bluuebunny/crossref_metadata_2025 huggingface dataset:
Difficult Ventilation in a Patient with a Giant Aortic Aneurysm
Authors: Montane-Muntane Mar , Ascaso María , Rivera-Vallejo Lorena , Navarro-Ripoll Ricard
Published: May 2024

Patients with Marfan syndrome present anatomic variations that may increase the risk of a difficult airway. Moreover, they can present large aortic aneurysms, which may cause extrinsic airway compression. Therefore, difficult ventilation during general anesthesia poses a challenge in that the anesthesiologist has to promptly make a crucial differential diagnosis. Multidisciplinary preoperative assessment and planning of the airway and ventilation management are of utmost importance in such uncommon and highly complex clinical cases. Fiberoptic bronchoscopy is probably a really useful tool in order to assess the severity and extent of the airway compression, both preoperatively and intraoperatively. We present a clinical case where difficult ventilation occurred immediately after the induction of general anesthesia.
Relationship between nurses’ emotional intelligence and their perception of patient safety climate
Authors: Kamel Ahlam Esmial , Seada Abeer Mohammed , Aly Sahar Hassan
Published: May 2024

Background

Emotional intelligence is regarded as an important characteristic for building stable and healthy emotions among nursing staff that enhances nursing performance, supports the concept of nurse–patient relationship, and encourages the nurses to be more involved in decision making in providing care. Emotional intelligence helps individuals to perform well in risky tasks and could be beneficial for patients under the care of nurses through improving the patient safety climate.

Aim

The aim was to assess the relationship between nurses’ emotional intelligence and their perception of patient safety climate.

Design

A descriptive correlational design was used for this study sample.

Patients and methods

The study was conducted at New Kasr Al-Aini Teaching Hospital, Cairo University Hospital, on a convenience sample of 250 staff nurses.

Results

The results revealed that the total mean percent of emotional intelligence of nurses was 86.64%, which indicates high level of emotional intelligence, and the total mean score of patient safety climate was 72.33%, which indicates high level of patient safety. In addition, there was a highly statistically significant positive correlation (P=0.00) between emotional intelligence and patient safety climate.

Conclusion

Nurses had high level of emotional intelligence and patient safety climate. There was a highly statistically significant positive correlation between emotional intelligence and patient safety climate.

Recommendation

There should be increased staff participation in development and training to emphasize the power of emotional intelligence. The aim should be to improve the level of self-awareness, self-management, social consciousness, and relationship management among nurses to increase emotional intelligence and maintain patient safety climate.
Impact of empowerment for pediatric nursing students on their knowledge about climate change and its impact on children health
Authors: Ibrahim Marwa A. , AbdElhafez Asmaa M.H. , Hassan Eman A. , Alaswad Nadia K.
Published: May 2024

Background

Ensuring the safe management of global climate change is a crucial objective of sustainable development in 2030. In this endeavor, the medical team’s role is as significant as that of climate scientists. This is due to climate change’s adverse impact on the health of individuals, children, and society. Numerous diseases, including skin disorders, respiratory issues, and gastrointestinal illnesses, are closely linked to climate change.

Aim

The aim of this study was to evaluate the impact of empowerment for pediatric nursing students on their knowledge about climate change and its effect on children’s health.

Research design

The pre–posttest quasi-experimental research design was used to fulfill the aim of the current study.

Setting

The study was conducted at the Faculty of Nursing, Cairo University.

Sample

A convenience sample of 200 pediatric nursing students.

Tools

Two were used for data collection: (a) a structured interviewing questionnaire schedule and (b) a knowledge assessment (pre–posttest).

Results

The mean satisfactory knowledge score after the empowerment was 67.3±3.2 and there was statistically significant differences between students’ knowledge about climate change’s effects on child’s health before and after empowerment (P≤0.05).

Conclusion

After the implementation of empowerment for pediatric nursing students, there was a significant improvement in the level of knowledge among them regarding climate change and its effect on children’s health.

Recommendation

Raising the awareness of students about climate change and its effect on all over child’s body system function so, it is urgent to add knowledge about climate change and its impact on child’s health in the pediatric nursing education curriculum.
Nurses Fatigue Level: Causes and Consequences
Authors: Zahran Aya. S.K. , Fekry Nehad. E. , Hebashy Amal E.
Published: May 2024

Background

Nurses play a critical and vital role in the delivery of patient care, they exposed to workplace hazards and violence, work overload, pain, exhaustionand fatigue which affect their health and social life.

Aim

Of the present study was aimed to assess nurses fatigue level causes and consequences.

Research design

A descriptive design was used to carry out this study.

Setting

The study was conducted in multispecialty private hospital in Cairo which is supervised by Ministry of Health; bed capacity approximately (n = 200 beds).

Sample

Convenient sample of all available nursing staff (n = 300) who are working during the period of data collection.
Data collection tools: The current study data was collected using self-administered questionnaire titled Fatigue Severity Scale (FSS).

