Researcher Bulletin of Medical Sciences

Objective: As the prevalence of the coronavirus increases, there is now more emphasis on reducing "face-to-face" patient visits. Therefore, the use of smartphones and their special medical applications can play an important role in following up patients. The aim of this study was to evaluate the use of smartphone in evaluating clinical outcomes and range of motion of patients after elbow operation.

Materials and Methods: Forty patients were randomly selected from patients undergoing elbow operation. Patients were divided into two groups, so that in the first group, the patients were visited and then were followed-up for 2,6, and 12 weeks as well as 6 months after first visit by smartphone connection and delivering the pictures and videos of involved organ to the physician as well as having the physical examination him. In the second group, all assessments were performed by clinical visiting at the same time points.

Results: The two groups were similar in baseline characteristics including demographics; the side of involved elbow, type of fracture, surgical approach, operation time, and mean Mepi score. Assessing the postoperative complications and also patients' satisfaction was also similar in both groups. There was no difference in different range of elbow motion degrees between the case and control groups at different times of following-up as well as the progress in motion of elbow after surgery in two groups. Moreover, there was no significant difference between the range of motion evaluated by smartphone and physical examination.

Conclusion: The use of the smartphone has a high degree of accuracy and sensitivity in assessing the status of elbow range of motion after surgical treatment, both in the short and long term after surgery.

Objective: The severe acute respiratory syndrome coronavirus 2(SARS COV 2) is an important health problem, which is widespread around the world. This study describes the characteristics of COVID-19 infections in healthcare workers (HCWs), related factors and deaths in Non- COVID pediatrics departments from the early phases of COVID-19 pandemic; February 20^th, 2020toJanuary19^th, 2021 in Tehran-Iran.

Materials and Methods: It is a multi-center cross-sectional descriptive study. The standardized questionnaire was designed according Demographics information, Coronavirus disease (COVID-19) history in HCW and Using and access to Personal Protective Equipment (PPE). All data analysis was performed by SPSS software version 21.

Results: Of the 82 HCW, 67 (81.7%) was female. The median age was 37.6 ±10.3 years old (rang 24 to 65). 44 (53.6%) were nurses, 14 (17 %) pediatrics residents,13 (15.9%) pediatrics faculty members,8(9.8%) environmental services staff and 3(3.7%) secretaries. Twelve out of our cases (14.6%) have underlying medical diseases. Thirty-six (42.7%) confirmed COVID19. In COVID-19 positive group 28(80%) were female. Among whom 51.4% were identified nurses, 17% faculty member and14.3% pediatrics residents. Secretaries and environmental services staff are more vulnerable job category in this study. Eighty-six percent of them follow protective health protocol and use PPE. COVID-19 cases were infected more on July 2020(25.7%), November 2020 (17.1%) and August 2020(14.2%).  

Conclusion: Approximately one half of HCWs in non-Covid-19 pediatrics department infected with corona virus 2 (SARS_COV_2) and most of them thought they were infected in workplace

Introduction: Gastrointestinal stromal tumor (GIST) is a rare mesenchymal tumor of the gastrointestinal (GI) tract that usually occurs in the stomach and the small intestine, respectively. This tumor often occurs in people over the age of 40 years, especially in the fifth and sixth decades of life. The range of symptoms varies from asymptomatic to symptomatic depending on the size and location of the tumor. The standard diagnostic of this tumor is the pathological examination of tissue specimens. Also today, the main treatment for this tumor is surgery and resection of the tumor. 

Case Report: A 43-year-old woman presented with melena and a decrease in hemoglobin level to 4. The patient underwent upper and lower GI endoscopy, CT angiography, and EUS, which was reported a vascular lesion below the ampulla of vater. After laparotomy and Whipple procedure, pathology reported tumor as GIST. The patient was discharged from the hospital in good general condition. 

Conclusion: we suggest that patients presented with gastrointestinal bleeding and the presence of a lesion in the diagnostic modalities, GIST should always be considered as a differential diagnosis.

Background and Objectives: Given the extensive number of surgical procedures available for correcting CL III anomalies, the present study was conducted in a private clinic from 2014-15 to determine whether simpler orthodontic and surgery techniques could be an alternative to the conventional techniques for resolving such functional and aesthetic problems.

Materials and Methods: The present study was conducted using a sequential before-after design on patients with mild to moderate maxillary deficiency. First, the study records including casts, photographs and radiographs were prepared. A Hyrax appliance with two tongue plates was then constructed for the patient before the Surgically Assisted Rapid Maxillary Expansion (SARME) osteotomy. The surgical technique involved local anesthesia without general anesthesia and the Lefort I osteotomy was performed without down fracture and without the manipulation of the pterygomaxillary suture. The transverse problem was corrected by unscrewing the Hyrax, and the tongue force exerted on the back of the tongue plate corrected the sagittal maxillary deficiency. To evaluate the efficacy of this appliance, the mean changes to the cephalometric indicators before and after the treatment were examined, and the paired t-test was used for the statistical analysis.

