Research Articles


Designing and elucidation of a social entrepreneurship model in the field of health

Alireza Mooghali, Bahador Kazemi

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e1

The aim of this study was to design and explain a social entrepreneurship model in the field of health. In the present descriptive-correlational study, the statistical population of the qualitative section of the health and health sector experts consisted of all the employees of the health area. The qualitative sampling was purposeful judgments. The sampling of a small, simple random sample with Morgan's table consisted of 290 health workers. In order to collect data, Delphi method was used in qualitative section and a questionnaire was used in the quantitative section. Descriptive statistics (means, standard deviations, frequencies and percentages) and inferential methods (Pearson’s correlation coefficient and factor analysis) were used to analyse data. SPSS 16.0 and Amos 8.5 software programs were used. The results of this research indicated that different aspects of financing, promoting entrepreneurship level awareness and identifying entrepreneurship opportunities have a positive and significant effect on social entrepreneurship in the field of health. In conclusion, by enhancing and appropriate financing arrangements, one can promote the level of entrepreneurial consciousness and identify entrepreneurial opportunities that are in fact the gate to enter entrepreneurship

Determination of anterior femoral bowing to length ratio in Iranian population

Abdol Rashid Amanjani, Reza Zandi, Saeed Saber Samandari

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e2

Due to the existence of different races and ethnicities and their different life styles, anatomical structure of people vary from one region of the world to another. The goal of this study is to determine the anterior femoral bowing to length ratio, which can be useful for planning major medical and therapeutic projects as well as designing medical equipment (including nails, orthoses and prosthetics). Lateral X-rays of femur bones of 250 patients who referred to Taleghani hospital in recent years (2011-2016) were retrieved from hospital archives and studied. 150 patients were females and 100 were males, ages ranging from 16 to 57 years old. All patients were Iranians with different ethnical backgrounds that referred to radiology centers of Tehran and Taleghani hospital and their records were saved in these centers archive. Based on femoral length, X-rays were categorized into eight groups; 300mm, 320mm, 340mm, 360mm, 380mm, 400mm, 420mm and 440mm, which are standards for manufacturing femoral nails in Iran as well as imported nails to Iran. Results showed significant difference compared to available femoral nails on the Iranian market, which indicates that these nails are not standard for Iranian population. Data analysis was based on anterior femoral bowing to length ratio alone. Gender and age were not considered for data analysis in this study and results were conclusive for all ages and genders.

Study of the quality of teaching environment and learning of cardiology residents of Shahid Beheshti University of Medical Sciences based on DREEM questionnaire

Azamx Noori Frothagh, Akhtar amali, Nadergholi Gourchian

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e3

Background: Educational environments are an integral part of the development of educational programs. Therefore, to improve the quality of clinical education environment, its status should always be evaluated. The purpose of this study was to assess the quality of teaching environment and learning the aids of cardiology residents of Shahid Beheshti University of Medical Sciences.


Materials and Methods: The study was a descriptive study, which evaluates the quality of the learning environment - the teaching of cardiology residents in a full-scale way. 33 people were included in the study. The questionnaire consisted of two sections of demographic information and 50 questions in five areas of learning, professors, student perception of their academic ability, educational atmosphere, student perception of their social conditions. Face validity was determined by medical education specialists and its reliability was 0.83 in Cronbach's alpha. Data was entered into SPSS-25 software and analyzed by descriptive methods and Independent t-test.


Result: The average scores earned in five areas were 4.99 out of a total of 200 points, which was relatively favorable with a tendency towards positive. In comparison with the educational groups, there was a significant difference in the attitude toward the teacher (p<0.01) and the individual's attitude toward their academic ability (p<0.01) between the second and third year residents. This was relatively favorable with a tendency towards positive. In comparison with the educational groups, there was a significant difference in the attitude toward the teacher (p <0.01) and the individual's attitude toward their academic ability (p <0.01) between the second and third year residents.


Conclusion: Although the quality of teaching and learning environment of the cardiology residents of Shahid Beheshti University of Medical Sciences tends to be positive and relatively favorable, but there is room for change. Therefore, the attention of the professors to create an appropriate educational environment should be emphasized on qualitative criteria in assessing the professional capabilities of the students

Evaluation of self-esteem in children with attention-deficit/hyperactivity disorder based on event-related potential

Mahdiyeh Sarraf-Razavi, Mahdiyeh Rahmanian, Maryam Zamani, Parivash Purabassi, Sara Ramezani, Hadis Ghaffari Khaligh

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e4

Background: Self-esteem, the value we place on ourselves, has been associated with effects on health, and life satisfaction. Many studies reported that children with attention-deficit/hyperactivity disorder (ADHD) suffer from low self-esteem has been associated with negative life outcomes. The present study investigated neural correlation of self-esteem in this group compared with typically developing children using the event-related potentials (ERP).