Results

The study subjects had high mean scores to all domains and total of fatigue consequences. Clarifying that the highest mean score (77.0 % and 76.6%) was regarding to fatigue and physical activities and Fatigue and lack of energy. Around half (47.3%) of nurses had moderate fatigue level. Also, (32.4%) of them had severe fatigue level. While, the least percentage (20.3%) of nurses had mild fatigue level. There was a highly statistical significant positive relation exists between the study subjects' perception of total fatigue level and their years of experiences, gender, current job position and current working unit (X2 = 15.99, P-Value = 0.00, X2 = 7.99, P-Value = 0.03 X2 = 5.94, P-Value = .015* and X2 = 10.38, P-Value = 0.04*) respectively. While, there is no statistically significant relation between the total fatigue level and their age and qualifications(X2 = 1.33, P-Value = 0.085, and X2 = 1.2 P-Value = 0.12) respectively.

Conclusion

Nurses had high mean scores to all domains and total of fatigue consequences. The highest mean score was regarding to fatigue and physical activities and, fatigue and lack of energy domains. Around half of nurses had a moderate level of fatigue, almost one third of them had a severe level of fatigue, while, the least percentage of them had mild level of fatigue. There was a highly statistically significant positive relation exists between nurses' perception of total fatigue level and their years of experiences, gender, current job position and current working unit. While, there is no statistically significant relation between the total fatigue level and their age and qualifications.

Recommendations

Unit managers should consider staff needs for monthly work scheduling and give the suitable break time during long hour shift and detect negative signs and symptoms of fatigue and how to support and manage nurses. Hospital administrators must encourage nurses to follow a healthy lifestyle, which includes a balanced diet, regular exercise, enough sleep, and stress management techniques and develop appropriate educational programs and preventive strategies for nurses to be able to control fatigue causes and consequences.
Comparing the Cerebral Resistive Index Using Doppler Ultrasound in Neonates before and after Transfusion of Red Blood Cell – A Prospective Observational Study
Authors: Panigrahi Nikita , Venkatesh HA , Patil Balote Vikrant , Kannur Netra S. , Nagesh N. Karthik , Pejaver Rajath
Published: May 2024

ABSTRACT

Background and Objectives:

Anemia is a common morbidity seen in neonates, having an impact on cerebral circulation. Commonly, severe anemia is managed with red blood cell transfusion. This study was done to determine the cerebral hemodynamic change occurring in neonates before and after packed red blood cell transfusion.

Methods:

Neonates who had undergone blood transfusions were prospectively studied using cerebral Doppler ultrasonography. Cerebral blood flow (CBF) velocity of the middle cerebral artery was calculated before and after PRBC transfusion.

Results:

Twenty neonates of median gestational age 34 weeks (interquartile range: 24–40 weeks) with a mean birth weight of 1670 g were enrolled. Pre and post transfusion mean resistive index (RI) were 0.7 and 0.67, respectively, with confidence interval (−0.04–0.09) (P = 0.40). There was a decrease in peak systolic velocity and an increase in end diastolic velocity, though not statistically significant.

Conclusion:

The study concluded that there was no statistically significant difference in the CBF velocities, including RI pre and post PRBC transfusion.
A Study on the Efficacy of Autologous Platelet-Rich Plasma Therapy in Erosive Lesions of Oral Cavity
Authors: Mathew Ashly Monson , Shah Sangita D. , Bhatnagar Nidhi , Shah Mamta C. , Patel Tarak , Bhattacharya Rituparna
Published: May 2024

ABSTRACT

Autologous platelet-rich plasma (PRP) enhances the recruitment, proliferation, and differentiation of cells involved in tissue regeneration. Platelets contain a number of growth factors (GFs) including platelet-derived GFs and transforming GF which stimulate the proliferation of mesenchymal cells and vascular endothelial GFs and fibroblast GF which stimulate new blood vessel formation. This study evaluates the efficacy of intralesional injection of PRP in erosive lesions of the oral cavity. Five patients who attended the dental outpatient department of a tertiary care hospital were selected irrespective of age and sex diagnosed with erosive lichen planus, pemphigus, and three with desquamative gingivitis. Initial assessment including blood investigations and evaluation of extent, severity, activity, and pain was done. Autologous was prepared from 30 milliliters of whole blood collected into a 350 ml blood collection bag after modifying the anticoagulant to whole blood ratio. A soft spin followed by a hard spin in Thermo Scientific™ Heraeus™ Cryofuge™ was used for PRP preparation. On the same day, 0.5 mL PRP was directly injected onto the base and edge of the erosions using a 31 gauge needle. Patients were followed up and evaluated weekly. In pemphigus and desquamative gingivitis, PRP therapy relieved pain, burning sensation, and bleeding which was proven from Visual Analog Scale score and severity score. No adverse reactions were noted in patients. Autologous PRP poses no risk of allergic reaction and natural collagen is formed in response to the presence of activated platelets. The use of PRP is safe, efficient, and economic. The inability to prevent recurrent lesions and the inability to heal the lesion completely are the major drawbacks.
A Survey on the Preexisting Knowledge, Attitude, and Practice of Blood Donation among Medical Students at Entry Level: A Cross-sectional Study
Authors: Wasnik Minal , Kashyap Nitin Kumar
Published: May 2024

ABSTRACT

Background and Objective:

In India, there is a huge gap between blood demand and supply of blood. Young people form blood donors for the future as they are full of idealism and enthusiasm. Targeting medical students at the entry level itself is beneficial as they can be included in the donor pool early. Hence, we planned this survey to understand knowledge, attitude, and practice of blood donation among them.

Methods:

Data were collected using a self-administered questionnaire. A briefing about the study was given to students, followed by 15 min to complete the questionnaire. A short awareness session was also conducted. A pre- and post-session willingness for blood donation was also taken.