Results: The present study was conducted on 11 patients (9 females and 2 males). The mean changes indicated a significant increase in Articular Angle, Jarabak index, and a significant decrease in L1 - NB (mm), L1 - NB (º) and Saddle Angle. The other indicators had either decreased or were not changed.

Conclusion: Using a Hyrax appliance combined with a tongue plate after a SARME surgery is effective in correcting CL III anomalies associated with maxillary deficiency.

Background & Objective: Doctor-patient relationship plays an important role in adherence of patients to treatment instructions. This study tries to examine the relationship between physicians and patients with type 2 diabetes in the treatment process by the grounded theory.

Materials and Methods: Eleven physicians and 9 diabetic patients in both sexes were selected from among all type 2 diabetic patients referred to physicians' offices in Shahid Beheshti University of Medical Sciences and Health Services. A semi-designed interview was used to gather information.

Results: The factor influencing the physician's lived experiences in dealing with the patient and the patient's lived experiences in dealing with the physician was named as the "physician-patient discourse" factor. This factor included 9 categories in 2 central codes "physician-centered" and "patient-centered" in the physician's lived experiences with the patient and 4 categories in 2 central codes "awareness" and "confidence-building" in the patient's lived experiences in dealing with the physician.

Conclusion: A discourse in which the physician allocates adequate time to efficiently convey training and information, and to take a complete history of the patient, and to establish an effective, friendly, and respectful relationship ultimately lead to the patient's trust. These factors can persuade the patient to adherence to the prescribed treatment.

One of the most important concerns during the covid-19 pandemic is an imbalance in health services.

Considering significant mortality among hospital staff and the general population, a great apprehension was raised in society. Consequently, many patients with symptoms were rushed to hospitals. In this regard, to keeping clinics away from overcrowding, call interview with patients plays a crucial role in not only patients screening but also treatment approach.

Background & Objective: Cancer is a global concern, and the management of cancer patients dealing with various psychological symptoms is a growing concern. Acceptance and commitment therapy (ACT) is effective psychological management in cancer patients improving psychological symptoms. However, the effect of ACT on cancer patients' resilience and general health has not been widely studied. The present study aimed to evaluate the effect of ACT on the general health and resilience of cancer patients undergoing chemotherapy.

Materials and Methods: Sixty patients with breast, lung, or colorectal cancer enrolled in the present study and allocated into intervention and control groups. The Connor-Davidson Resilience Scale (CD-RISC) and General health questionnaire (GHQ) were filled as pretest and post-test after ACT as eight sessions (each session 9') during four weeks for the intervention group and after 4-weeks for the control group.

Results: The mean age of the participants was 35±76.3 years, and the mean age, gender, cancer duration, duration of receiving chemotherapy, and marital status were not significantly different among the study groups. After adjusting for baseline scores, there was a significant difference in study groups in resilience and general health scores. The effects indicate that treatment accounted for 70.9% and 62.6% of the post-test covariance of resilience and general health scores, respectively.

Conclusion: ACT could be an effective psychological intervention in increasing general health and resilience among cancer patients

Introduction
Coronaviruses are a family of viruses identified in the 1960s (1). In December 2019 Chinese scientists and clinicians identified a new coronavirus, SARS-CoV-2 as the pathogen that causes the coronavirus disease 2019 (COVID19) (2, 3). Age is the most considerable risk factor for COVID-19 disease and its fatal clinical outcomes (4-6). Angiotensin-converting enzyme 2 (ACE2) receptors are the critical receptors for the pathogenesis of COVID-19(7). The virus has a high affinity to ACE2 receptors, which are expressed in alveolar cells in the lungs (3) A significant number of aged people have prescribed ACE2 inhibitors and angiotensin II receptor blockers to control hypertension, diabetes, and chronic kidney disease, therefore, these medications increase the risk of infection by SARS-CoV-2 (8).It has shown that ageing individuals with serious medical conditions are more susceptible to develop a severe illness due to COVID-19 infection than healthy individuals (9, 10). However, poor oral hygiene increases the risk of developing the same medical disorders. Thus, improving oral health in older people  may decrease the morbidity of COVID-19 (10). Also this specific population is at risk for developing severe complications related to COVID-19 (11, 12)

Due to the restrictions preventing the spread of COVID-19, oral health care provision for older adults has reduced considerably (13). Besides, older adults may have the fear of being exposed to dental aerosol-generating procedures (14). The reduction in access to dental care during this current pandemic may have considerable and lasting impacts (13).such as worsening oral health, triggering infections lead to local and systemic complications, and compromising general health (15). Oral health care has been stopped in most Long-term Care Facilities due to the recommended measures for isolation (16). Abrams et al. stated the necessity of special infection control in nursing homes during COVID-19 outbreaks (17).

