Researcher Bulletin of Medical Sciences

Objective: Health has different dimensions. One of the most important dimensions of health is its mental and spiritual aspect, which has recently received the attention of researchers. Spirituality is considered one of the important aspects of human life. In today's civilized world, paying too much attention to the material aspects of human life has caused the spiritual dimension of human life to be forgotten.

Materials and Methods: One of the important areas in which this dimension of human life is manifested is the time when a person is suffering from illness and goes to health and treatment centers. Man's confrontation with illness makes the soul aware of the mortality of material life and is a push to pay more attention to spirituality and immaterial dimensions; However, in healthcare centers, this issue has not been paid much attention and is often ignored.

Results: Although various studies have confirmed the usefulness of using religious and spiritual beliefs in patient care, most people involved in patient care refrain from doing so. This is while giving importance to the spiritual dimension during illness and illness, especially in centers that deal with human health, causes the pain and suffering of patients to subside and raise their level of health; In addition, spiritual attention also plays an important role in the awareness of the human soul and provides a suitable ground for getting close to God and human evolution.
Conclusion: Therefore, this study was carried out with the aim of explaining the concept of spirituality in the field of healthcare services and investigating various solutions for its application in this field, so that the necessary recommendations and training can be provided to people related to healthcare professions.

Objective: The impact of learning disabilities, struggles with life changes, and difficulties in communicating one's needs has been documented in a wide range of health and social care evidence. Therefore, this study aimed to determine the effectiveness of Acceptance and Commitment Therapy (ACT) on sleep disorder and quality of life in mothers of children with learning disabilities.

Materials and Methods: The research approach is a quasi-experimental one, specifically a pre-test-post-test design with a control group. The research population consisted of all mothers with at least one child with learning disabilities who sought services at the Learning Disability Centers at District 2 of Tehran in the year 2023. A purposive sampling approach was employed, selecting 30 participants based on the inclusion and exclusion criteria for the study. These participants were then randomly divided into two groups: an experimental group and a control group. To gather data, the following instruments were used: Individual Clinical Characteristics Form, Pittsburgh Sleep Quality Index (PSQI). Multivariate Analysis of Covariance (MANCOVA) was used to analyze quantitative data using the SPSS statistical software, version 26.

Results: The findings of the study revealed that after controlling for the effect of the pre-test scores, the difference in the pre-test-post-test scores between the two groups for the variables of sleep quality and quality of life was statistically significant. Additionally, the mean scores of the Acceptance and Commitment Therapy (ACT) group on the sleep quality and quality of life variables were also significantly higher than those of the control group (p < 0.05).

Conclusion: Based on the research findings, it can be concluded that Acceptance and Commitment Therapy (ACT) is effective in improving sleep disorder and quality of life in mothers of children with learning disabilities.

Objective: University students are particularly vulnerable to emotional distress, especially during times of academic pressure, relationship challenges, or personal loss. Emotional failure can lead to negative emotional states, such as anger, resentment, and bitterness, which can hinder personal growth and interpersonal relationships. This study investigated the effectiveness of interpersonal analysis group therapy, schema therapy, and emotionally focused therapy on interpersonal forgiveness among university students experiencing emotional failure.

Materials and Methods: This study utilized a quasi-experimental pre-test-post-test control group design. A convenience sample of 60 participants was randomly assigned to one of four groups: transactional analysis therapy, schema therapy, emotionally focused therapy, or a control group. The Interpersonal Forgiveness Measurement Questionnaire (IFMQ) was administered to collect pre- and post-intervention data. Data analysis was conducted using SPSS version 22, employing analysis of covariance and Bonferroni post hoc tests.

Results: The findings revealed that transactional analysis therapy, schema therapy, and emotionally focused therapy significantly enhanced interpersonal forgiveness in university students experiencing emotional failure compared to the control group (P<0.001). Moreover, no statistically significant differences were observed among the effects of these three therapeutic interventions on interpersonal forgiveness in this population.

Conclusion: The study found that transactional analysis therapy, schema therapy, and emotionally focused therapy were all effective in increasing interpersonal forgiveness among university students who had experienced emotional failure. This suggests that psychotherapists can choose any of these therapies based on the individual needs of their clients.