Results:

The median age range was 19.36 ± 1.15 years with more males than females. There was a significant difference between knowledge among 1st and 2nd year students; however, attitude and practice showed no difference. Females showed significantly higher knowledge and better attitudes but significantly low practice than males. Significant reasons for blood donation among donors were to help others, even the unknown at the time of need and health benefits for blood donors. The most common reason for nondonation cited by nondonors was fear of weakness/anemia; however, it was not statistically significant. Willingness for donation improved from 83.4% to 93% after the awareness session.

Conclusion:

The participants had a good amount of knowledge and favorable attitude toward blood donation, but the practice of blood donation was less, especially among females. Improved willingness to donate blood following awareness sessions suggests that conducting regular educational and motivational activities will be helpful.
Analysis of Human Leukocyte Antigen Frequency among Renal Transplant Recipients and Donors in Nepal
Authors: Manandhar Rekha , Pandey Gaurab , Bhatta Ranjan Raj , Jha Runa
Published: May 2024

ABSTRACT

Background and Objectives:

Kidney transplants are effective for advanced renal failure, but graft rejection can occur when the recipient’s immune system misidentifies the kidney as a foreign object. Human leukocyte antigen (HLA), a component of the host’s immunological defense system, acts as a barrier to graft rejection. Selecting potential kidney recipients and donors for transplantation requires careful consideration of histocompatibility for the HLA-A, HLA-B, and HLA-DRB1 antigens. Mismatches between donors and recipients prolong transplant therapy, leading to lower graft survival and higher mortality. The objective of the study was to analyze HLA-A, HLA-B, and HLA-DRB1 antigens frequency in live-related renal transplant recipients and donors visiting the Department of Histocompatibility and Immunopathology at the National Public Health Laboratory, Teku, Kathmandu, Nepal.

Methods:

A retrospective study was conducted by using data from 104 renal transplant recipients and donors whose samples had previously been collected, processed, and analyzed to identify the Class I loci (HLA-A and HLA-B) and Class II loci (DRB1) between November 2021 and February 2024.

Results:

The study found that the majority of donors were female, and the majority of recipients were male. In this study, 10, 17, and 12 different HLA-A, B, and DRB1 alleles were found in recipients and donors. Alleles found more frequently are A*11 (25.00%), A*24 (23.08%), sB*15 (22.60%), B*35 (12.98%), DRB1*15 (22.60%), and DRB1*12 (21.63%).

Conclusions:

The study suggests that both donors and recipients of renal transplants in Nepal have a diverse HLA antigen distribution, which could aid in selecting a genetically closer group as potential matched donors for transplant recipients.
Monoclonal Gammopathies of Undetermined Significance and Abnormal Serum Protein Rates Prevelance in Blood Donors: For Improved Transfusion Safety
Authors: Benzouarhia Marwan , Anibat Hajar , El Maliki Bouchra , Morjan Asmaa , Kamal Nabiha , Hajout Khadija , Zahir Abdellatif , Habti Norddine
Published: May 2024

ABSTRACT

Background and Objectives:

Protein abnormalities include monoclonal gammopathies of undetermined significance (MGUS) and malignant lymphoplasmacytic tumors such as multiple myeloma (MM), Waldenström macroglobulinemia, and amyloid light-chain amyloidosis. MGUS prevalence increases with age, especially in individuals over 50. MGUS progresses to various lymphoplasmacytic diseases, including smoldering MM and MM. Almost all blood donors (BDs) are asymptomatic but some of them could present protein abnormalities. Our objective was to assess the prevalence and impact of protein abnormalities and monoclonal gammopathies (MGs) on transfusion safety among BDs in Morocco.

Methods:

Two hundred eighty-one serum samples were collected from BDs aged over 40 years old. Total serum protein measurement and protein electrophoresis were performed using the Architect ci8200 and Capillarys-2-Piercing automated systems, respectively. Immunofixation was conducted using hydrates.

Results:

Protein levels ranged between 59 and 87 g/L (average = 71.69 ± 4.96 g/L). Our results showed 195 (69.39%) normal profiles, 6 (2.13%) MGs, 14 (4.98%) heterogeneous restriction of γ-globulins, and 66 other abnormalities (23.48%) regarding the levels of albumin and proteins from alpha and beta fractions.

Conclusion:

Our preliminary results appeal to blood transfusion professionals regarding ethical considerations and transfusion safety. BDs with abnormal protein levels should benefit systematically from diagnostic tests and therapies.
A Case Report on the Successful Management of Catastrophic Antiphospholipid Syndrome: Multidisciplinary Approach
Authors: Silwal Pragya , Tiwari Aseem Kumar , Aggarwal Geet , Mehta Chitra , Mehta Yatin
Published: May 2024

