Researcher Bulletin of Medical Sciences

Objective: We aimed to assess the role of virtual media in people's participation in controlling the COVID-19 pandemic.

Materials and Methods: This cross-sectional study was conducted from January to March 2022 using a researcher-made questionnaire via a panel expert. Considering participation of 10 experts, according to Lawshe table, the minimum value of the CVR index of 0.62 and the minimum score of the CVI index of 0.79 were acceptable. The questionnaire included two parts of demographic data and the assessment of the use of social network and its effect on people's participation to manage COVID-19 pandemic. The questionnaire was circulated, and all people were invited for participation.

Results: The response rate was 58% and 468 participants with a mean age of 38.5 ± 11.5 years took part in this study of which 42.3% were male.

The quality of the samples and data were suit for factor analysis, KMO index was more than 0.6 and the p-value (0.05) with Cronbach's alpha (0.88.).

So according to the highest factor loading, 7 factors including the level of knowledge, the role of non-interactive media for providing information regarding COVID19, the level of people's participation regarding compliance with protocols, the role of the media and trust in the media, controlling the psychological burden of the disease, the role of the interactive media, the role of other sources of information.

Conclusion: The confirmatory factor analysis revealed that this tool by 7 factors could assess the role of virtual media in people's participation to control the COVID-19 pandemic

Objective: Given the high prevalence of metabolic syndrome and GDM in pregnancy and their impacts on maternal and newborn outcomes, this study was performed to assess the relationship between the components of metabolic syndrome in the first trimester with gestational diabetes occurrence.

Materials and Methods: A fasting blood sample was obtained for measuring fasting blood sugar (FBS) triglyceride (TG) and High-Density Lipoprotein (HDL) levels. If the mother had 3 or more of the following criteria, they were considered as having gestational metabolic syndrome (GMS). 1-Pre-pregnancy BMI≥Kg/m² 2- FBS≥100 mg/dl, 3- TG≥150 mg/dl,4-HDL<50 mg/dl,5-BP≥130/85 mm/Hg.

Results: Gestational diabetes occurred in 78 participants (15% of mothers). The results showed that metabolic syndrome itself (p-value: 0.022) and high triglyceride and FBS levels (p-values <0.001 both) had significant relationships with the occurrence of gestational diabetes. Logistic regression analysis showed increasing maternal age (OR:1.065, p-value: 0.046) and a history of gestational diabetes in previous pregnancies (OR: 6.562, p-value: 0.010) were significantly related to the occurrence of GD.

Conclusion: It was observed in this study that among the components of metabolic syndrome, high levels of blood sugar, and triglycerides in the first trimester of pregnancy were associated with the occurrence of gestational diabetes.

Objective: The aim of this study was investigating the effect of 8 weeks of moderate resistance training (MRT) and Lactobacillus Reuteri probiotic on the serum concentration of liver enzymes and weight changes in male Wistar rats with non-alcoholic fatty liver disease (NAFLD).

Materials and Methods: This research was conducted on 32 male Wistar rats aged 8 to 10 weeks with a weight range of 230 to 300 grams. Male rats were randomly divided into 4 groups of 8. All animals were weighed at the beginning and weekly using a digital scale. Serum levels of liver enzymes were checked at the beginning, middle and end of the study.

Results: In general, the findings of this study showed that at the end of the intervention, the level of ALT was significantly reduced in the groups receiving supplements and resistance training, but the serum level of AST was significantly reduced only in the group receiving probiotic supplements (P<0.05). Changes in weight also showed a significant increase in all 4 groups at the end of the eighth week.

Conclusion: The findings of the present research showed that 8 weeks of moderate intensity resistance training and Lactobacillus Reutteri probiotic supplement alone improved liver enzyme function (especially ALT serum level) in rats with non-alcoholic fatty liver disease.

Objective: Watching porn can have many consequences at different ages. Adolescence is one of these periods that is important for human sexual development, and unhealthy sexual development in this period may expose adolescents to a variety of problems such as high-risk sexual behaviors. Our aim in this study was to investigate the correlation between childhood traumas and watching porn in Iranian male adolescents.