Objective: MRI is a non-invasive imaging technique with high accuracy for detecting the appearance features of endometriosis, including rectal endometriosis. The degree of muscle involvement is also an important factor in determining the degree and progression of rectal endometriosis, which is based on the results of histopathology. The aim of this study is to investigate the relationship between the degree of muscle involvement and the appearance features of rectal endometriosis in patients referred to the Imam Hossein Medical and Educational Center in 2021 to 2023; so that by determining the relationship between the appearance features of endometriosis and the degree of involvement of the rectal muscle, we can predict the degree of muscle involvement and the progression of endometriosis using MRI as a non-invasive method compared to histopathology

Materials and Methods: The present study is a descriptive-analytical study conducted on 144 patients with rectal endometriosis who referred to Imam Hossein Hospital between 2021 and 2023. In this study, patients who underwent MRI before surgery or histopathology of rectal endometriosis were included. The data were analyzed using SPSS version 27 software and logistic regression test.

Results: The results of two-level logistic regression analysis show that there is a significant relationship between the variable of muscle involvement and the length and number of rectal endometriosis (P-value <0.05). So that for each unit increase in length, the chance of muscle involvement increases by a factor of 1.03 and for each unit increase in the number of involved nodules, the chance of muscle involvement increases by a factor of 4.65. The results also show that there is no significant relationship between the variable of muscle involvement and the thickness of rectal endometriosis (P-value >0.05).

Conclusion: According to the results obtained from the two-level logistic regression test, it can be understood that the length and number of rectal endometriosis nodules have a positive effect on muscle involvement and increase the chance of muscle involvement. While the thickness of rectal endometriosis has almost no effect on muscle involvement.

Background: Considering the high prevalence of Post-traumatic Stress Disorder (PTSD) and its comorbid mental disorders, and considering the vast number of patients diagnosed with mental disorders who remain without suitable mental health treatment, employing online methods of delivering mental health therapies seems to be mandatory.

Objectives: The present research aimed to investigate the effectiveness of Internet-based Trauma-Focused Cognitive Behavioral Therapy (I-TF-CBT) on reducing the symptom severity of PTSD and other comorbid mental disorders, such as depression, anxiety, and positive and negative affect among patients diagnosed with PTSD. Materials and Methods: The study design was quasi-experimental. Of the 450 individuals who completed the PTSD checklist for DSM-5 (PCL-5), 83 were selected via purposive sampling and interviewed using the SCID-5 clinical interview. Finally, 24 participants were eligible to receive I-TF-CBT. Participants completed a battery of questionnaires, namely Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), and Positive and Negative Affect Scale (PANAS), online and in three time periods i.e., before, after, and one month after receiving I-TF-CBT. Finally, after the removal of a number of participants, the collected data from 19 participants was analyzed in SPSS-26, using repeated measures ANOVA statistical analysis method.

Results: The findings revealed that I-TF-CBT  was effective in reducing the symptom severity of PTSD,  depression, anxiety, and negative among patients with PTSD. However, this effectiveness was not significant with regard to positive affect.

Conclusion: This was the first study that investigated the effectiveness of I-TF-CBT on various variables among those diagnosed with PTSD in Iran. The findings revealed that I-TF-CBT was effective with regard to many variables among this population. Nevertheless, more research is needed in order to reach a better conclusion about the effectiveness of this treatment on different variables, especially positive and negative affect.

Objective: Present study aimed to explore the Kahoot platform as a technology for feedback-driven evaluation in medical education

Materials and Methods: Three focus groups including undergraduate and dental students were formatively evaluated using the Kahoot platform, during two semesters include at least three exams. Students participated in the scheduled exam using a special code. The answer immediately was shown and the teacher was able to provide oral and textual explanations and even upload slides if there was any ambiguity in the answer. To evaluate the platform efficiency, a standardized 12-item questionnaire was provided. Data analysis was conducted using descriptive statistics.

Results: Kahoot made the exam more pleasant and reduced stress (97%). It was an effective way to learn more accurately and deeply regarding feedback and reflective learning (91.4%). Providing feedback, created better environment learning than traditional learning (88.6%). Motivate to learn more (88.5%) and focus on the subject (84.7%) were other results.

Conclusion: Kahoot platform can facilitate students’ perceptions about their educational weaknesses. Deeper learning takes form by interaction with the teacher and the weaknesses are eliminated. This process can create a test-learning bridge by making evaluation enjoyable and targeting the two together. So, it’s a promising tool for formative assessment in medical education.