The manifestations of covid-19 in geriatric patients might be severe difficulty in breathing, confused state of mind, bluish lips, and persistent pressure on the chest (15). Due to the weak immune system of geriatrics, dermatological manifestations may be helpful during screening. An irregular oral ulcer has been reported which was suspected to be the oral symptom for SARS-CoV-2 (18). A critical aspect of geriatric oral health care is knowing reduced immunity and impaired healing capacity while managing COVID positive adults (15). Other manifestations of SARS-CoV-2 patients include myalgia, encephalopathy, encephalitis, necrotizing hemorrhagic encephalopathy, stroke, and epileptic seizures (19, 20). Mao et al. (21), reported  36% of the patients who experienced neurological symptoms, were older adults. As the dentists must use additional personal protective equipment during COVID-19 (22), it may develop challenges in patients who have a cognitive impairment, or dementia, because the use of this equipment makes communication difficult. For example, elderly people who have a hearing impairment, find it more difficult to understand a dentist who uses this equipment (23).

Sivaraman et al. (15) proposed five basic steps for effective screening, diagnosis, and treatment of aged patients in the COVID-19 pandemic. These steps are inducted through telephone, texting, or video calls before the patient arrives. In the first step, dentists document personal details and the chief complaint of the patients. In the next step, they should record, medical dental, and drug history. In the third step they evaluate special clinical manifestations of SARS-CoV-2 Infection. Then they present a treatment plan based on the chief complaint and necessity. In the last step, they mention recommendations before, during, and after dental treatment (15). The dental team must emphasize the importance of oral hygiene to the older patient as a part of post-operative instructions (15).

Poor oral hygiene can increase the risk of acute respiratory distress syndrome, pneumonia, septic shock, sepsis, and death in COVID positive aged patients (24).Thus, improved oral hygiene and frequent professional oral health care reduce the progression or occurrence of respiratory diseases, especially in older people (25).

Two strategies can be used to deliver dental care to aged people during the current pandemic: (23) minimal intervention dentistry (MID)(26) and tele-dentistry (27). According to the restrictions during the pandemic, MID can become the low risk strategy for caring for dependent older adults (23). Tele-dentistry is a cost-effective approach to provide the oral care needs for the aged who have no access to care (28, 29). The oral health program including Oral Health Therapists (OHTs) and tele-dentistry can improve the oral health status of residents of nursing homes(30). In conclusion, MID and tele-dentistry can become the new standard way of care for pandemic dentistry for elderly people, including those with cognitive impairment and dementia (23).

Introduction
Coronaviruses are a family of viruses identified in the 1960s (1). In December 2019 Chinese scientists and clinicians identified a new coronavirus, SARS-CoV-2 as the pathogen that causes the coronavirus disease 2019 (COVID19) (2, 3). Age is the most considerable risk factor for COVID-19 disease and its fatal clinical outcomes (4-6). Angiotensin-converting enzyme 2 (ACE2) receptors are the critical receptors for the pathogenesis of COVID-19(7). The virus has a high affinity to ACE2 receptors, which are expressed in alveolar cells in the lungs (3) A significant number of aged people have prescribed ACE2 inhibitors and angiotensin II receptor blockers to control hypertension, diabetes, and chronic kidney disease, therefore, these medications increase the risk of infection by SARS-CoV-2 (8).It has shown that ageing individuals with serious medical conditions are more susceptible to develop a severe illness due to COVID-19 infection than healthy individuals (9, 10). However, poor oral hygiene increases the risk of developing the same medical disorders. Thus, improving oral health in older people  may decrease the morbidity of COVID-19 (10). Also this specific population is at risk for developing severe complications related to COVID-19 (11, 12)

Due to the restrictions preventing the spread of COVID-19, oral health care provision for older adults has reduced considerably (13). Besides, older adults may have the fear of being exposed to dental aerosol-generating procedures (14). The reduction in access to dental care during this current pandemic may have considerable and lasting impacts (13).such as worsening oral health, triggering infections lead to local and systemic complications, and compromising general health (15). Oral health care has been stopped in most Long-term Care Facilities due to the recommended measures for isolation (16). Abrams et al. stated the necessity of special infection control in nursing homes during COVID-19 outbreaks (17).