Materials and Methods: The research method of this study was cross-sectional and convenience sampling method was used for recruiting participants. 154 male adolescents completed the self-reported questionnaires through the online link. All analyses were performed by SPSS software version 26.

Results: Results indicated that sexual abuse was significantly correlated with watching porn (rs = -0.161, p<0.05) and there weren’t any correlations between other traumas with it.

Conclusion: Screening watching porn in adolescents at risk and incorporating prevention programs are needed. Future research that uses multiple methods of assessment, includes longitudinal designs, and identifies pathways between watching porn and adolescent health risks is recommended.

Objective: Non-alcoholic fatty liver disease is known as one of the chronic liver diseases that is closely related to obesity and metabolic disorders, and borage improves oxidative indices due to its antioxidant properties. The aim of this study is to investigate the effect of a part of aerobic exercise with borage extract on the serum concentration of liver enzymes and lipid profile in rats with non-alcoholic fatty liver disease.

Materials and Methods: In this experimental study, 40 male Wistar rats weighing 250-300 grams were divided into 4 groups (N: 10). The groups were: Control group (suffering from fatty liver and receiving enough water and food/without exercise and supplements) supplement group (suffering from fatty liver and receiving 200 mg/kg borage extract) exercise group (suffering from fatty liver and doing aerobic exercise daily for 8 weeks) exercise + supplement group (suffering from fatty liver and receiving 200 mg/kg borage supplement and performing aerobic exercise for 8 weeks). At the end, blood was drawn from all the animals, then the serum lipid profile, including total cholesterol and triglycerides, as well as liver enzymes such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured by ELISA method. They were analyzed with SPSS and a significance level of <0.05.

Results: The findings of the present study showed that in the comparison of total cholesterol serum level changes during the study period after poisoning, there was a significant decrease in the control groups (P=0.004) and supplement (borage extract) + exercise (0.047). P=0) was observed. Nevertheless, the training and supplementation groups showed a significant increase in serum total cholesterol levels during the study period. In addition, comparing the changes in serum triglyceride levels during the study period after poisoning, only a significant decrease was observed in the supplemented group (P=0.002). Also, comparing the changes of serum ALT level during the study period after poisoning, a significant increase in serum ALT level was observed in the control (P=0.045) and exercise (P=0.002) groups. The supplement group also showed a significant decrease in ALT serum level (P<0.001). In comparing the changes of AST serum level during the study period

after poisoning, a significant decrease was observed in the control (P=0.003) and supplement (P=0.006) groups.

Conclusion: The findings of the present study showed that 8 weeks of supplementing with borage extract alone reduced serum triglyceride, AST, and ALT levels, and 8 weeks of aerobic exercise with borage extract reduced total cholesterol levels in rats with non-alcoholic fatty liver disease.

Objective: This study aimed to predict mental health through Attachment style, the experience of pain, and coping strategies in MS patients of the Iranian MS association.

Materials and Methods: The present study is a cross-sectional Study. It was conducted using the available Sampling method over 345 MS patients of the Iranian MS association. After obtaining informed consent, the General Health Questionnaire (GHQ-28), Short Form-McGill Pain Questionnaire-2 (SF-MPQ-2), Adult Attachment Inventory (AAI), and Coping Inventory for stressful situations short form (CISS-SF) responded. Used statistical methods, including Pearson correlation coefficient and multiple regression, were used for data analysis software were used SPSS24.

Results: Mental health has a positive and significant relationship (sig=0.00 t=7.1 β=0.30) and plays a significant role in predicting mental health. Also, coping strategy (sig=0.03 t=2.1 β=0.90) and pain experience (sig=0.00 t=11.3 β=0.48) significantly predicted mental health in people with MS.

Conclusion: These results suggested that mental health can predicting through attachment style, pain experience, and coping strategies.

Objective: The prevalence of high-risk behaviors among individuals living with HIV remains a significant concern. Understanding the factors that contribute to these behaviors is crucial for developing effective interventions. This study aims to use network analysis to examine the complex relationships between personality traits, attachment styles, and high-risk behaviors in people with HIV, with the goal of identifying key factors and informing targeted interventions.