Materials and Methods: A total number of 10 children with ADHD were compared with 10 typically developing children matched with their age, gender and IQs. We employed the event-related potential (ERP) technique to explore neural manifestations of implicit self-esteem using the Go/Nogo association task (GNAT). Participants generated a response (Go) or withheld a response (Nogo) to self-words and good or bad attributed.


Result: ERP results showed delayed N200 response in frontal areas in bad condition in normal children compared to ADHD children (p <0.05), indicating positive self-esteem.


Conclusion: The present study provides neural evidence for probably low self-esteem in ADHD children.

Prevalence rate of cytomegalovirus infection in individuals with and without systemic lupus erythematosus

Fatemeh Ferdowsi , Anousheh Haghigh, Mitra Barati, Fatemeh Shirani, Hossein Keyvani, Mehri Naghdalipour, Nahid Kianmehr

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e5

Background: The role of cytomegalovirus (CMV) infection in triggering or exacerbating systemic lupus erythematosus (SLE) remains a subject of debate. The aim of this study was to compare the prevalence rate of CMV infection between individuals with and without SLE.


Materials and Methods: This cross-sectional comparative study recruited 52 consecutive patients with SLE (based on the criteria determined by the Systemic Lupus Collaborating Clinics, 2012) and 52 healthy subjects. The exclusion criteria were immunodeficiency and other background diseases. CMV infection was assessed according to serology (enzyme-linked immunosorbent assay) and polymerase chain reaction (PCR).


Results: Immunoglobulin G (IgG) was positive in all participants. Immunoglobulin M (IgM) was positive in eight SLE patients (15.4%) and none of the controls (p = 0.003). The PCR was positive in four SLE patients (7.7%) and none of the controls (p = 0.041). IgM level was not related to age, gender, literacy, marital status, family history, SLE disease activity index (SLEDAI), or duration of the disease (p > 0.05).


Conclusion: According to this study, CMV infection was higher in SLE patients but was not related to the type of organ involvement, type of immunosuppressive drug, or SLEDAI.


 

Investigating the relationship between personality disorders and criminal thinking styles in prisoners convicted of violent crimes

Mohammad Hossein Shabahrami, Farideh Dokaneh-I Fard

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e6

Psychologists believe that there is a relationship between personality and criminal behavior. The aim of this study was to investigate the relationship between personality disorders and criminal thinking styles in prisoners convicted of violent crimes. To what extent is there a link between the types of personality disorder, the type of criminal thinking style, and the type of crime in prisoners convicted of violent crime? Is there a relationship between personality disorders in prisoners convicted of violent crimes and their gender? To what extent is there a relationship between the type of personality disorder of prisoners and the frequency of committing violent crimes? These are the factors that led to the research. The research method is a descriptive-correlational study, in which a sample of 996 offenders were selected in terms of demographic characteristics. Data were collected using a questionnaire in two sections: demographic information and Christian Texas Intellectual Thinking Questionnaires and Millon Personality Disorder.


The results show that there is a relationship between the type of personality disorder and the type of crime in prisoners sentenced to violent crimes. Different styles of criminal thinking lead to certain forms of violent crime. It was observed that based on tables and inferential tests, different criminal thinking styles are related to the prevalence of different types of crime. It has been clearly observed that some disorders are more common among women offenders and others are more common among men. However, there are some disorders that are similar in men and women. Different styles of criminal thinking relate differently to the number of crimes, the history of the crime, and the history of the same crime, and this shows that different styles of criminal thinking can create different patterns in the commission of a crime.

Comparative study of influence of two sperm preparation, swim up and density gradiant-swim up, on the outcomes of intrauterine insemination (IUI) in different types of semen samples infertile men referred to infertility research and treatment center, ACEC

Elnaz lak, Elena Lak, Mahmod Hashemitabar, Mahsa Afrogh, Kamran Nasirzadeh, Fatemeh Shamolaghamsari