ABSTRACT

Catastrophic antiphospholipid syndrome (CAPS) is a multi-organ systemic thrombotic condition precipitated due to various secondary conditions such as infection, surgery, and estrogen use. The subsequent formation of various autoantibodies and various organ involvement such as the brain, heart, and kidneys cause rapid progression of the disease. The acute features of thrombosis and the predominant involvement of kidneys and the brain make the differentiation of this condition with other thrombotic microangiopathies difficult. However, early suspicion of CAPS with prompt management is key to favorable prognosis in such patients. Multidisciplinary approach to diagnosis and medical management plays an important role in the successful outcome of CAPS patients. The three pillars of management are therapeutic plasma exchange (TPE), steroids, and anticoagulants. TPE plays a major role in eliminating incriminating antibodies, cytokines, tumor necrosis factor, and complement. We present a case of 34-year-old female with definite CAPS, managed successfully with the triple regimen comprising a total of seven TPE sessions, pulse therapy with steroids, and anticoagulants.
Hemangioendothelioma: A Rare Entity at an Unusual Location
Authors: Patel Jayesh , Patel Nandini Hemant , Maheshwari Jaint , Ajediya Kartik Parmanbhai , Patel Arya
Published: May 2024

Epithelioid hemangioendothelioma (EHE) is a rare type of vascular tumor that behaves in a manner halfway between benign hemangiomas and malignant angiosarcomas. It is histologically distinguished by angiocentricity and solid, cord-like arrangements of epithelioid cells with intracytoplasmic lumina containing red blood cells. Although uncommon in childhood, it can develop at any age and affects both sexes equally. Accurate diagnosis may require further evaluation with tru-cut biopsy due to its potential for false-positive metastatic cancer diagnoses. Treatment approaches vary based on symptomatology, ranging from regular follow-ups for asymptomatic patients to surgical resection with embolization for symptomatic cases. With the help of this case, we want to discuss the importance of considering EHE in the differential diagnosis of vascular lesions and the significance of tailored treatment strategies based on individual patient characteristics.
Atypical Presentation of Vasculitis: A Rare Case of Pediatric Critical Limb Ischemia
Authors: Sony Jithin , Satish Umesh Gheewala , Sagar Radhika , Vinay K S , Palaniswamy Poornima , Nekkanti Muralikrishna
Published: May 2024

Vasculitis is a systemic disorder characterized by inflammation of the blood vessels. Very rarely, it can manifest as critical limb ischemia. In this report, we present a case of a 10-year-old male child who presented with a nonhealing ulcer on his right lower limb for 2 years. After evaluation, he was diagnosed with large-vessel vasculitis and started on steroid therapy. However, the disease progressed despite immunosuppression. An angiogram revealed stenosis in the right external iliac, femoral, and popliteal arteries. Successful balloon angioplasty was performed to treat the stenosis, resulting in a significant improvement in the ankle-brachial pressure index. The patient was continued on steroids and antiplatelets, and subsequent follow-up showed both clinical and symptomatic improvement.
Superior Mesenteric Artery (Ileocolic Branch) Pseudoaneurysm with Contained Rupture Managed with Emergency Covered Stenting: A Case Report and Review of the Literature
Authors: Poornima P , Muralikrishna N , Sravan CPS , Sony Jithin , Vinay K S , Gheewala S Umesh , Vidhyasagar Radhika , Amullya K R , Babu Narendra
Published: May 2024

Splanchnic artery aneurysms are rare, and aneurysms of the superior mesenteric artery (SMA) and its branches are rarer. A pseudoaneurysm can occur in SMA and its branches due to various factors such as infections or inflammation, postsurgical, and posttrauma. Although rare, they can have lethal consequences. Hence, they have to be identified and managed promptly. Here, we present a rare case of pseudoaneurysm of the ileocolic artery (branch of SMA) with contained rupture in a patient postappendicectomy, which was managed endovascularly with a covered stent.
Factors Associated with Mortality among Patients with Colorectal Cancer at the Secondary Care Hospital in Southern Thailand: Hospital-Based Retrospective Cohort Study
Authors: Maimard Yameela , Woradet Somkiattiyos , Chaimay Bhunyabhadh
Published: May 2024

Background:

Globally and in Thailand, the incidence of colorectal cancer (CRC) is third-ranked behind lung and breast cancer, respectively. This hospital-based retrospective cohort study aimed to determine factors associated with mortality among patients with CRC.

Methods:

This study was performed by using the secondary data of the cancer registry among patients with CRC registered in Phatthalung Hospital. Two hundred twenty-eight patients with CRC were diagnosed and followed up from January 2014 to December 2018. Multiple logistic regression analysis was used to analyze factors associated with mortality among subjects with CRC.

Results:

The results revealed that the proportion of mortality among subjects with CRC was 50.44% (115 cases) at six months of following up. Subjects who had an increasing age every ten years (adjusted odds ratio [ORadj] = 1.40, 95 percent confidence interval [95% CI]: 1.09–1.80) were diagnosed with CRC at stage 3 (2.64, 1.19–5.84) and at stage 4 (11.63, 2.69–50.15) more likely to die. Also, subjects who received a combination of chemotherapy and radiotherapy treatment (3.44, 1.20–9.85), combination treatment of surgery, and postoperative care (2.46, 1.22–4.94) were more likely to die. Subjects who had not had surgery treatment were more likely to die (35.00, 7.44–168.27).

Conclusions:

In conclusion, factors such as the age of patients, stage of CRC, and treatment were associated with mortality among patients with CRC. Hence, medical and health professionals should consider these factors according to the treatment and optimization in patients with CRC.
Role of Overcorrecting minus Lens Therapy in Intermittent Exotropia for Prevention of Constant Exotropia in Children under the Age of 7 Years
Authors: Alizadeh Yousef , Medghalchi Abdolreza , Soltanipour Soheil , Mohammadi Mohammad J. , Soltani-Moghadam Reza , Behboudi Hassan , Azaripour Ebrahim , Soleimani Altinai
Published: May 2024

Background:

The basis of the overcorrecting minus lens is to induce compliance and consequently prevent constant exotropia. Some previous studies advocated early surgical therapy and others suggested over-minus treatment. Our purpose is to evaluate the success rate of the over-minus lens.