The manifestations of covid-19 in geriatric patients might be severe difficulty in breathing, confused state of mind, bluish lips, and persistent pressure on the chest (15). Due to the weak immune system of geriatrics, dermatological manifestations may be helpful during screening. An irregular oral ulcer has been reported which was suspected to be the oral symptom for SARS-CoV-2 (18). A critical aspect of geriatric oral health care is knowing reduced immunity and impaired healing capacity while managing COVID positive adults (15). Other manifestations of SARS-CoV-2 patients include myalgia, encephalopathy, encephalitis, necrotizing hemorrhagic encephalopathy, stroke, and epileptic seizures (19, 20). Mao et al. (21), reported  36% of the patients who experienced neurological symptoms, were older adults. As the dentists must use additional personal protective equipment during COVID-19 (22), it may develop challenges in patients who have a cognitive impairment, or dementia, because the use of this equipment makes communication difficult. For example, elderly people who have a hearing impairment, find it more difficult to understand a dentist who uses this equipment (23).

Sivaraman et al. (15) proposed five basic steps for effective screening, diagnosis, and treatment of aged patients in the COVID-19 pandemic. These steps are inducted through telephone, texting, or video calls before the patient arrives. In the first step, dentists document personal details and the chief complaint of the patients. In the next step, they should record, medical dental, and drug history. In the third step they evaluate special clinical manifestations of SARS-CoV-2 Infection. Then they present a treatment plan based on the chief complaint and necessity. In the last step, they mention recommendations before, during, and after dental treatment (15). The dental team must emphasize the importance of oral hygiene to the older patient as a part of post-operative instructions (15).

Poor oral hygiene can increase the risk of acute respiratory distress syndrome, pneumonia, septic shock, sepsis, and death in COVID positive aged patients (24).Thus, improved oral hygiene and frequent professional oral health care reduce the progression or occurrence of respiratory diseases, especially in older people (25).

Two strategies can be used to deliver dental care to aged people during the current pandemic: (23) minimal intervention dentistry (MID)(26) and tele-dentistry (27). According to the restrictions during the pandemic, MID can become the low risk strategy for caring for dependent older adults (23). Tele-dentistry is a cost-effective approach to provide the oral care needs for the aged who have no access to care (28, 29). The oral health program including Oral Health Therapists (OHTs) and tele-dentistry can improve the oral health status of residents of nursing homes(30). In conclusion, MID and tele-dentistry can become the new standard way of care for pandemic dentistry for elderly people, including those with cognitive impairment and dementia (23).

Conflict of interest

Author declares no conflict of interest.

Objective: With the introduction of digital crypto currency, the worth of data has been obvious to everybody. Of course, this research is in the sphere of medicine. The goal of this research is to perform a comprehensive evaluation of studies in the area of health information system data sharing and secondary uses of health data, with the goal of generating value in multiple dimensions by sharing these data.

Material & Methods: The researchers used the intelligent Web of science and IEEE search engines to conduct a systematic evaluation of English-language keyword searches. Two tactics have been studied in this respect, one using keywords related to "health data value" and the other using terms linked to "health data sharing."

Results: Although several studies have suggested solutions for decreasing obstacles to health information system data sharing, they have often simply addressed the problem, according to one criticism of the papers examined. The sharing barrier has no remedy, and its relevance is simply emphasized.

Conclusion: It was discovered that not all of the successful components of data sharing, particularly data from health information systems, were addressed in the evaluated studies.

Objective: Long non-coding RNAs (lncRNAs) are characterized as non-coding transcripts greater than 200 nucleotides. lncRNAs have extensive molecular connections with proteins and microRNAs, which are important in the regulation of gene expression in physiologic and pathologic states including cancer. About 18% of human LncRNAs were recently found to be associated with tumours. Many studies indicated that aberrant expression of LncRNAs play key roles in the progression and metastasis of NSCLC. In this study we evaluated the expression of long non-coding RNAs: GHET1, BACE1-AS, PANDA, UCA1 in non-small cell lung cancer.

Material & Methods: In this study, RNA was extracted from tumor tissues of NSCLC and paired adjacent normal lung tissues. After cDNA synthesis, the relative expression level of lncRNA GHET1, BACE1-AS, PANDA, and UCA1 genes was studied by TaqMan Real-Time PCR, and the data were analyzed by 2^-∆∆CT. The t-test was used to compare the values and P-value < 0.05 was considered statistically significant.

Results: The data of qRT-PCR analysis revealed that the expression level of GHET1 gene in patients with NSCLC is increased (P= 0.0032) and BACE1-AS showed down-regulation (P= 0.0093). There was no significant change in the expression of PANDA and UCA1 genes.

Conclusion: Our study sheds lights on the expression signature of several crucial lncRNAs in human lung cancer. This data not only could be further be utilized for different therapeutic approaches but also reveal the changes in biological processes of human lung tumors.