Background and Aim: Emotional disorders are characterized by disturbances in mood and affect, often accompanied by cognitive deficits. Among the cognitive factors, repetitive negative thinking and executive functions have garnered attention due to their roles in emotional regulation and cognitive processing. Repetitive negative thinking involves persistent negative rumination and worry, while executive functions include inhibition, set-shifting, and updating. This study tries to investigate the relationship between repetitive negative thinking and executive functions in emotional disorders in a trans diagnostic way and to determine the mediating role of general distress in this relationship.

Materials and Methods: 107 individuals with emotional disorders were selected by purposeful sampling. All participants completed the Repetitive Thinking Questionnaire, Anxiety, Depression, Stress Scale, Stroop Color-Word Tests, Wisconsin Card Sorting Test and N-Back task. Correlation and regression analysis were used to analyze the data.

Results: The findings showed that only updating among the executive functions is related to repetitive negative thinking. Also, the present study showed that general distress cannot mediate the relationship between updating and repetitive negative thinking.

Conclusion: According to our knowledge, the present study is the first one that investigated the relationship between repetitive negative thinking and executive functions in emotional disorders in a transdiagnostic way. The findings of this research contribute to a deeper understanding of the cognitive basis of emotional disorders and emphasize the importance of addressing executive function deficiencies in order to reduce repetitive negative thinking and its effects on affective well-being.

Background and Objective: Depression during adolescence is a significant mental health concern, often associated with a range of negative outcomes, including peer victimization, difficulties with emotional regulation, and heightened feelings of guilt. This study investigated the effectiveness of schema therapy on peer victimization, distress tolerance, and guilt feelings in adolescents experiencing depressive symptoms.

Materials and Methods: Method: This study employed a quasi-experimental pre-test post-test control group design. The study population comprised adolescent boys residing in Ahvaz who presented with depressive symptoms during the year 2023. A convenience sample of 30 adolescents was recruited, and participants were then randomly assigned to either the experimental (n=15) or control (n=15) group. The experimental group received eight 90-minute sessions of schema therapy, administered weekly. The control group did not receive the schema therapy intervention. Data collection instruments included the Illinois Bully Scale (IBS), Distress Tolerance Scale (DTS), and Guilt Questionnaire. Analysis of covariance (ANCOVA) was conducted using SPSS version 27 to analyze the collected data.

Results: The results showed that schema therapy was effective in reducing peer victimization and feelings of guilt and increasing distress tolerance in adolescent boys with depressive symptoms (P<0.001).

Conclusion: This study concludes that schema therapy effectively reduces peer victimization and guilt while increasing distress tolerance in adolescent boys with depressive symptoms. These findings suggest schema therapy's potential as a valuable intervention for improving the social experiences, emotional regulation, and self-perception of depressed adolescents by targeting maladaptive schemas and fostering healthier coping mechanisms.

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Objective: Achalasia is an uncommon esophageal motility disorder that significantly impacts quality of life due to dysphagia, chest pain, and other related symptoms. Laparoscopic Heller myotomy (LHM) is a preferred treatment, although the necessity of adding fundoplication to prevent postoperative gastroesophageal reflux disease (GERD) remains debated.

Materials and Methods: This prospective cohort study from January 2023 to March 2024 at Imam Hossein Teaching and Therapeutic Center included 25 patients with type II achalasia. The study assessed the incidence and severity of GERD and dysphagia postoperatively at baseline, 3 months, and 6 months using the Achalasia Patient-Reported Outcomes Questionnaire (APRO), Brief Esophageal Dysphagia Questionnaire (BEDQ), and Gastro-Esophageal Reflux Disease Questionnaire (GERDQ).

Results: Post-surgery, dysphagia scores decreased significantly from 18.96 (SD = 4.02) to 12.11 (SD = 3.88) at 3 months (p < 0.01) and to 11.45 (SD = 3.67) at 6 months (p = 0.64). GERD scores also significantly reduced from 19.32 (SD = 4.18) to 9.14 (SD = 3.77) at 3 months (p < 0.05) and to 4.97 (SD = 2.45) at 6 months (p = 0.001).

Conclusion: LHM without fundoplication significantly reduces dysphagia in type II achalasia. Although effective in alleviating this primary symptom, it does not consistently prevent postoperative GERD, highlighting the need for individualized surgical planning.