Methods:

This descriptive cross-sectional study was carried out on 106 patients under the age of 7 years with intermittent exotropia (IXT) who attended Amir-Al-Momenin Hospital at Guilan University of Medical Sciences, Iran. The data was gathered by a form including sex, age, level of cycloplegic refraction, the amount of deviation before and after using the over-minus glasses, visual acuity, the amount of the over-minus glasses, duration of treatment, recovery, and follow-up. The success rate was defined as decreasing exotropia to less than ten prism diopters or exophoria.

Results:

A total of 106 patients with a mean age of 2.25 ± 0.74 years were enrolled in this study. The mean exotropia before and after treatment was 20.96 ± 8.20 and 12.16 ± 11.04 prism diopters, respectively, and there was a statistically significant difference (P < 0.002). The mean refractive spherical and astigmatic errors (cycloplegic refraction) were +1.34 ± 1.07 and −0.32 ± 0.72 diopters, respectively. At the end of the follow-up, exotropia increased in 5.6% of patients, there was no change in 15% of patients with a mean deviation of 25.0 ± 6.06 prism diopters, and 79.24% of patients were treated successfully.

Conclusions:

According to the results of this study, treatment of IXT by over-correcting lenses can be a safe procedure and effective in preventing exotropia.
Global Implications of COVID-19 Pandemic on Adults' Lifestyle Behavior: The Invisible Pandemic of Noncommunicable Disease
Authors: Musa Sarah , Dergaa Ismail , Bachiller Veronica , Saad Helmi Ben
Published: May 2024

COVID-19 pandemic, with its subsequent lockdown and mobility restriction is a public health emergency that has obliged substantial modifications in daily routines and lifestyle of people worldwide. The drastic measures of social isolation and home confinement has impacted to a great extent the physical and psychological health. The resultant abrupt in lifestyle-related behavior such as physical inactivity, unhealthy dietary habit, sleep disturbance, stress, tobacco use, and alcohol intake, is directly linked to the rising global burden of non-communicable disease. This review aims at gaining a rich and extensive understanding of the potential negative impact triggered by COVID-19 on lifestyle-related behaviors that will influence long-term physical and mental wellbeing. Electronic database search was conducted on PubMed, ScienceDirect, Google Scholar, and Scopus from January 1, 2020 to March 15, 2021. Data related to COVID-19 impact on lifestyle habits were extracted from these studies. Articles were included if meeting the inclusion criteria (i.e., assessed the impact of COVID-19 on physical inactivity and sedentary behavior, dietary habits, sleep, mental health, vitamin D, and substance use among adults. Further search was conducted to address these behavioral changes among athletes. While physical isolation is a necessary public health measure to protect the population, outcomes of this review indicate that in light of adverse lifestyle changes brought by the pandemic, noncommunicable disease remains a critical concern. Hence, adopting healthy lifestyle behavior is essentially important especially during the current time to boost immunity and reduce the risk of COVID-19 infection. Recognizing the pandemic collateral effects offers a forward-looking perspective to guide the government and health authorities in planning prevention and control programs that focus on resilient and sustainable behavioral change.
The Effect of 4 Weeks Aerobic Exercise Training with Detraining Courses in Various Prevention Phases on BCl-2 and BAX Genes Expression and Proteins
Authors: Koohshoori Yousef Shahvali , Marandi Sayed M. , Kargarfard Mehdi , Vaseghi Golnaz , Moshtaghian Seyed J.
Published: May 2024

Background:

The aim of this study was to investigate the effect of aerobic exercise with detraining in different phases of prevention on BCL2 Associated X (BAX) and B-cell lymphoma 2 (BCl-2) gene expression and proteins.

Methods:

For this purpose, 32 female Balb-c mice (18–20 g) were purchased and randomly assigned to primordial prevention (A), primary prevention (B), secondary prevention (C), and control (D). A group performed aerobic exercise for 4 weeks, after 4T1 cells injection detrained for 8 weeks. Group B performed aerobic exercise for 4 weeks immediately after injecting 4T1 cells and then detrained for 4 weeks. In C group, the 4T1 cells were first injected and did not perform any activity for 4 weeks, followed by 4 weeks of aerobic exercise. Forty-eight hours after the last training session and detraining courses, after anesthesia, sacrificing, and tissue removal, were performed. Reverse transcription polymerase chain reaction (RT PCR) was used to measure gene expression and Western blot (WB) was used to measure protein content. One-way Analysis of variance (ANOVA) test was used to analyze data.

Results:

The results showed that aerobic exercise in A, B, and C groups compared to D group reduced BCl-2 gene expression and protein and increased BAX gene expression and protein.