Objective: Recognition of probable risk factors for cardiovascular disease is crucial in non-CAD patients for preventive programming. The purpose was determination of 10-year cardiovascular disease (CVD) among patients without current cardiovascular disease.

Material & Methods: In this observational study that was performed as a diagnostic survey, 606 consecutive patients without current cardiovascular disease, referring to Modarres and Loghman Hospitals, Tehran, Iran in 2017 and 2018 were enrolled and ASCVD plus score determined the 10-year cardiovascular disease among them.

Results: The results in this study demonstrated that mean ASCVD plus score was 13.1 ± 14.9 points. Among cases 284 (40.9%), 67 (11.1%), 154 (25.4%), and 137 (22.6%) patients were in groups 1, 2, 3, and 4, respectively. The mean risk was higher in men, diabetics, smoker, users of anti-hypertensive, statins, and aspirin, older, with higher blood pressure, and also with higher total and LDL cholesterols.

Conclusion: Totally, according to the obtained results in current study, it may be concluded that 10-year risk of cardiovascular disease is relatively high among patients without current cardiovascular disease. This matter shows the importance of routine screening in such population.

One of the most important problems from the past to the present is deadly opportunistic disease in developing countries, which leads to increase mortality in the world. Microbial pathogens such as fungi, bacteria, parasites, and viruses can cause these deadly opportunistic infections. Herbal medicines in the form of nanoparticles, nanocapsules, and biocompatible polymers, and liposomes can be effective in reducing mortality from these infections. Also due to the excessive use of antibiotics, microbial resistance is expanding day to day. On the other hand, indigenous, cheapness, availability, and rich source of effective herbal substances have made these compounds have many applications in biomedical fields. The aqueous extract, essential oil, and active ingredients of various parts of plants such as bark, stems, leaves, fruits, and seeds are used in the treatment of infectious diseases. This article provides information about medicinal plants that have antibacterial properties and are used to treat microbial infections. It is hoped that using this method can reduce and treat microbial infections to some extent.

Background: The frequent use of brain computed tomography (CT) scans in emergency settings necessitates accurate reporting of CT results as quickly as possible. Conventional CT scans produce grayscale images, requiring window width and center level changes, resulting in a need for time-consuming interpretation by experienced radiologists. This study aimed to design a novel software application for automatic smart colorization of conventional brain CT images and to evaluate the diagnostic accuracy, visual quality, ease of diagnosis, and reporting time for color CT images compared to conventional grayscale CT images.

Materials and Methods: First, we designed an application that converted non-enhanced grayscale brain CT images into color images according to the Hounsfield unit value of different tissues (e.g., brain, fat, bone, fluid, air) with minimal noise so that all brain tissues could be evaluated using one window level. This process took less than one second, without the need for high-end systems. Next, 75 printed images (25 unprocessed grayscale CT, 25 processed color CT, and 25 magnetic resonance imaging [MRI]) from 25 patients with hemorrhagic or ischemic stroke were read by two experienced radiologists. The radiologists scored the CT images from each patient (unprocessed grayscale and processed color) on a ten-point scale for visual quality and ease of diagnosis compared to the MRI image.

Results: The mean visual quality score was 18% higher and the mean ease of diagnosis score was 23% higher for colorized images than for grayscale images (both P < 0.001). Statistically, there were no significant differences in the diagnostic accuracy or reporting time between color and grayscale images.

Conclusion: This is the first study to report automatic smart colorization of non-enhanced brain CT images, producing high-quality colorized images with better visual quality and ease of diagnosis compared to grayscale CT. This low-cost solution can be widely applied in clinical settings, regardless of minimal facility or resource availability.

Background and Objective: Periodontal problems are very common among patients undergoing fixed orthodontics treatment. Using mouthwashes such as Listerine and Persica is recommended in order to prevent such complications. There have, however, been no information on the comparative effects of Listerine and Persica mouthwashes so far. Thus the comparative study presented here under the title of “Evaluating the comparative effects of Listerine Zero and Persica Mouthwashes on the Periodontal Conditions of fixed orthodontics Patients was conducted at the Department of Dentistry of Azad University of Tehran.

Materials and Methods: A blind randomized clinical trial was conducted on 30 patients. All subjects were between 20 and 50 years of age; had been under fixed orthodontic treatment for at least two months; did not have serious systemic health complications; had a minimum of 5 teeth in each quadrant for evaluation. Root planning and scaling were conducted on male and female subjects prior to their entry into the study. The SI, GI, PI, and BOP indices of each subject were then recorded in the base-line stage. The subjects were then divided into two random groups. The first group was treated with Persica (Pursina Co., Iran) and the second group with Listerine Zero (Johnson & Johnson, New Jersey, USA). The two groups were followed up twice after two and four weeks of treatment and their SI, GI, PI, and BOP indices were recorded.