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e7

Infertility is one of the developing problems in most countries and it has a lot of problems, which can be emotional, social and political. Intrauterine insemination (IUI) is the first line Assisted Reproduction Treatment (ART) modality for infertile couples because this method is inexpensive and non-invasive, which is effective for the treatment of couples with unexplained infertility or patient with normal or mild male factor. Two methods, mainly considered as laboratory techniques for improving the quality of sperm, includes Swim-Up (SU) and Density Gradient Centrifugation (DGC). The SU is a common technique in IVF labs, and is mainly performed in a sample of semen having normal sperm concentration. In this technique, sperms are selected based on their motility and their capacity to leave the semen plasma. In the DGC method, sperms are selected based on the density, motile sperm are separated from dead sperms, leukocytes and other high-density semen plasmatic compounds. The aim of this method is thus to select sperms with high motility and morphology rates. Therefore,  the aim of the present study is to compare  the effect of these two methods on the outcome in intrauterine insemination  in different groups, including normal samples (< 60 million (type1)) and 20-60 million/ml (type2), oligospermia (type3) and  asthenospermia (type4), in patients referred to the Infertility Center. The present experimental study was performed on 545 couples  who referred to the Infertility Research and Treatment Center, in 2016 for infertile reasons and were in a good status in terms of general health. Processing of sperm was done by two common methods, swim-up and Density Gradient Centrifugation according WHO. Our study showed the effectiveness of the Density gradient-Swim up technique compared to Swim-up as a sperm preparation method with a favourable IUI success.


 

The effectiveness of cognitive behavioral group therapy on anxiety-depressive symptoms and emotion regulation in child laborers

Leila Salek Ebrahimi , Imaneh Abasi, Sogand Ghasemzadeh, Abolfazl Mohammadi, Mohsen Saberi Isfeedvajani, Abbas Masjedi Arani

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e8

Objectives:   This study was aimed to determine the effectiveness of Cognitive Behavioral Group Therapy on anxiety-depressive symptoms and emotion regulation in child laborers. Materials & Methods:  This study was a randomized clinical trial conducted on child laborers.
The obtained data were collected from 15 participants in the experimental and 15 in
the control group. The members of control group didn’t receive any intervention. The participants in experimental group received the cognitive-behavioral group therapy based on "coping cat" program. The treatment consisted of 18 weeks of 90-min sessions meeting once a week. Participants of two groups completed the Revised Child Anxiety and Depression Scale (R-CADS) and Cognitive Emotion Regulation Questionnaire-child version (CERQ-K) before and after intervention and three months later. Results: Repeated measurement of ANOVA indicated that the CBT significantly decreased depressive-anxiety symptoms and negative emotion regulation strategies as well as increased positive emotion regulation strategies. Furthermore, results yielded moderate to large effect sizes for improvement of dependent variables. Conclusion: This study showed significant differences in anxiety-depressive symptoms and emotion regulation between two groups. Therefore, CBT seems to be an effective intervention in child laborers. However when applying this intervention, the special cultural, social, educational and economic conditions of these children must be considered.


 

Cholecystectomy: Long term effect on serum lipid profile and Vitamin D

Mohammad Fathi , Mohsen Soori , Fariborz Rashnoo , Esmaeil Hajinasrollah

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e9

Background: The association between cholecystectomy and abnormal lipids and later increase in the risk of diseases related to dyslipidemia showed controversial results. This study aims to evaluate the association of lipid profile and Vitamin D level before and after cholecystectomy.


Materials and Methods: Ninety-eight patients with symptomatic gallstones were studied prospectively. Plasma concentration of cholesterol, triglycerides, LDL, HDL and vitamin D was analyzed preoperatively and postoperatively after six months of cholecystectomy. None of the patients received any lipid-lowering drug or dietary restriction.


Results: Sixty-seven (68.4%) female and 31 (31.6%) male patients were studied for six months. There was a significant increase in total serum cholesterol besides a significant decrease in vitamin D and HDL serum level after six months. Also, there was a non-significant increase in the serum level of LDL and triglyceride. In stone based sub analysis the same results achieved.


Conclusion: There was a significant decrease in plasma concentration of vitamin D and HDL and the significant increase in cholesterol , triglyceride, and LDL in cholecystectomy patients postoperatively. These changes in plasma lipids and Vitamin D are likely to have a significant effect on the development of different disease related to dyslipidemia such as coronary artery disease and low bone density after cholecystectomy in the long term.


 

Study on the rate of using, awareness and satisfaction of scientific database by Mazandaran University of Medical Science student’s and related factors to it

Afshin Mousavi Chalak, Aref Riahi

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e10

Introduction: Scientific databases are one of the most important information resources in academic community and can play determinative role in different aims and goals of student. This study aimed to determine the rate of using, awareness and satisfaction of scientific database among student of Mazandaran University of Medical Sciences.


Materials and Methods: This study is an applied-survey study and has been done during the 2016-2017 educational period. Self-questionnaire that made according to review of internal and external resources about the subject (in 6-sections), and its reliability and validity being approved, distributed among 238 Students of Mazandaran University of Medical Sciences (Master, PhD, Doctors and Medical residents). To analysis data, we use descriptive statistics, statistical test and SPSS 16.