Materials and Methods: Participants were recruited online, resulting in a sample of 452 individuals (68.1% male) with a mean age of 33.4 years. Measures included the PID-5-BF for personality traits, Self-reported Attachment Style for attachment styles, and RISQ for risky and impulsive behaviors.

Results: The network analysis showed that among the study variables, PID 6 ("I'm not good at planning ahead") emerged as the most central node, exhibiting high values in betweenness centrality. Similarly, PID 7 ("My thoughts often don't make sense to others") displayed considerable centrality, highlighting its importance in shaping the overall network structure.

Conclusion: These findings shed light on the complex relationships between personality, attachment, and high-risk behaviors in individuals with HIV. The identification of central nodes and strong edges provides valuable information for understanding the network structure and potential intervention targets

Objective: Due to increased worldwide prevalence of cancers, efforts have been made to identify the correlations between chronic disorders as probable risk factors in inducing cancers. Allergies have been long proposed as having promoted or protecting roles against oncogenesis. This study aimed to investigate the probable role of allergic disorders in cancer development in children.

Materials and Methods: Children between 2 to 18 years of age with a history of malignancy referred to Shohadaye Tajrish Hospital (Tehran, Iran), from 2011 to 2015 were recruited to this study. They were all referred to Allergy Clinic for further evaluation for the presence of allergic disorders or any histories of it. A questionnaire was filled for every patient including demographic information such as their age, sex, type of cancer, signs and symptoms of allergy and their severity at onset and before the diagnosis of cancer.

Results: The study was conducted with a total of 56 patients with a mean age of 10.8±4.5 years (2-18 years) and a diagnosis of cancer. The most common cancers in this study were osteosarcoma (39.3%) and acute lymphocytic leukemia (19.6%). Twenty-four (43%) children had a history of allergic disease before the diagnosis of cancer. The most common allergic disease was allergic rhinitis (21.4%). Eosinophilia was detected in 44.6% of children.

Conclusion: To conclude, in children suffering from cancers, particularly those with solid tumors, allergic disorders and eosinophilia were significantly prevalent and also the relative risk of cancers in food allergies were rather high.

Objective: Teaching hospitals have the main role in the health system in developing countries to achieve universal coverage and health equity. This research was aimed to identifying the dimensions of good governance in teaching hospitals in Iran.

Materials and Methods: This research was a qualitative study using thematic analysis. The study population were included managers, leaders and policy makers, Service providers and experts and faculty members of teaching hospitals. Sampling was done purposefully and with the convenience method. Data collection was done using a semi-structured interview. The Brown and Clark method was used in data analysis. To ensure and trustworthiness of the qualitative findings, external audit, long-term involvement in the data, peer check, and participant respondent were used. Data analysis was done using Max.qda 22 software.

Results: Fifteen main themes, 41 sub-themes and 145 codes were extracted from qualitative data analysis. The main themes identified include transparency, management of conflicts of interest and corruption, social accountability, legal factors, social political participation, determining the role and functional area, how to implement policies, policy evaluation factors, educational challenges of the hospital, fulfilling the goals of stakeholders, ethical factors and values, economic accountability (financial factors), educational indicators, service delivery indicators and the rule of law indicators.

Conclusion: Transparency in educational hospitals is the main issue in good governance, so attention should be paid to transparency of costs, transparency of revenues, transparency of payments and even transparency of incentive mechanisms

Objective: Proteus species are the most important cause of urinary tract infections after Escherichia coli. Due to the increasing prevalence of this pathogen and the emergence of antibiotic-resistant strains, this study aims to investigate the genetic diversity between P. vulgaris and P. mirabilis isolates isolated from patients with UTI.

Materials and Methods: 260 samples were collected from October to January 2021 from men and women in different age distributions. P. vulgaris and P. mirabilis species were identified using routine biochemical and microbiology methods. After determining their antibiotic resistance pattern, the genetic relationship of the selected strains was determined using the RAPD-PCR technique.