Results: The SI, GI, PI, and BOP indices were found to have changed by similar amounts in both groups (P<0.12). The changes in GI, PI, and BOP were, however, statistically significant within each group (P<0.02). The changes in SI index within the Persica group were found to increase only within the first two weeks of treatment (P<0.05).

Conclusion: Following the comparative study described above, both mouthwashes appear to positively affect the periodontal condition of fixed orthodontics patients. Both mouthwashes were, however, found to have similar effects.

Background and Objective: The outbreak of coronavirus in Wuhan, China in 2019 has caused numerous mental health problems around the world. Among the psychological problems that have emerged due to the Covid-19 pandemic are symptoms of psychological distress, such as anxiety, depression, and PTSD disorder. The present study aimed to investigate the relationship between psychological distress, coping strategies, and PTSD among three various populations, namely the general population, hospital staff and staff of health centers during the Covid-19 pandemic.                                                                 

Materials and Methods: Pearson’s correlation coefficient was used to investigate the relationship between the study variables. Using convenience sampling, a sample of 450 individuals (150 participants from each population) was selected to participate in the research.

Results: The findings indicated that psychological distress was significantly and negatively correlated to PTSD between two populations, i.e., the general population (r = -0.708, P < 0.01), and health center staffs (r = -0.216, P < 0.01), but coping strategies were not associated with psychological distress and PTSD in these two populations. However, the results were different among hospital staffs; in that psychological distress was significantly correlated with coping strategies (r = -0.170, P < 0.05), and PTSD (r = -0.216, P < 0.01), and there was a significant correlation between coping strategies and PTSD (r = -0.270 P < 0.01) among this population.

Conclusion: These findings highlighted the need for educational courses and psychological interventions to inform different populations about various coping strategies in stressful situations, and to reduce symptoms of psychological distress during the pandemic

Malaria, the best example of infectious protozoan diseases, has been tremendously impacted the human genome. The global spread of malaria reflects the successful adaptations of Plasmodium in human host and its Anopheles vector. The potential defences of Plasmodium deal with diverse mechanisms of host immunity and persist in human with headstrong success. In an evolutionary arms race, human has developed malaria protective polymorphisms to survive. These polymorphisms provide safeguards human against the malaria. Anopheles has developed pesticide resistance for their survival. This article briefs the interactions among Plasmodium, Anopheles, and human to provide evolutionary insight on malaria related genetic polymorphisms and to determine the evolutionary fitness of human, Plasmodium and Anopheles.

Background and Objective: Covid-19 pandemic is a worldwide bothersome issue. Although the appropriate strategy for plasma donation from recovered Covid-19 cases should be based on clinical, laboratory, and demographic characteristics of cases, consent for plasma donation is crucial. Moreover, the safety of donation is important not only for receiving cases but also for donor subjects. Accordingly in this study, the existing conditions in plasma donors for Covid-19 were assessed.

Materials and Methods: In this descriptive cross-sectional study, 264 consecutive cases with positive Covid-19 infection history were enrolled in 2020 a total of 64 cases were eligible for plasma donation. The initial two stages for consent and medical history were done by phone call and two final steps including laboratory results and physical examination were carried out after patients’ attendance to the hospital.

Results: Mean (standard deviation) age was 45.3 (9.1) years. There were 58 male cases (90.6%). Totally 70.3% had academic literacy and 90.6% were married. Even thirteen cases (20.3%) had underlying diseases. There was not any significant early or late complication during donation. Causes for plasma donation were mentioned help to humankind, severe disease experience, and help to research projects in 41 (64.1%), 14 (21.8%), and 9 (14.1%) cases, respectively.

Conclusions: It is necessary to inform the post-covid-19 patient about the advantages of plasma donation as a safe way for critically ill patients to decrease the burden of the disease in their current condition without confirmed drugs.

Background and Objective: The COVID-19 emergence obliged many governments to exert public health measures. However, it seems a vast difference in levels of respect towards health-related guidelines. Among all age groups, adolescents are known to have low conformity to such rules and display a crucial role in spreading the virus. In efforts trying to find the key contributing factors of such extensive non-compliance, much pandemic research attention has been focused on the adult population and adolescents have not been widely addressed. This paper examined the role of personal fable, sensation seeking and social alienation in the adoption of Covid-19 recommended practices in adolescents.

Materials and Methods: This cross-sectional study collected data from 355 adolescents during strict restrictions imposed on the country. The survey was administered online over three weeks. Participants were asked to complete self-report measures. Data were analyzed by correlation and regression analysis.

Results: Data shows an inverse correlation between the variables and compliance, among which disinhibition and invulnerability had the strongest association. These subscales were predictors of non-conformity with official pandemic guidelines. Likewise, social alienation was predictive of rule disrespect. Furthermore, females and those lacking history of Corona disease exhibited more active pandemic-related behaviors.