Results: Findings show that most of student use scientific database because of clinical activities (average of 4.27). Also we funded that most knowledge level of those students about database were ISI (average of 4.43) and they used Pubmed more than other database (4.30). Also the highest satisfaction rate of database was ISI (4.28) and “unfamiliarity with the English language "funded as the most barriers related to use of scientific database.


Conclusion: Rate of using, awareness and satisfaction of scientific database among student of Mazandaran University of Medical Sciences was more than average and close to high level. Mazandaran Medical Science University by planning and tacking suitable policy and also destroy of barriers and challenges can provided better conditions of student's using scientific database and created cause of growth of their scientific and professional developments.
 

The effectiveness of acceptance and commitment therapy (ACT) on quality of life of women with chronic low back pain

Seyedeh Maryam Mousavi, Adis Kraskian Mujembari, Peyman Hassani Abharian, Sara Pashang

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e11

Introduction: Acceptance and commitment therapy [ACT] can enhance psychological flexibility and
subsequently improve mental health and quality of life of individuals. Also, recovery of patients with
chronic low back pain (LBP) depends on several physical and psychological factors. Therefore, the
authors aimed to examine the effectiveness of acceptance and commitment therapy (ACT) on quality
of life of women with chronic low back pain.
Materials and Methods: It was a semi-experimental research in pre-test and post-test design together
with control group. Participants were 14 women with chronic low back pain attending clinical centers
and hospitals of Rasht who were selected by convenience sampling. Next, they were randomly
assigned to experimental (ACT+ usual medical care) and the control group (usual medical care only).
Then, experimental group received ACT for 8 one-hour sessions. To analyze the data, covariance
analysis was used. The instrument was self-reported by the World Health Organization's quality of
life. Data analysis was performed using analysis of independent t-test.
Results: Results indicated reduction effect in pain severity in the patients who practiced 8 sessions
ACT reported significantly lower pain than patients who only received usual medical care. Also, the
results shows that except of subscale of physical health (p < 0.38) there was significant increase in all
other subscales of quality of life in experimental group (p < 0.001).
Conclusion: The results show that acceptance and commitment therapy reduces pain severity and
improves the quality of life and recommends use of coping strategic with pain in patients with chronic
low back pain (CLBP). Counselling of treatment counsellors and family therapists recommended a
counselling centers and family education classes in order to improve quality of life of female patients
with CLBP.

Evaluation of Active aging condition in the elderly in Tehran and its relative factors

Bahareh kashanimovahhed, Alireza Bahrami, Mohammad Bodaghabadi, Masoumeh Shokri

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e12

Scientific and international assemblies now consider active aging as an important concept in an aging positive approach. The goal of this study is to evaluate active aging condition in the elderly in Tehran and its relative factors. This study is a cross-sectional descriptive research, which is performed in June and July 2018. The sample includes 131 old adults (people with the age of 60 or more than 60) living in Shemiranat area of Tehran. These people are selected via two-stage cluster sampling. Data- gathering tool includes “active aging” questionnaire, “life satisfaction in elderly” questionnaire  and demographic data of old adults. Data analysis is performed by SPSS software and also using descriptive statistics, t-test and Pearson correlation. In this study, data suggest that only 9.2 % of case study were at the higher level of aging. According to six index of active aging, most respondent status were weak in “active mind maintenance” and “social-institutional participation” and were average in  “agent attitude”, “physical-functional activity”, “social contacts” and “productive engagement”.  There were reverse and meaningful relation between age and number of children variables and active aging (    and there were positive and meaningful relation between education, occupation and income level variables ( . However, there were no meaningful relation between sex and marital status . The results of this study also suggest that there is positive and meaningful relation between “life satisfaction of elderly” and “active aging” ( . According to low level of active aging in old adult of Tehran, this issue needs to be addressed by the authorities. Therefore, it is necessary to consider and modify the needed solutions to improve the level of active aging and special services for this group in the future planning of the country. On the other hand, considering the concept of active aging has recently been raised in the scientific community, researchers need to plan and implement more extensive studied in this area.


 

The relationship between attachment styles and autistic traits: considering the mediating role of empathy

Samira Ameli, Saber Ghaderi, Maryam Aslezaker, Mohammad Hassan DavazdahEmami, Hossein Dadashzadeh

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e13

Introduction: This purpose of this study is to investigate the relationship between autistic traits and attachment styles, and also the mediating role of empathy.


Materials and Methods: 254 students of Tehran’s universities were chosen by using cluster-sampling method. After that, the demographic questionnaire, Close Relationship-Revised Questionnaire (ECR-R), Autism Spectrum Quotient–Short (AQ-S), and The Empathy Quotient-Short (EQ-S) forms were distributed amongst them in order to be filled.