Results: The antibiotic resistance pattern investigation results showed that all the isolated strains were sensitive to nalidixic acid, cephalothin, ciprofloxacin, and nitrofurantoin. In contrast, all the strains had 100% resistance to tetracycline and penicillin. 34 P. vulgaris isolates were classified into two clusters, A and B. Cluster B predominated among P. vulgaris isolates, and the isolates in this cluster had the most similarities. In comparison, cluster A contained just two isolates. Also, 22 isolates of P. mirabilis were placed in 4 clusters (A-D). The most prevalent sizes of DNA banding patterns identified were 300, 400, 600, and 1000 base pairs.

Conclusion: These findings revealed the genetic variety of the investigated clinical P. mirabilis and P. vulgaris isolates. RAPD-PCR was shown to be a suitable fingerprinting technology for Proteus spp. which may be employed for epidemiological investigations and infection control measures.

Objective: The diagnosis of strangulated hernias cases prior to surgery remains to be a challenging issue. Various diagnostic tests can be used in these patients. Hence, we aimed to evaluate the diagnostic value of leukocytosis, left shift, and ABG in the diagnosis of strangulated cases with incarcerated inguinal hernia.

Materials and Methods: 107 males and 2 females were enrolled in the study. Medical records of emergency hernia operation cases from March, 2016 up to March, 2021, have been evaluated. Preoperative data such as blood tests, medical history, and surgical outcomes were recorded.

Results: Age was higher in the strangulated and incarcerated group. The rate of involvement of the small intestine, the duration of more than 6 hours from the onset of symptoms to surgery, and enlarged prostate size in patients in the strangulated group were higher. Evaluation of WBC, neutrophils, platelets count, and neutrophil to lymphocyte ratio blood levels showed that, except for platelets blood levels, other biomarkers were significantly higher in the strangulated-incarcerated group. The sensitivity of the tests were 0.84, 0.85, and 0.84, respectively. Also, the diagnostic value cut-off points of each of the tests were 9150-9250, 81-84, and 4.71-4.94, respectively.

Conclusion: The results of the present study showed that, the ratio of neutrophils to lymphocytes, neutrophils, and WBC count can be good predictors of strangulated hernia.

Objective: Children with intellectual disabilities (IDs) have deficits in sensory profile, balance, and academic achievement, which diminishes their adaptive functioning. The present study aimed to investigate the effects of computer-based cognitive rehabilitation on sensory profile, balance, and academic achievement of children with mild IDs.

Materials and Methods: This was a quasi-experimental study with a pre-test-post-test design and a control group. The statistical population comprised all the elementary school students with mild IDs aged 7-11 years in Shiraz (Iran) in 2021-2022. A sample of 30 students was purposively selected and divided into two groups: a computer-based cognitive rehabilitation group and a control group (15 students per group). To collect data, the sensory profile, static and dynamic balance tests, and academic achievement were used. The data were analyzed using the analysis of covariance (ANCOVA) in SPSS v. 24.

Results: There was a significant difference between the children with mild IDs in the computer-based cognitive rehabilitation and control groups in the sensory profile, balance, and academic achievement (P<0.01).

Conclusion: Given that computer-based cognitive rehabilitation improved the sensory profile, balance, and academic achievement of children with mild IDs, parents and teachers are advised to use this method to enhance these children's abilities in the mentioned domains.

Objective: Cardiovascular diseases (CVDs) are among the most common non-communicable diseases. They are the leading cause of death worldwide. Omega-3 unsaturated fatty acids are not produced in the human body, so they are essential for humans and are vital for the regulation of human performance. The aim of this study was to evaluate the effect of omega-3 fatty acid supplementation on Nitric oxide (NO) serum levels and anthropometric indices in men with cardiovascular disease.

Materials and Methods: In this double-blind study, 40 male Wistar rats were divided into 4 groups (N: 10). The groups were: Control group, supplement group, exercise group, and exercise + supplement group. At the end, blood was drawn from all the animals, then the serum lipid profile, were measured by ELISA method. They were analyzed with SPSS and a significance level of <0.05.

Results: No statistically significant difference was observed in any of the anthropometric indicators and blood pressure levels (systolic and diastolic) before and after the intervention, as well as within the groups. Also, no significant difference was observed in the serum level of NO before and after the start of the study in both groups, and within each group before and after the intervention, there was no statistically significant difference (P>0.05).