Conclusions:

Therefore, exercise can cause apoptosis in tumor cells by increasing pre-apoptotic factors and decreasing antiapoptotic factors in tumor cells, and consequently improving the disease status.
Study Protocol for the Interactions between Dietary Patterns and ARL15 and ADIPOQ Genes Polymorphisms on Cardiometabolic Risk Factors
Authors: Mollahosseini Mehdi , Yazdanpanah Zeinab , Nadjarzadeh Azadeh , Mirzaei Masoud , Kalantar Seyed Mehdi , Mirzaei Khadijeh , Mozaffari-Khosravi Hassan
Published: May 2024

Background:

Cardiovascular diseases (CVDs) are recognized as one of the leading causes of death worldwide. Studies have shown the impact of genetic predisposition and dietary factors on developing these diseases. Dietary patterns and genetic factors such as polymorphisms related to the level of adiponectin may also interact with each other and produce variances in the effects of these factors on different individuals. The purpose of this study is to investigate the interactions between food intake patterns and polymorphisms on ADIPOQ and ARL15 genes in relation to cardiometabolic risk factors.

Methods:

This cross-sectional study is conducted on 380 adults (20 to 70 years old) living in Yazd, Iran. Individuals were selected from the participants in Yazd Health Study (YaHS) and its sub-study called Taghziyeh Mardom-e Yazd (TAMYZ) after reviewing the inclusion and exclusion criteria. YaHS is a population-based cohort study which has been conducted on 9962 adults living in Yazd since 2014. In the present study, rotated principle component analysis (PCA) with Varimax rotation is used to identify the major dietary patterns. The polymerase chain reaction-restricted fragment length polymorphism (PCR-RFLP) method is used in order to identify rs1501299 and rs6450176 variants (on ADIPOQ and ARL15 genes, respectively). General linear models (GLM) as well as regression models are used to investigate the interactions between the studied genotypes and the extracted dietary patterns.

Conclusions:

The results of this study can help to personalize dietary recommendations for the prevention of CVDs according to the genetic predisposition of individuals.
Severe Vitamin D Deficiency as a Risk Factor in Newly Diagnosed Tuberculosis Patients: Comparative Study on Inhabitants of High Altitude Region
Authors: Thejaswi S G , Koirala Prakash , Pradhan Ujjawal , Papanaik H , Bhuyan Shreyasmita
Published: May 2024

Background:

The present study was conducted to find the association between tuberculosis and vitamin D levels and assess severe vitamin D deficiency (VDD) as a risk factor for developing tuberculosis at high-altitude regions.

Methods:

This cross-sectional study was carried out at a tertiary care hospital situated at an average altitude of 5,412 feet above sea level. Newly diagnosed active cases of tuberculosis (Group A) and unmatched healthy individuals (Group B) were recruited in the study. Serum samples were analyzed for Vitamin 25(OH) D levels and correlated between the groups.

Results:

The study included 54 newly diagnosed tuberculosis patients (Group A) (47 pulmonary and 7 extrapulmonary tuberculosis) and 87 healthy controls (Group B). Of the total 141 participants, 69 (49%) had severe VDD and 44 (31%) had VDD. The mean (SD) vitamin D level was significantly lower in patients having tuberculosis (12.6 ± 7 ng/mL) as compared to Group B (15.9 ± 7 ng/mL). The risk of tuberculosis infection was 2.13 times higher among those who had VDD (odds ratio = 2.13) (P-0.106), whereas those with severe VDD were at 3.2 times higher risk of developing tuberculosis (crude odds ratio = 3.2) (P = 0.001) and severe VDD independently contributed to being diagnosed with tuberculosis (adjusted odds ratio = 3.1) (P = 0.002).

Conclusions:

Vitamin D levels are significantly low in tuberculosis patients and severe VDD independently contributes to developing tuberculosis infection.
Reviewing the National Health Services Quality Policies and Strategies of the Iranian Health System: A Document Analysis
Authors: Fallah Razieh , Maleki Mohammadreza , Aryankhesal Aidin , Haghdoost Aliakbar
Published: May 2024

Background:

High-quality health care is an important component of efforts to reach Universal Health Coverage (UHC). Given this pivotal fact, poor quality of care is a significant bottleneck in the endeavors of Iran to UHC. This study was part of a broader qualitative study and aimed to provide supplementary data about the documents related to the National Quality Policies and Strategies (NQPS) health services in the health system of Iran to determine the degree of alignment with the World Health Organization (WHO) approach for NQPS, and to track change and development over time.

Methods:

This document analysis was performed following the READ approach for systematic document analysis in health policy research. Furthermore, qualitative content analysis following parallel forms of the mixed analysis in which the textual material proceeded with different inductive and deductive content-analytical procedures simultaneously, applying the WHO practical approach for NQPS, was selected.

Results:

The 15 included records that met the inclusion criteria were released in the post-Islamic Revolution period. The Ministry of Health was found as the most responsible authority for publishing the NQPS among the other authorities. Furthermore, 67% of NQPS was aligned with the goals and priorities of a broader national plan or policy. Contradictions, variations, and ambiguities were also found in the literature circumstances of the NQPS. There was no NQPS concentrated on the entire pathway of care in the Iranian health system, which developed according to the WHO approach for NQPS.

Conclusions:

Qualitative analysis of the current NQPSs based on the eight inter-dependent elements and critical supplements, the technical perspective of broad stakeholders, community engagement, and steady commitment of policymakers are our recommendations for future efforts towards having NQPS.
Why Patients Discard Their food? a Qualitative Study in Iranian Hospitals
Authors: Anari Razieh , Amini Maryam , Nikooyeh Bahareh , Ghodsi Delaram , Neyestani Tirang R.
Published: May 2024

Introduction:

Food waste reflects inadequate food intake and is of economic and environmental importance. Therefore, understanding the underlying factors is a must to combat food waste.