Results: Pearson product-moment correlation coefficient indicated that there is a significant relationship between the components of autistic traits with empathy, and avoidance and anxiety attachment. Also, there was a significant relationship between empathy and avoidance and anxiety attachment. Chi-square, SRMR, and other indexes indicate that empathy mediates the relationship between the autistic traits with the anxiety and avoidance attachment styles.


Conclusion: According to the results, it can be concluded in the way that individuals with high autistic traits have lower empathy. Individuals, who report more anxiety and avoidance attachment, are less likely to have empathy in their relationships. As a final point, the high autistic traits are correlated with anxiety and avoidance attachment through their association with low empathy.


 

Predicting emotional divorce based on metacognitive beliefs and psychological flexibility

Younes Parvaz, Maryam Bakhtiari, Abbas Masjedi Arani, Maryam Asle Zaker

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e14

Introduction: This study aimed to predict emotional divorce based on metacognitive beliefs and psychological flexibility.


Materials and Methods: The type of study was cross-sectional. The target population was the total married individuals in Tehran. Using cluster random sampling 467 married people (282 women, 185 man) were chosen to complete the Gottman emotional divorce scale, Meta Cognition Questionnaire (MCQ-30), acceptance and commitment inventory and demographic information sheet.


Results: findings showed that metacognitive beliefs and psychological flexibility had a significant relationship (p <0.01) with emotional divorce. These variables accounted for 24% of variance in emotional divorce. Negative metacognitions had a positive significant relationship with emotional divorce. In other words, by incremental level of negative metacognitions the rate of emotional divorce will increase. Also, positive metacognitions and psychological flexibility had a negative significant relationship with emotional divorce. Results showed that by increasing in level of psychological flexibility and applying Positive metacognitions instead of negative metacognitions the rate of emotional divorce will diminish.


Conclusion: The current study support empirical evidence that a significant relationship does exist between aforementioned constructs. Given the implications of this research, by modifying of metacognitive beliefs and increasing psychological flexibility, the marital relationship can be improved. Thereby diminishing emotional divorce in couples.


 


 

The effect of educational workshop on educational and informational skills of nurses in hospitals of Zahedan University of Medical Sciences, 2014

Nahid Shahabi, Fatemeh Rakhshani

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e15

Background & Aims: Providing qualified care service with proper education and information for clients is promising.  Nurses are the primary providers of most health cares in the health system and they have a considerable power to affect the quality of health care. The purpose of this study is to assess the effect of educational workshop on educational and informational skills of nurses working in hospitals in Zahedan University of Medical Sciences.


Materials & Methods: This research was conducted as semi-empirical with control group in April-May 2014. Samples included 181 nurses working in hospitals in Zahedan University of Medical Sciences. They were selected by random sampling from the list of nursing staffs in nursing office of aliIbn Abi Talib (98) and Khatam (83) hospitals. Questionnaire was developed based on expected skills for patient education. To determine the validity of the questionnaire, it was given to 8 experts and CVR and CVI were obtained as 0.93 and 0.89 and for reliability the Cronbach's alpha was 0.86. After the data collection phase, a workshop was held and after waiting two months, data was recollected.


Results: The intervention increased scores of nurses, Informational skills 8% and educational skills 24%.


Conclusion: Educational and informational skills, which are important factors in improving the quality of services delivery, can increase through effective educational interventions.


 

Comparison of rumination between men and women with obsessive- compulsive disorder and social anxiety disorder: a cross-sectional study

Leila Salek Ebrahimi, Seyedeh Mousavi, Soheila Belal Habashi, Jafar Hasani

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e16

Introduction: Ruminations are one of the influencing factors in the development and continuation of obsessive-compulsive disorder and social phobias. Therefore, this study aimed to compare the rumination between man and women with obsessive-compulsive disorder and social anxiety.


Materials & Methods: The research design was cross-sectional. The research participants included 30 patients with social anxiety disorder and 30 patients with obsessive-compulsive disorder who were aged between 15 and 50 years from Zanjan city in 2017. Samples were selected on the basis of psychiatrist diagnosis and structured diagnostic interviews (SCID-I) and (SCID-II), and the inclusion and exclusion criteria. The rumination response style questionnaire (RRS) was used to measure the variables.


Results: The results of MANOVA showed that women with OCD have more rumination and distraction than men with this disorder (p≤0.05). However, there was no significant difference between two groups regarding the component of contemplation. There was no significant difference between men and women in social anxiety disorder in terms of rumination and its related components.