Conclusion: The findings of the present study showed that 10 weeks of supplementing with omega-3 supplementation at a dose of 4 grams per day, didn’t cause any significant changes in serum levels of NO

Objective: Overweight and obesity are among the most important public health concerns associated with several negative health outcomes. Several studies have found that the positive impact of orange juice may be due to the presence of its antioxidants, especially flavonoids and vitamin C. Vitamin C as an antioxidant is capable of neutralizing water-soluble ROS. Therefore, this study aimed to investigate the effect of eight weeks of aerobic exercise with orange juice extract on antioxidant capacity and inflammatory factors in overweight women.

Materials and Methods: A total of 60 overweight women participated in this study voluntarily. The research sample was selected using a random sampling method. They were then randomly divided into 4 groups. The treadmill endurance training protocol was carried out with a run-walk program for eight weeks, three sessions per week. All data were then entered into SPSS 24 to be analyzed.

Results: The results obtained by this study showed that eight weeks of aerobic exercise with orange juice consumption had no significant effect on high-sensitivity C-reactive protein (hs-CRP) levels and total antioxidant capacity in overweight middle-aged women, but eight weeks of aerobic exercise with orange juice consumption had a significant effect on malondialdehyde (MDA) levels and VO2max amount in overweight middle-aged women (P= 0.001).

Conclusion: Statistical studies showed that eight weeks of aerobic exercise with orange juice consumption causes a reduction in MDA levels, and orange juice consumption combined with aerobic exercise can have a synergistic effect compared to aerobic exercise alone and increase the effect of exercise on the oxidative stress suppression

Objective: Weight loss is a basic strategy for the management of Type 2 diabetes mellitus (T2DM). Some studies have suggested that calorie restriction has beneficial effects in the management of diabetes symptoms. The aim of the present research was to evaluate the effects of a low-calorie diet (LCD) on cardio-metabolic risk factors, body composition, and liver enzymes in normal and overweight patients with T2DM.

Materials and Methods: 120 eligible patients (49 female and 71 male) were randomly assigned to one of the four following groups: low caloric (LCD with -500 kcal lower than need) and isocaloric (control) diets for 12 weeks for normal and overweight T2DM patients. Glycemic and lipid profiles, liver enzymes and body composition were assessed before and after the intervention.

Results: 104 patients completed the study. LCD groups presented significant decrease in anthropometric measurements compared to control groups (P<0.05). Glycemic markers, triglyceride, and alkaline phosphatase (ALP) were significantly decreased only in normal-weight LCD group compared to control group. Homeostatic model of insulin resistance, LDL-C, and ALP were significantly decreased only in overweight LCD group (P<0.05). However, insulin sensitivity was significantly increased in LCD groups compared to control groups (P<0.05).

Conclusion: It was found that LCD improved cardio-metabolic risk factors, liver enzymes and body composition in normal and overweight T2DM patients.

Objective: Differentiation of brain tumor recurrence from necrosis caused by radiation after radiotherapy is often considered a radiological ambiguity. The purpose of this study is to investigate the effectiveness of magnetic resonance spectroscopy in differentiating the recurrence of primary brain tumors (glioma) from necrosis caused by radiation.

Materials and Methods: 15 patients (with an average age of 40.07, 8 men and seven women) were examined in this study. The samples of this study were selected from patients who have already been confirmed to have a glioma brain tumor and requested radiotherapy. 12 weeks (or three months) after radiotherapy, MRS imaging sequences with CSI technique and DWI imaging sequence with b-value=1000 s/mm2 were performed for all patients, and metabolic coefficients and quantitative ADC maps were also obtained. Then, the average ADC value and metabolic ratios were calculated for all patients.

Results: The pathological and clinical results of the patients were compared with the results of MRS and DWI. By analyzing the ROC curve on the data obtained from the two techniques implemented in this study, it shows that the area under the ROC curve for ADC maps was higher than that of the MRS technique, which shows that the results of DWI can reliably diagnose and differentiate tumor recurrence from radiotherapy necrosis. Also, the result of this study showed that tumor recurrence has a significantly lower ADC compared to radiotherapy necrosis (p=0.035).