Conclusions: It seems that some peculiar characteristics of this developmental stage have an outstanding role in explaining adherence to pandemic-related preventative behaviors.

Background and Objective: Since the Covid-19 virus has caused many psychological problems for humans since its initial outbreak, Therefore, the present study aimed to determine the moderating role of emotion regulation in predicting sleep quality based on coronary anxiety and stress caused by the Covid-19 virus.

Materials and Methods: The present study was a descriptive correlational study. The statistical population of the study includes all the people of Iran in 2020, which were selected through questionnaires that were placed electronically on popular sites, channels and media, and finally, 239 people answered the questionnaires. Research tools include; Alipour Corona Anxiety Questionnaire (2020), Lavibund and Lavibund Stress Questionnaire (1995) (which was presented to the participant with emphasis on Covid-19 syndrome), Emotional Regulation Questionnaire (ERQ-10) and Pittsburgh Sleep Quality Questionnaire (1989). The obtained data were studied by descriptive statistics, correlation coefficient, regression analysis and analyzed simultaneously and hierarchically by SPSS-23 statistical software.

Results: The results showed that anxiety and stress caused by Covid-19 have a significant relationship with sleep quality (P <0.001), so that both can cause 0.41 changes in sleep quality. Also, the results of hierarchical regression analysis to predict the quality of sleep from the multiple of the deviating scores of anxiety and stress confirmed the moderating role of emotion regulation, which was significant at the level (P <0.001).

Conclusions: Therefore, it can be concluded that anxiety and stress caused by Covid-19 can predict the quality of sleep and in the meantime, emotion regulation can play a moderating role, therefore it is suggested Health professionals focus on the important role of emotion regulation in critical situations.

Background and Objective: For about three decades, the internationalization concept has been crucial and necessary for medical education from the viewpoint of universities and the government. The "internationalization" definition depends on the educational conditions in related studies is not the same and indicated diverse concepts. Developing a conceptual model of medical faculties’ perspective is the first step to stimulating and localizing the internationalization program in Iran.

Materials and Methods: A mixed-method was applied. Semi-structured interviews with experts were performed and an expert panel was formed by the snowball method. To complete the construction of the questionnaire, based on the experts' viewpoint, the internal consistency of the components was evaluated by Kendall's coefficient of concordance (W). The questionnaires were distributed randomly stratified selected 450 faculty members of medical universities and their responses were quantitatively analyzed using SPSS24 software. Cronbach's alpha index was applied to examine the reliability of the questionnaire-research tool. To identify the structural relationship between the components and dimensions, the method of Structural Equations with Partial Least Squares (PLS) was performed.

Results: The developed conceptual model extracted and emphasis on two dimensions of at-home and cross-border.

Conclusions: The model suggested that policymakers should consider internal and external internationalization dimensions and their seven rationales. Regardless of the higher significance of the external dimension, the hidden components of the internal dimension (in specific planning, and facilities/budget) demonstrated the highest impact factor on the internationalization of medical education.

Background and Objective: The purpose of this research is the effectiveness of teaching communication skills on the quality of life and mental health of nurses. The design of this research was semi-experimental, pre-test-post-test. The community of this research is Karaj nurses.

Materials and Methods: The sample of this research included 15 nurses from Karaj. These people were selected by voluntary sampling method with replacement and random application and 15 people were evaluated before the training through the questionnaire of communication skills, quality of life and mental aspect and after the training they were evaluated again by the aforementioned questionnaires. Eight sessions of two days a week with two hours a day of Dr. Qasimiannejad's communication skills package were conducted by researchers (Malekzadeh and Alishiri) in Februrary 2020. The research data was analyzed with SPSS version 22 software.

Results: The results showed that there was a significant difference in the components of general psychology, anxiety, depression and aggression in the pre-test and post-test of the experimental group, so that the presence of these components in the experimental group decreased after training.

Conclusions: It can be concluded that teaching communication skills can improve the mental health and quality of life of people.

Background and Objective: More than a century after discovering probiotic strains, the food and dairy industries are increasingly looking to improve their products with these beneficial bacteria. This study aimed to analyze the potential characteristics of Iranian native probiotics and evaluate the safety of native probiotic Bifidobacterium isolated from the intestines of local chickens to discover the production potential of additives for food and dairy industries and feed.

Materials and Methods: After sampling and preparing serial dilution, the samples were identified using biochemical tests. To confirm probiotics, growth ability was performed at different pHs, dilutions of bile salts and NaCl, isolated antimicrobial activity against common pathogens, and antibiotics susceptibility. Finally, the optimal strains were identified by molecular methods.