Conclusion: According to research findings, rumination plays an important role in obsessive-compulsive disorder and social anxiety, which are experienced by both groups. Therefore, the role of ruminations in women with obsessive-compulsive disorder is more intense.


 

Operative Treatment of Acute Distal Femur Fractures: Review of literature

Reza Zandi, Mohammad Reza Minator Sajjadi, Mohammad Ali Okhovatpour, Mehrdad Sadighi, Adel Ebrahimpour, Pooyan Jalalpour

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e17

Fractures of the distal femur may be extra articular or have an intra articular component. Mismanagement of any of these fractures can result in abnormalities of alignment of the load-bearing axis of lower limb and/or rotational deformities. Essentially all supracondylar femur fractures require operative intervention because of the severe potential risks of prolonged bed rest. Yet, despite their proven track record and benefits over older implants, technical errors are common and must be overcome with proper preoperative planning and intra-operative attention to details. The goal of this study was   to present an update on the management of these fractures

Evaluating diagnostic accuracy of Ovarian instant frozen sections compared to delayed paraffin embedded permanent sections

Hossein Hatami, Zhaleh Mohsenifar, Amir Salimi

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e18

Introduction: Frozen section is mainly performed to determine malignity, so it is of fundamental importance to evaluate the diagnostic accuracy of frozen sections performed for each group of tissues in order to reduce false diagnoses, unnecessary surgeries and following unwanted complications. This study is conducted to evaluate the diagnostic accuracy of frozen section performed on ovary tissue compared to permanent sections.


Materials and Methods: In this retrospective study, we evaluate frozen sections performed at Taleghani hospital pathology department in five years and their results were compared with permanent sections’ results to calculate sensitivity, specificity, negative predictive value and positive predictive value. In cases which results were discordant, we check for probable reasons.


Results: 83 species were evaluated from patients with a mean age of 42.9 years; the smallest was 19 and the oldest was 86 years old (Std. dev: 12.84). 75 cases of frozen sections were benign (90.4%) and 8 cases were malignant. 73 cases of permanent sections were benign (88%) and 10 cases were malignant (12%. Sensitivity, specificity, positive predictive value and negative predictive value rates were 66%, 100%, 100% and 96.55% respectively.


Conclusions: This study shows the importance of cooperation between pathologist and surgeons that they can prevent unnecessary surgeries. In our study the only cases of discordancy were borderline tumors and the diagnostic accuracy for all other species were perfect. 


 

Comparing the effects of group discussion and lecture educational methods on preventive behaviors of high blood pressure in Eslamshahr women

Ali Ramezankhani, Ameneh Pooresmaeil, Sakineh Rakhshandehrou, Soheila Khodakarim

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e19

Introduction: Nowadays, high blood pressure is a major risky factor for heart disease, stroke and kidney diseases and education is one of the effective factors that reduces high blood pressure. This study was designed and conducted to compare the effects of group discussion and lecture methods on preventive behaviors of high blood pressure in Eslamshahr school stu­dents’ mothers.


Materials & Methods: In this experimental study, a two-stage cluster sampling was conducted and 168 students were selected. Then, these students were divided into three groups of 56 members each. In addition, their mothers were invited to participate in the study. Samples into three groups (two case groups and a control group) were divided into three stages and with a questionnaire which consists of demographic information questions and questions related to knowledge, attitude, behavior developed by the researcher, were evaluated. provide educational content, lectures and group discussion methods were to used. Data collected using software SPSS-21 and ANOVA, chi-square test and Kruskal-Wallis test were used.


Results: The test showed significant differences between the two methods in the confidence level of 0.95, so that the ratings of knowledge and attitudes and preventive behaviors were higher in grou discussion (p<0.001). These results suggest that education in group discussion in comparison with lecture method is more effective and encouraging.


Conclusion: The results showed that the group discussion method is more effective than lecture is. therefore recommended to pay more attention to high blood pressure in mothers, in this educational method, especially in the education of preventive behaviors.


 

Effect of sono-guided fascia iliaca block versus spinal anesthesia on tourniquet pain during foot and ankle orthopedic surgery

Faramarz Mosaffa , Shideh Dabir , Nima Tavakoli , Behnam Hosseini , Amir Sabaghzadeh

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e20

Introduction: The pneumatic thigh tourniquets are routinely used in below knee orthopedic surgeries to provide a bloodless operative field. Moderate to severe thigh pain following tourniquet inflation is a common patient complaint that can be so severe that necessitate general anesthesia. In the present study, we assessed the effectiveness of a single dose fascia iliaca block on thigh tourniquet pain during unilateral orthopedic foot and ankle surgery performed under popliteal sciatic nerve block.