Conclusion: The results of MRS indicates that the metabolic ratios of Cho/NAA and Cho/Cr are higher in people who have had tumor recurrence than in people in whom necrosis from radiotherapy has been reported. DWI images obtained with b-value = 1000 s/mm2 provide more reliable results than MRS images with the CSI technique and are considered a valuable tool in differentiating tumor recurrence from radiotherapy necrosis; the reliability of both imaging results increases, and the ability to detect tumor recurrence from necrosis caused by radiotherapy

Objective: Social anxiety disorder, one of the most chronic and prevalent anxiety disorders, is often referred to as a "hidden disorder" and can significantly impair both occupational and social functioning. This study aimed to determine the efficacy of rumination-focused cognitive-behavioral therapy (RFCBT) in reducing interpretation bias and social isolation among adolescent girls with social anxiety disorder.

Materials and Methods: This study employed a quasi-experimental pre-test, post-test, and follow-up design. The population of the study consisted of all female high school students diagnosed with social anxiety disorder in Ramashir in 2023. A sample of 25 participants was selected using purposive sampling based on the inclusion criteria. Participants completed the interpretation bias and social isolation questionnaires at pre-test, post-test, and follow-up stages. The experimental group received 10 sessions of 90-minute RFCBT. Data analysis was conducted using repeated measures analysis of variance.

Results: The results indicated that RFCBT led to a significant reduction in interpretation bias and social isolation at post-test (P<0.001). This effect was maintained at follow-up, demonstrating the durability of RFCBT.

Conclusion: RFCBT is an effective treatment for social anxiety disorder in adolescent girls. This suggests that RFCBT is a valuable tool for helping individuals with social anxiety disorder overcome cognitive distortions and improve their social functioning. However, more research is needed to determine if these findings apply to different populations and to identify factors that might influence treatment outcomes.

Objective: The swift rise in the elderly population globally presents significant health and social challenges. The World Health Organization (WHO) has crafted the Global Strategy and Action Plan on Ageing and Health (2016-2020) to enhance healthy ageing on a worldwide scale. This study examines how Finland and Japan implement this program and analyze how these countries utilize their policies to improve the situation of the elderly.

Materials and Methods: Data on national ageing programs and population policies in Finland and Japan were reviewed. The experiences of these countries in using evidence to inform policy and program decision-making were also analyzed.

Results: The findings show that Finland focuses on educational and family policies, particularly through the National Programme on Ageing 2030 and studies on future population ageing and productivity, to ensure the improvement of the functional abilities and well-being of the elderly. Japan, meanwhile, uses advanced technologies such as robotics and AI, as well as comprehensive health and welfare policies, to improve the situation of the elderly.

Conclusion: Although Finland and Japan face similar challenges in terms of population ageing, they have adopted different approaches to address these challenges. Both countries can benefit from each other's experiences and contribute to improving the ageing population's situation through international cooperation.

Objective: The healthcare industry is increasingly exacerbated by costs and demands for quality care, creating opportunities to develop service models that can meet this challenge. Value-based healthcare (VBHC) is one of the emerging solutions for simultaneously considering cost and quality.This study was designed to develop a conceptual model for developing new health services utilizing a VBHC approach to health care.

Materials and Methods: A qualitative methodology was utilized, and semi-structured interviews were conducted with 24 project managers from healthcare organizations. Thematic analysis was then conducted on interviews utilizing MAXQDA software; Reliability was ensured through intercoder agreement (ICA = 0.71) and two-case model testing, with independent coding and conflict resolution by a third coder.

Results: The thematic analysis resulted in 964 coded segments, which were categorized into seven themes: Innovation Evaluation, Innovation Process, Innovation Technology, Innovation Culture, Customer Value, Interactive Interface, and Customer Participation. The primary findings highlighted the importance of acquiring cost-effective new services that enhance customer value, promoting an innovative culture within the organization, utilizing high technology, and actively engaging with patients and referring physicians through a patient-centric approach.

Conclusion: The conceptual model provides an initial guide for healthcare organizations to create new services based on VBHC principles. This model simultaneously addresses cost efficiency, technology-oriented innovation, and patient participation in producing health services aligned with patient improvement per cost. Future research can test and validate this model to context and application within a healthcare setting to better understand its usefulness in helping organizations implement more VBHC services.