Objective: While laparoscopic abdominal surgery has many benefits, the results of past studies regarding the rate of complications after surgery using different laparoscopic approaches are contradictory. According to the different results of previous studies, we have prospectively investigated pot-related complications in laparoscopic abdominal surgeries in the Iranian population.

Materials and Methods: This study was conducted as a prospective cohort. Number of 346 patients’ candidates for abdominal surgery using the laparoscopy technique referred to Imam Hossein Hospital in Tehran, Iran, in 2021-2023 were included in the study based on the inclusion and exclusion criteria. Demographic information about the patients (age, gender, and underlying disease) and information related to surgery and complications related to the port were examined and recorded by the surgeons for six months after surgery.

Results: In this study, 346 patients were examined. The mean age of patients was 44.34 ± 11.80 years, ranging from 16 to 77 years. 206 (59.5%) were women, and 140 (40.5%) were men. Out of 346 operated patients, 129 patients (37.3%) had cholecystectomy, 117 patients (33.8%) had bariatric surgery, and 71 patients (20.5%) had herniorrhaphy. Port-related complications were seen in 11 patients (3.2%). Port site infection was diagnosed in 10 patients (2.9%). An incisional hernia was diagnosed in one patient (0.3%). There was no port site bleeding, omentum injury, or other possible port-related complications.

Conclusion: Although laparoscopic surgery is safe, requires sufficient expertise, training, and appropriate equipment. In this study Port-related complications of Iranian population have been reported to compare with others.

Objective: One of the groups at risk of Internet addiction are hyperactive people, who have been warned in many previous studies about the higher possibility of Internet addiction among them than the general population. The present study was conducted with the aim of investigating the correlation of internet addiction, type of online activities and attention deficit hyperactivity disorder among medical students of Kashan.

Materials and Methods: This   cross-sectional study was conducted in Kashan. The questionnaires were given electronically and in paper form to the people. The questionnaire   included demographic, the IAT   and ASRS. The information was entered into the SPSS software version 26 and analyzed using Chi-2 and t-tests.

Results: In this study the average score of the ASRS questionnaire   among the students was 46.2 ± 13.2, of which 50 (11.3%) with ADHD. The average score of the IAT was 67.3 ± 13.0, and most of the participants, 336 (76.2%) had a moderate addiction to the Internet and the rest, 105 (23.8%) had a severe addiction to the Internet.   The most used cases of Internet   in the study are, respectively, chat and social communication in 191 cases (43.3%), watching clips and movies in 88 cases (20.0%) and playing Internet games in 54 cases.     The Internet addiction score among people with ADHD was 75.0±9.5, which was significantly higher than that of people without ADHD.

Conclusion: Based on the findings of this study, most of the students had a moderate addiction to the Internet, and hyperactivity had a significant relationship with Internet addiction.

Objective: Corona virus can severely affect the performance and functional parameters of the heart, causing damage to the myocardium and reducing the ejection fraction in patients with this disease. The present study was conducted with the aim of investigating the changes in cardiovascular parameters such as cardiac ejection fraction, blood pressure and heart rate after myocardial infarction in patients with covid-19 and comparing it with non-covid-19 patients.

Materials and Methods: In this case-control study and based on purpose-based sampling, among all the patients' files in Imam Musa bin Jafar (AS) hospital in Qochan city, who were hospitalized with a diagnosis of heart attack and since the beginning of the outbreak of the Covid-19 disease (March 2018). , 90 cases of patients with covid-19 (45 people) and non-covid-19 (45 people) were selected based on the inclusion criteria and the desired parameters were extracted from them. The results were analyzed using SPSS, t-test and Mann-Whitney test.

Results: The statistical analysis of the data of this study did not show any significant difference between mean ejection fraction, heart rate, systolic and diastolic blood pressure in post-heart attack patients with and without covid 19.

Conclusion: Although the statistical analysis of the data of this study did not show a significant difference between the mean ejection fraction, heart rate, systolic and diastolic blood pressure in post-heart attack patients with and without covid-19, due to the emerging nature of the disease, more studies are needed in this area.