Materials and Methods: Seventy-two American Society of Anesthesiologists physical status 1 or 2 patients were randomly divided into two equal groups of spinal anesthesia and fascia iliaca block. Spinal anesthesia was provided with 15 mg of 0.5% hyperbaric bupivacaine. Fascia iliaca and popliteal blocks were performed under the guidance of ultrasound using 30 ml of 1.5% lidocaine and 20 ml of lidocaine 1.5% with epinephrine 1:200000, respectively.


Results: Intraoperative tourniquet pain and the use of analgesics were significantly higher and patient satisfaction was significantly lower in the fascia iliaca block group than in the spinal anesthesia group.


Conclusion: Fascia iliaca block alone was inadequate for relieving thigh tourniquet pain during surgery. However, for patients who are not suitable for spinal or general anesthesia, it can be used with supplementary intravenous analgesia for tolerance of thigh tourniquet in foot and ankle surgeries performing under popliteal sciatic nerve block.

Study of symptoms of anxiety and depression and quality of life before and after radioactive iodine intake in patients with thyroid cancer

Shahab Banihashem, Mehdi Arabzadeh, Mohsen Ghotbi

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e21

Introduction: Thyroid cancer can affect the quality of life of patients and no validated study has been
conducted to evaluate the quality of life in patients with thyroid cancer in Iran. The purpose of this
study was to evaluate the changes of quality of life in patients with thyroid cancer treated with
radioactive iodine.
Materials and Methods: According to a prospective longitudinal study, quality of life and mood in
these patients were studied by two questionnaires: Short Form Health Survey (SF36) and Hospital
Anxiety and Depression Scale (HADS) provided to the patients by the researcher. The questionnaires
were completed one month before iodine injection, on the day of injection, at the end of the second
week, and sixth month after radioactive iodine injection. The patients were treated in two groups of
100 and 150 μ Curie. After completing the questionnaires, the resulting scores at four different time
points were evaluated and compared.
Results: The mean SF36 scores were lower than one month before iodine intake and after 6 months,
the mean scores were lower than one month before iodine intake. The mean HADS scores one month
after iodine intake were not significantly different from the time of iodine intake, but after two weeks,
anxiety and depression were reduced, and the result continued till the sixth months. No difference was
found in the levels of anxiety and depression between the doses of 100 and 150 μ Curie.
Conclusion: The highest level of anxiety and depression and quality of life during the first two weeks
of iodine intake reduced with time and iodine intake dose did not affect it.

Diagnostic value of early postoperative color doppler ultrasonography to predict vascular complications following liver transplantation

Seyed Mohammad Reza Nejatollahi , Maryam Khoshkholgh Sima , Habibollah Peirovi, Farhad Niaghi

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e22

Introduction: Blood flow and hemodynamic of the transplanted liver has an important predictive role in the survival of the patients. We aimed to determine the diagnostic value of early post-operative color doppler ultrasonography (CDU) for detecting vascular complications following liver transplantation at our center.


Materials and Methods: In this prospective study, consecutive patients who underwent deceased donor liver transplantation between March 2016 and March 2017 were enrolled. Color Doppler ultrasonography was performed within the first week following surgery. The follow-up CDU was performed after 1 year from the liver transplantation. Using the findings of follow up CDU as the reference standard, we calculated values of the capability of the initial CDU in the diagnosis of the hepatic artery, portal vein and intrahepatic veins' stenosis, including the level of agreement, sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy.


Results: The data of 50 patients were analyzed in this study (mean age=38.9±13.2 years, 26 [52%] men). In the initial ultrasonography, 16 cases had hepatic artery stenosis, 4 cases had portal vein stenosis and 4 patients had IVC stenosis. The diagnostic value of the early postoperative CDU for hepatic artery stenosis, portal vein stenosis, and other vascular stenosis were 71.9, 96.0, and 62.0, respectively.


Conclusion: Early post-operative CDU is a safe and feasible method that can detect the development of hepatic artery or portal vein stenosis in liver transplant recipients with a low to moderate positive predictive value and a high negative predictive value.


 

Blood lead level and related factors in ADHD patients of Loghman Hakim Hospital in 2016- 2017

Alireza Rezayi, Fariba Farnaghi, Shiva Sadeghian, Hossein Hassanian-Moghaddam , Nasim Zamani, Latif Gachkar, Narges Gholami

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e23

Introduction: Lead is a highly neurotoxic metal mainly in early life. In this study we investigate blood lead level (BLL) in children with attention deficit/ hyperactivity disorder (ADHD) and some related factors mainly opium exposure, as a source of lead exposure in recent years in Iran.