Methods:

A qualitative study was conducted using semi-structured interviews with managers, nurses, nutritionists, food providers, kitchen staff, and inpatients at three hospitals in Tehran. Responses were recorded, coded, and analyzed thematically.

Results:

Forty-eight face-to-face interviews led to three core categories: 1. opinions/performance; 2. causes, related factors, and characteristics; and 3. rooting and suggestions. We found that the majority of the hospitalized patients did not consume their entire food. In spite of overall satisfaction with the quantity and quality of food, anorexia, personal taste, and poor quality of raw materials prohibited patients from eating. Also, rice was the most discarded food. Economic barriers were the most important hindrance to elevate the quality, and some strategies, like the supply of high-quality materials and recruiting skillful cooking team, were proposed to improve it.

Conclusions:

Our findings delineated a limited budget as the main barrier to improve the quality. Nevertheless, the low quality of hospital foods may actually impose a heavier economic burden due to food waste.
The Effect of Home Care on Metabolic Profile and Blood Pressure in Type 2 Diabetic Patients who Underwent General Surgeries
Authors: Heidapour Maryam , Kabirzadeh Arefeh , Faridani Lila , Akbari Mojtaba , Abazari Parvaneh
Published: May 2024

Background:

The stress of surgery itself results in metabolic disturbance. Few studies have mentioned how to manage the metabolic profile of diabetic patients after discharge from the hospital. The present study aimed to determine the effect of home care on metabolic profile and blood pressure in type 2 diabetic patients who underwent general surgeries.

Methods:

Seventy type 2 diabetic patients who were undergoing surgery were assigned to the intervention and control groups via blocking order. The intervention group received a 3-month home care with an interprofessional team approach. The levels of fasting blood glucose, glycosylated hemoglobin (HbA1c), total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterols, systolic blood pressure, and diastolic blood pressure were measured before and three months after the intervention in both groups. In the control group, only routine care was performed in the postsurgery period. Data were entered in SPSS software version 23 and were analyzed. Results: There were no significant differences between the intervention and control groups for background characteristics. Systolic blood pressure (P < .001), diastolic blood pressure (P = 0.005), lipid profile (P = 0.001) [except for triglycerides level], fasting blood glucose (P = .001), and HbA1c (P = .003) decreased significantly in the intervention group. After controlling baseline data by applying analysis of covariance, a significant increase in HDL-c (P = .032) was seen. Also, the difference between the mean percentage of variations in HbA1c levels between intervention and control groups was significant. Conclusions: Our study showed improvement in HbA1c and HDL-c levels with home care programs in patients with diabetes who underwent general surgeries. More studies with longer follow-ups are necessarily addressing the effects of home care on other metabolic parameters in these patients.
Near Two Decades of the Family Physician Program in Iran and the Structural Challenges: A Systematic Review
Authors: Heidarzadeh Abtin , Hedayati Bita , Huntington Mark K. , Madani Zahra Hamidi , Farrokhi Babak , Mohseni Farzad , Dadgaran Ideh , Mirkazemi Roksana
Published: May 2024

The family physician program (FPP) is one of the most significant health care reforms in Iran; however, many studies showed that this program has not been able to achieve its intended objectives because of a variety of challenges. This program, despite the existing challenges, is going to be expanded across the country. To improve the likelihood of its success, identification of the structural and infrastructural challenges is necessary. This systematic review was conducted to assess the structural and infrastructural challenges of FPP in Iran. This systematic review of the literature was conducted in order to investigate the infrastructure and structure needs of the current program in Iran. All published articles related to the FPP in Iran were the subject of this study. The eligibility criteria included original articles, reviews, or case studies published in English or Persian during 2011–2021 related to the challenges in the referral system of FPP in Iran. Data were extracted based on Sample, Phenomenon of Interest, Design, Evaluation, Research type technique and were reported based on the structure of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. International credible scholarly databases were searched. The search strategy was defined based on keywords and the search syntax. This study identified different challenges of the referral system in the areas associated with legal structure, administration, and social structure. The identified challenges in this program should be addressed in order to ensure that this program will lead to improved quality of care and equity in Iran health care system.
Obesity and Mortality of Hospitalized COVID-19 Patients in Asian and Western Countries: a Systematic Review and Meta-Analysis
Authors: Nindrea Ricvan Dana , Lailani Mutia , Masrul  , Usman Elly , Katar Yusticia , Hendriyani Heni , Sari Nissa Prima
Published: May 2024

Background: The authorities recently emphasized the importance of dietary control for COVID-19 patients in hospitals. However, there is limited detail about the obesity and death of COVID-19 patients who are hospitalized in the Asian and Western countries. The aim of this study was to find the role of obesity and mortality of the hospitalized COVID-19 patients. A systematic review of the studies on obesity and mortality of hospitalized COVID-19 patients in the Asian and western countries.

Methods:

Databases of ProQuest, PubMed, and EBSCO were used to find relevant articles published between January 2020 and March 2021. A total of 3,70,836 patients in 17 studies were included. Results: We found significant correlation between obesity and mortality in hospitalized COVID-19 patients (pooled odds ratio [POR] = 1.28, 95% CI: 1.23–1.33). In particular, this study demonstrated that the Asian countries had higher POR (1.44, 95% CI: 1.16–1.79) compared to the western countries (1.28, 95%CI: 1.23-1.33). The heterogeneity calculation showed heterogenous among studies included (I2 > 50%).