Objective: Breast cancer remains the leading cause of cancer-related deaths among women worldwide. Researchers classify Triple-Negative Breast Cancer (TNBC) by the absence of oestrogen receptor (ER), progesterone receptor (PR), and HER-2 expression. This subtype accounts for 10–15% of breast cancer cases and shows poorer prognosis with higher recurrence rates compared to other forms. This study investigates the age distribution and demographic characteristics of TNBC patients in Iran.

Materials and Methods: Researchers collected data from TNBC patients who referred to Shohada Tajrish Hospital in Tehran over six years. They recorded clinical and demographic information and conducted statistical analyses using SPSS version 26.

Results: The study revealed that the average age of TNBC patients was 44.6 years, with most cases presenting invasive ductal carcinoma (IDC). Researchers noted that breast-conserving surgeries were the predominant treatment strategy.

Conclusion: TNBC in Iran aligns with global patterns, highlighting the higher prevalence of this subtype among younger age groups. Findings emphasize the importance of targeted approaches for early diagnosis and effective management.

Objective: Introduction: Dyslexia is one of the most common types of learning disabilities, defined as a specific learning disability in reading. Dyslexia-related issues are significant and acute educational problems that can be the primary cause of academic failure, leading to serious educational consequences. The present study aims to determine the effectiveness of storytelling on improving cognitive skills, visual perception, and academic progress in elementary school students with dyslexia.

Materials and Methods: The statistical population of this study includes female elementary school students in Tehran during the academic year 1402, with 30 participants selected voluntarily. They were then randomly assigned to two groups of 15: an experimental group and a control group. The experimental group was tested before and after the storytelling intervention, while the control group was assessed at the end of the intervention using equivalent tools. Data collection involved the use of questionnaires, including the Dyslexia Symptoms Questionnaire, Najati's Cognitive Abilities Assessment, Benton’s Visual Retention Test, and an Academic Progress Questionnaire. The experimental group underwent treatment using a designed therapeutic protocol over 10 sessions, totaling 10 hours (one hour per session).

Results: The empirical data obtained from the research were analyzed using the ANCOVA statistical method in SPSS version 24. The results of this study align with previous research, indicating that storytelling therapy has a positive and significant effect on improving cognitive skills, visual perception, and academic progress in students with dyslexia, with an effect size of (0.67) and statistical significance within the range of (0.00).

Conclusion: The effectiveness of storytelling therapy on cognitive skills, visual perception, and academic progress paves a clear path for therapists, educators, and educational specialists to improve outcomes for students with dyslexia.

Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most significant hospital-acquired pathogens, responsible for numerous life-threatening infections globally. The increasing resistance of this bacterium to commonly used antibiotics poses a major challenge in managing infections effectively. . This study aimed to evaluate the antibacterial properties of hydro alcoholic Moringa oleifera extract against clinical MRSA isolates. The primary goals were to determine the minimum inhibitory concentration (MIC) of the extract, assess its bactericidal activity, and investigate the correlation between antibiotic resistance genes and MIC values.

Materials and Methods: Clinical MRSA isolates were collected from hospitalized patients Moringa oleifera extract was prepared using maceration in a hydro alcoholic solvent (70% ethanol). The antibacterial activity of the extract was assessed via the agar diffusion method, using disc placement on Mueller-Hinton agar. Each test was repeated three times, and inhibition zone diameters were measured and recorded to calculate the antibacterial activity. The MIC was determined using the broth microdilution method. Additionally, the presence of antibiotic resistance genes, including mecA, was evaluated in relation to MIC values. Statistical analyses were conducted using specialized software to ensure accuracy and reliability.

Results:  Out of 100 samples studied, 23 were confirmed as MRSA. Statistical comparisons revealed significant differences between the inhibition zones produced by Moringa oleifera leaf extract and the standard antimicrobial agent (Linezolid) against MRSA isolates (p-value < 0.001). Concentrations below 8 µg/mL significantly reduced the killing time and exhibited superior efficacy in controlling MRSA infections. Furthermore, all MRSA isolates were found to carry the mecA gene, which encodes methicillin resistance.

Conclusion: This study demonstrated the strong antibacterial effects of hydro alcoholic Moringa oleifera extract against clinical and standard MRSA isolates. The findings highlight the potential of Moringa oleifera as a source for developing new and effective antibiotics to treat MRSA-associated infect Moringa oleifera ions. This research underscores the importance of exploring plant-based therapeutic options to address the growing challenge of antibiotic resistance