Materials and Methods: In this cross-sectional descriptive study children & adolescents aged < 18 years in Child Neurology Clinic of Loghman Hakim hospital with ADHD criteria according to DMS-V in Tehran-Iran were studied. Lead Care II checked BLLs using 0.5-milliliter heparinzed venous blood. Demographics characteristic   and some   related factors such as old housing, parents’ job, pica, opium exposure were   asked and analyzed.


Results: Fifty-one children and adolescents <18 years, 25.5% female and 74.5% male with mean ages of    71.4+30.3 months entered the study. Mean BLL was 6.34+2.63  µg/dl. The mean BLL in 100 normal children in Loghman Hakim hospital was 3.4 µg/dl. Mean BLL was 57/6 µg/dl in boys and60/6  µg/dl in girls, (p=0.973).  Also, the difference in mean BLLs were not significant in terms of living place, sex, age, pica and parents job.  Totally, 43 patients (84.3%) of the study samples had BLL ≥5 µg/dl. The highest blood lead level in our patient was 20.1 µg/dl. Eighteen (32.7%) of our patients have positive history for opium exposure in their family that BLL in this group was 5.84 µg/dl in comparison 6.95 µg/dl in cases with no opium exposure, that there were not statistically significant. (p=0.148)


Conclusion: Based on the results of our study, clinicians are encouraged to take accurately attention about possible lead exposure and to rule out environmental hazards when evaluating for ADHD, particularly in young children and laboratory investigation for this toxin in high-risk cases and further researches recommended

Wearable smart blanket system model for monitoring the vital signs of patients in ambulance

Sorayya Rezayi , Ali Asghar Safaei , Nilofar mohammadzadeh

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e24

Introduction: The timely and managed intervention reduces the consequences of disease and sudden death among the patients in emergency conditions. Monitoring the patients in emergency conditions requires rapid and appropriate decisions to save their lives. The present study aimed at modeling the wearable smart blanket system for monitoring the patients in the emergency conditions of ambulance.


Materials and Methods: The present study was based on an applied and descriptive-developmental design. Firstly, the requirements and features of wearable smart blanket system were elicited and secondly a smart blanket system was modeled by using the UML charts and elicited requirements. Finally, the designed architecture was evaluated using ARID scenario-based method.


Results: The functional requirements of wearable smart blanket system with its data elements and physical-structural features of this system as well as non-functional requirements were elicited. Based on the requirements and data elements elicited from the questionnaire, class diagram, activity, use-case diagram, sequence, deployment, and component were drawn. Then, using the UML and the relationships between components, systems, and users from the structural and behavioral perspectives used the ARID scenario-based evaluation method to indicate that the designed architecture could provide the expected scenarios from the proposed system.


Conclusion: Wearable smart blanket system collects the data related to medical signals by the sensors installed on the blanket and such data are processed by the smart system. Therefore, it can be concluded that the design of this system makes it possible to monitor and control patients in risky conditions with better quality and to integrate vital signs. The analyzing biological data makes it easy for doctors to take early diagnosis and interventions

The mutual relationship between euthanasia and preservation of life from the Islamic jurisprudence perspective

Morteza Abdoljabari, Mahdi Fani, Seyyed Majid Ghoreishi, Ali Rajabzadeh , Marzieh Karamkhani

Researcher Bulletin of Medical Sciences, Vol. 24 No. 1 (2019), 31 August 2020 , Page e25

Introduction: All divine religions have paid a special attention to the preservation of life. In a similar vein, the last monotheistic religion, Islam, has emphasized the need to respect this right and the need to preserve human life. Some solutions have always been proposed on the need to respect and exercise this right. All divine religions are against euthanasia and the views of its opponents and euthanasia has been interdicted in many verses in the Quran. The current study was an attempt to demonstrate the importance of preservation of life from the perspective of Islam and to examine this issue from a religious point of view and the emphasis on the need to preserve human life


Materials and Methods: The study adopted a descriptive-analytical design. In line with this design, various books on Islamic sciences, interpretation, narrations, and jurisprudence were consulted. Furthermore, using the databases, related papers were also consulted.


Results: According to Islam, God is the genuine owner of human bodies and lives. Humans cannot jeopardize their lives and perform euthanasia without a legitimate reason based on jurisprudence or wisdom but should use their life in line with the goal of creation, i.e., to serve God. The importance of preservation of life is primarily recognized by wisdom1. The Holy Quran and Islamic narrations have also recognized the need to preserve human life. Islamic scientists (clergymen) have also emphasized its obligation.


Conclusion: Human beings are obliged to avert dangers and do their best to preserve their lives. Every action, which may lead to euthanasia, is against wisdom Islamic jurisprudence