Conclusions:

The mortality of COVID-19-hospitalized patients is related to obesity, which requires a multi-stakeholder mitigation approach to avoid and control obesity and its impacts.
Investigating the Relationship between Structural Features of Built Environment and Physical Activity Using Geographic Information Systems (GIS)
Authors: Noormohammadpour Pardis , Ghadimi Ehsan , Memari Amirhossein , Selk-Ghaffari Maryam , Ali Mansournia Mohammad , Kordi Ramin
Published: May 2024

Background:

Built environment determinants of engaging in physical activity are dependent on the properties of societies. This study investigates the relationship between structural variables of the environment using geographic information systems (GIS) and the level of physical activity in 22 districts of Tehran.

Methods:

This cross-sectional study was based on Urban Health Equity Assessment and Response Tool (Urban HEART-2). Physical activity level was assessed via the Global Physical Activity Questionnaire (GPAQ). The characteristics of the neighborhood environment, including land use, street pattern, population density, and traffic, were determined via ArcGIS software. Walkability index (population density, street pattern, land use) was calculated to assess the effect of the main variables of living environment on physical activity level.

Results:

Among the built environmental variables, land use was associated with the total physical activity and travel-related physical activity level (r: 0.155, P value: 0.001, and r: 0.122, P value: 0.007, respectively). The walkability index indicated an association with the total physical activity level and travel-related physical activity level (r: 0.126, P value: 0.006, and r: 0.135, P value: 0.001, respectively). Higher levels of the walkability index were associated with an improved level of physical activity (OR: 2.04).

Conclusions:

Walkability index and land use positively correlate with total physical activity level, and providing action plans that improve walkability index and land use might lead to increased physical activity level.
The Effect of Garlic (Allium Sativum) on Polycystic Ovary Syndrome Related Hormones and Glycemic Parameters: A Randomized, Double-Blinded Clinical Trial
Authors: Zadhoush Roya , Alavi-Naeini Amirmansour , Feizi Awat , Naghshineh Elham , Ghazvini Mohammad Reza
Published: May 2024

Background:

The purpose of the present study was to investigate the effect of garlic supplementation on androgen levels and glycemic-related markers in patients with PCOS.

Methods:

In these 8 weeks of randomized double-blinded control trial, 80 women were randomly assigned into two groups in which patients were asked to intake either 800 mg/day garlic or an identical placebo. A blood sample was obtained pre- and post-trial to assess androgens and glycemic-related parapets. A 3-days- food record and a short form of international physical activity questionnaires (IPAQ) were also evaluated at the beginning and end of the trial.

Results:

All participants completed the trial. Garlic supplementation resulted in significant reduction in fasting plasma glucose (-3.22 ± 7.41 vs. 0.72 ± 5.37; P = 0.008) and homeostatic model assessment for insulin resistance (HOMA-IR) (-0.29 ± 1.45 vs. 0.28 ± 1.20; P = 0.02). In addition, a trend to a significant improvement was detected in free androgen index (FAI) (P = 0.09), insulin levels (P = 0.07), and quantitative insulin sensitivity check index (QUICKI) (P = 0.06). However, no significant difference was found in testosterone and sex hormone-binding globulin (SHBG) (P > 0.05).

Conclusions :

Present study indicates that garlic supplementation could be beneficial for FPG and insulin resistance improvement. However, garlic supplementation does not show remarkable efficacy on androgens. Further studies are warranted to confirm the results.
Combined Ursolic Acid and Resistance/Endurance Training Improve Type 3 Diabetes Biomarkers-Related Memory Deficits in Hippocampus of Aged Male Wistar Rats
Authors: Ghadiri Neda , Esfarjani Fahimeh , Marandi Sayed Mohammad , Banitalebi Ebrahim , Saghaee Elham
Published: May 2024

Background:

Both aging and diabetes are two well-established risk factors related to type 3 diabetes and memory deficits. Accordingly, diabetes multiplies the effects of aging on cognition impairments once these conditions occur simultaneously.

Methods:

In this present experimental study, 56 male Wistar rats with HFD/STZ-induced T2D were randomized into seven groups (n = eight animals per group): (1) sedentary old non-diabetic (C); (2) sedentary HFD/STZ-induced T2D (D); (3) sedentary HFD/STZ-induced T2D plus UA (UA) (DU); (4) endurance-trained HFD/STZ-induced T2D (DE); (5) resistance-trained HFD/STZ-induced T2D (DR); (6) endurance-trained HFD/STZ-induced T2D plus UA (DEU); and (7) resistance-trained STZ-diabetic plus UA (DRU) rats. Two-way ANOVA was applied to measure the training, supplementation, and interaction effect on serum and gene expression outcomes.

Result:

The study results established no significant interaction effect between the UA supplementation and the resistance/endurance training with regard to the levels of glucose (P = 0.534), insulin (P = 0.327), brain-derived neurotrophic factor (P = 0.191), and insulin-like growth factor-1 (P = 0.448).

Conclusions:

To develop novel practical nutritional strategies involving UA intake, further studies are thus needed to clarify how chronic consumption of UA with/without resistance/endurance training reverses cognition disorder process in old male Wistar rats with HFD/STZ-induced T2D.