Results: Four strains of the 15 gram-positive catalase-negative strains were biochemically similar to Bifidobacterium. Themes grew at PH 3-9 and different concentrations of bile salt and NaCl. These bacteria also had antimicrobial activity against common pathogens and were resistant to many antibiotics. Strains E1 and E4 had better probiotic properties. Finally, the molecular test showed that strains E1 and E4 were 100% similar to Bifidobacterium animalis and Bifidobacterium langum, respectively.

Conclusions: The intestines of local chickens in Ardabil province contain probiotic bacteria such as Bifidobacterium animalis and Bifidobacterium langum. Therefore, these bacteria can be used in the food and dairy industries and improve livestock and poultry feed

Abstract

Background and Objective: The use of angiography is the gold standard in the diagnosis of pulmonary embolism (PE). However, the invasive side effects and being less accessible, it is rarely performed. This study sought to determine the sensitivity, specificity, accuracy and positive and negative predictive value of Wells Rule and Revised Geneva Score in identifying patients with pulmonary embolism.

Materials and Methods: This cross-sectional study was performed on 214 patients with suspected pulmonary embolism who referred to Masih Daneshvari Hospital in Tehran, Iran in 2020. The researchers recorded the CT angiographic findings of patients suspected of having pulmonary embolism. All the patients were evaluated based on each of the Wells Rule and revised Geneva score. Finally, the sensitivity and specificity of each score was evaluated in comparison with CT angiography as the gold standard method in the diagnosis of pulmonary embolism.

Results: The overall mean scores of the Revised Geneva Score and Wells Rule were 99.2± 33.6 and 68.2± 96.3, respectively. The sensitivity, specificity and accuracy of the Revised Geneva Score were 90.6, 47.4 and 72%, respectively. The sensitivity, specificity and accuracy of the Wells Rule were 71.8, 75.3 and 77%, respectively. The positive predictive values (PPV) for the Wells Rule and the Revised Geneva Score were 67.5 and 77.8, respectively. Finally, the negative predictive values (NPV) for the Wells Rule and Revised Geneva Score were 80.7 and 68.9, respectively.

Conclusions: The Revised Geneva Score is highly accurate in diagnosing pulmonary embolism. The score could be used as a non-invasive clinical evaluation tool in the diagnosis of PE.

Background and Objective: Various studies have investigated the role of emotional contagion in various emotional disorders, but the role of emotional contagion dimensions in the psychological symptoms during the Covid-19 epidemic has not been investigated. Therefore, the aim of this study was to investigate the dimensions of emotional contagion on depression, anxiety and post-traumatic stress disorder of hospital staff during the Covid-19 epidemic.

Materials and Methods: This was cross-sectional descriptive correlational study. The present study population consisted of hospital staff of Shahid Beheshti University of Medical Sciences who were selected by convenience and with the help of inclusion criteria in the winter of 1399 that 200 people were selected by Convenience Sampling and measured by Depression Anxiety Scale (DASS)(PTSD check list for DSM5 (PCL-5) and the Emotional contagion Scale.

Results: The dimensions of emotional contagion can explain 18% of the variable changes in the criterion of depression. The dimensions of emotional contagion can explain 28% of the variable changes in the anxiety criterion. The dimensions of emotional contagion can explain 43% of the variable changes in the post-traumatic stress disorder criterion.

Conclusions: According to the findings of the present study, it can be concluded that education about emotional contagion and awareness of its effect on psychological problems play an important role in improving the psychological condition of hospital staff in pandemic conditions.

Background and Objective: It is now well known that thyroid disorders can affect the structure and function of the gastrointestinal tract. Hypothyroidism is associated with a wide range of intestinal symptoms, including constipation, bloating, flatulence, atrophic gastritis, ileus, atony, and dilatation of the esophagus stomach, gallbladder, small intestine, and colon. In uncontrolled and severe cases, the disease can lead to intestinal pseudo obstruction, paralytic ileus, and megacolon. In this case report, we presented a patient suffering from intestinal pseudo obstruction secondary to severe hypothyroidism.

Case Presentation: The patient was an 83-year-old woman who was hospitalized due to abdominal pain. The patient had uncontrolled hypothyroidism and complained of intestinal obstruction with the main symptom of no gas and fecal excretion. Abdominal CT scan shows dilated small and large bowel down to the rectum especially more dilated rectum, more suggestive of bowel ileus without mechanical obstruction. With the proper replacement of thyroid hormones, the patient's obstruction was resolved and she was discharged from the hospital in good general condition.

Conclusions: Since hypothyroidism can rarely lead to intestinal pseudo obstruction, we recommend that hypothyroidism be considered as an underlying cause in patients with uncontrolled hypothyroidism and obstruction of the small intestine without any mechanical obstruction.