to its subjective nature.
Shahnaz Shahrjerdi, Zahra Geramipour,
Volume 28, Issue 2 (4-2025)
Abstract
Introduction: Hallux valgus is a common foot deformity causing lateral deviation of the first toe and progressive subluxation of the first metatarsophalangeal joint. The purpose of this study was to investigate the effect of kinesiotype and ankle strengthening exercises with a bosu ball on pain, balance and big toe angle in women with hallux valgus.
Methods: This clinical trial study used a pre-test and post-test design. First, forty-five women with hallux valgus and flat feet were selected via convenience sampling and randomly assigned to three groups: a kinesiotape group (four weeks, three sessions/week, 24-hour tape application per session), a kinesiotape with Bosu ball ankle strengthening exercises (four weeks, three sessions/week, 30 minutes of exercises and 24-hour tape application per session), and a control group (no intervention). Pain, balance, and hallux valgus angle were measured using the Visual Analogue Scale (VAS), stork test, and goniometer, respectively. Data were analyzed using one-way ANOVA at a significance level (P ≥ 0.05).
Results: After performing the exercises, comparing the data between the two groups before and after 4 weeks revealed a significant difference in pain, balance, and hallux valgus angle in the two groups of kinesiotape and kinesiotape along with the strengthening exercises of Boussou bathop compared to The control group showed (P = 0.001).
Conclusions: A combined program of kinesiotape and Bosu ball ankle strengthening exercises may improve pain, balance, and hallux valgus alignment in women.
Mehdi Mikelani Akhoreh Ouliaei, Farnaz Farhad, Hamid Sarlak,
Volume 28, Issue 2 (4-2025)
Abstract
Introduction: Considering parents' preferences and opinions is an important factor in dentists' choice of treatment techniques. Despite the relatively low attitude of parents towards the use of the "parental presence/absence" technique, dentists still use this technique during pediatric dental treatment. The present study was conducted with the aim of simultaneously investigating the dentists' attitudes regarding the "presence/absence of parents" technique during the treatment of 4-10-year-old children and determining the factors affecting this attitude.
Methods: In this cross-sectional study, the attitudes of 83 dentists regarding the "presence/absence of parents" technique were evaluated using an investigator-designed questionnaire. The questionnaire scored dentists' attitudes regarding the above technique and evaluated the background factors affecting the child's attitude. Data were analyzed with a significance level of 0.05.
Results: The mean attitude score of the participants was 60.61±12.99. Also, 55.4% of participants considered this technique "unsuccessful". The factors "type of treatment", "child's age", "child's behavior", "parental behavior" and "implementation of the presence/absence technique", significantly affected the participants' attitudes.
Conclusions: Dentists do not hold a highly positive attitude toward the "presence/absence of parents" technique. According to dentists working in pediatric dentistry, this technique has low success in guiding children’s behavior.
Afsaneh Talaei, Fatemeh Rafiei, Glonaz Motamedi, Ali Chehrei,
Volume 28, Issue 2 (4-2025)
Abstract
Introduction: Thyroid nodules are highly prevalent. The role of insulin resistance in thyroid nodule formation has recently gained attention. While several studies have explored the relationship between metformin and insulin resistance, limited research has assessed the effect of metformin therapy on thyroid nodule volume and number. This study investigated the effect of metformin on the size and number of thyroid nodules.
Methods: A total of 240 euthyroid women with thyroid nodules were divided into four groups. Group 1 received levothyroxine 100 μg/day, Group 2 received metformin 500 mg twice daily, Group 3 received a combination of both drugs for three months, and Group 4 served as the control group with no treatment. Thyroid ultrasound was performed at baseline and after three months. Statistical analyses included the Kruskall–Wallis, Wilcoxon, and Chi-square tests, examined the differences of the size of thyroid nodules and the mean of thyroid hormones levels between groups, for Each group included 60 people and to compare the percentage of differences between the groups, respectively. Also P value less than 0.05 was considered meaningful.
Results: Results showed no statistically significant differences in thyroid hormone levels after treatment among the three groups except the levothyroxine group. Additionally, only the levothyroxine group showed a significant post-treatment decrease in TSH and increase in T4. Thyroid nodule size significantly decreased in the levothyroxine group and the levothyroxine-metformin combination group compared to the metformin-alone and control groups.
Conclusions: This study indicates that metformin does not reduce the size of thyroid nodules, contradicting studies suggesting its potential antineoplastic effects on the thyroid. However, the study duration may be insufficient for definitive conclusions, necessitating further high-quality studies with larger sample sizes and longer follow-up periods.
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.
Mostafa Mirzaei, Mohammadreza Amiri Nikpour, Rezvan Noruzzadeh,
Volume 28, Issue 2 (4-2025)
Abstract
Introduction: Imaging of the vascular system supplying the brain parenchyma is a diagnostic tool in the evaluation of stroke patients. This study aimed to compare the results of digital subtraction angiography with color Doppler ultrasound of the carotid arteries in patients with ischemic stroke.
Methods: In this cross-sectional-analytical study, the medical records of patients with ischemic stroke admitted to Imam Khomeini Hospital from July 1401 to July 1402 were reviewed to collect data. Demographic information, along with the results of color Doppler ultrasound and digital subtraction angiography of the patients, were extracted and evaluated.
Results: This study included 48 patients with ischemic stroke with a mean age of 12.8 ± 0.67 years. Hypertension was present in 68.8%, diabetes mellitus in 20.8%, and smoking in 25% of patients. Based on the results of digital subtraction angiography and color Doppler ultrasound, the most common vascular abnormality was plaque (79.2%). Vascular stenosis and occlusion were present in 91.7% of patients. Color Doppler ultrasound in examining the right and left internal carotid arteries had a sensitivity of 94.9% and 92.8%, specificity of 66.7% and 38.9%, positive predictive value of 92.1% and 70.3%, and negative predictive value of 75% and 77.8%.
Conclusions: Color Doppler vascular ultrasound demonstrated high sensitivity and specificity in detecting the presence and severity of stenosis in internal carotid arteries of ischemic stroke patients, supporting its use as a non-invasive and cost-effective method in clinical practice.
Ali Jalalvand,
Volume 28, Issue 2 (4-2025)
Abstract
Introduction: This study aimed to investigate the effect of the backward gait training protocol on postural sway and balance in elderly men with a history of falls.
Methods: A total of 28 healthy elderly individuals with a history of falls participated in this research. The backward gait protocol was considered the independent variable, and the mean parameters of postural sway, including range, center of pressure displacement, center of pressure velocity, and center of pressure acceleration, were examined as dependent variables. A Kistler force platform was used to assess postural sway. A mixed-design repeated measures ANOVA was performed at a significance level of 0.05.
Results: No significant differences were found in the anterior-posterior amplitude and medio-lateral acceleration of the center of pressure between healthy elderly individuals and those with a history of falls (P > 0.05). However, individuals with a history of falls exhibited greater medio-lateral amplitude, anterior-posterior displacement, anterior-posterior velocity, and anterior-posterior acceleration of the center of pressure (P = 0.001). Conversely, they demonstrated lower medio-lateral displacement (P = 0.001) and medio-lateral velocity of the center of pressure (P = 0.005).
Conclusions: Changes in center of pressure parameters may predict fall risk in the older adults. These parameters have varying sensitivities for detecting subtle differences in postural control. The responses of various parameters are influenced by compensatory mechanisms, weaknesses, and balance disorders. The backward gait protocol serves as a targeted intervention to improve balance and stability in elderly individuals at risk of falls.
