Original Article
matin noroozi; hamed ghorani; Negin Ghafarzadeh; Arash Khameneh Bagheri
Abstract
Background and Objective
The abnormal buildup of fluid in the peritoneal cavity is known as ascites. It is practically crucial to evaluate the characteristics of ascitic fluid in order to distinguish its etiology. The purpose of this study was to evaluate the properties of tapped ascitic fluid in the ...
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Background and Objective
The abnormal buildup of fluid in the peritoneal cavity is known as ascites. It is practically crucial to evaluate the characteristics of ascitic fluid in order to distinguish its etiology. The purpose of this study was to evaluate the properties of tapped ascitic fluid in the Shohadaye Tajrish Hospital’s interventional radiology department from 2019 to 2022.
Material and method
We gathered the medical records of ascites patients who had paracentesis in the interventional radiology unit for this retrospective descriptive-analytical analysis. Age, gender, ascitic fluid’s total protein and albumin levels, white and red blood cell counts, and fluid culture outcomes were among the variables under investigation. Transudate and exudate fluid were distinguished using the serum-ascites albumin gradient (SAAG).
Results
Patients were 54.8 years old on average (SD = 14.4). Malignancies were the leading cause of ascites (32.04%), followed by heart failure (7.04%) and liver cirrhosis (16.9%). 8.06% of patients had a positive ascitic fluid culture, while 91.93% had a negative one. Patients with malignancies had SAAG levels below 1.1 g/dL, whereas those with cirrhosis and heart failure had SAAG levels above 1.1 g/dL.
Conclusion
In the population under study, cirrhosis and cancer were the most frequent causes of ascites. While combining SAAG with additional diagnostic techniques improves accuracy, SAAG is still a useful tool for distinguishing between transudative and exudative ascites.
Review article
Nursing
Yeganeh Salehi; Fatemeh Sameh; Mahtab Khajeh; Mostafa Rad
Abstract
Background: Sleep disorders are common in patients with chronic kidney disease (CKD), with effects observable even in early stages. This study aimed to identify factors associated with poor sleep quality in early-stage CKD patients.
Materials and Methods: This systematic review synthesized evidence from ...
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Background: Sleep disorders are common in patients with chronic kidney disease (CKD), with effects observable even in early stages. This study aimed to identify factors associated with poor sleep quality in early-stage CKD patients.
Materials and Methods: This systematic review synthesized evidence from seven cross-sectional and observational studies (2015–2025) on factors linked to poor sleep quality in early-stage CKD (stages 1–3). Following PRISMA guidelines and registered in PROSPERO (CRD420251233840), the review included studies using validated sleep measures. Two reviewers independently extracted data and assessed study quality via the Joanna Briggs Institute checklist.
Results: Poor sleep in early-stage CKD is influenced by a complex interplay of demographic, clinical, psychological, and lifestyle factors. Older age, female sex, lower education, and living alone were significant demographic correlates. Clinically, more advanced CKD stage (lower eGFR), anemia, comorbidities (hypertension, diabetes), obesity, and longer disease duration were linked to worse sleep. Psychologically, depression was the strongest, most consistent predictor, often mediating the CKD-sleep relationship; anxiety, fatigue, and reduced quality of life also played key roles. Objective sleep measures highlighted associations with sleep-disordered breathing and periodic limb movements. Modifiable factors like physical inactivity and high-altitude residence further contributed.
Conclusion: Sleep impairment in early CKD is not merely a symptom but a multidimensional issue embedded in biopsychosocial contexts. Effective management requires integrated interventions addressing mental health, social support, and lifestyle modifications alongside standard renal care. Such a holistic strategy may improve well-being, potentially slow CKD progression, and reduce healthcare burdens.
Original Article
Nursing
hanie honarbakhsh; Ali Taj; zahra parsaei mehr; Mohammad hassan Rakhshani; Mostafa Rad
Abstract
Introduction:Due to the varying prevalence of workplace bullying across different cultures and its potential impact on physical health problems such as headaches, along with the lack of sufficient information in this area, this study was conducted to investigate the prevalence of workplace bullying, ...
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Introduction:Due to the varying prevalence of workplace bullying across different cultures and its potential impact on physical health problems such as headaches, along with the lack of sufficient information in this area, this study was conducted to investigate the prevalence of workplace bullying, related factors, and its association with tension-type headache among nurses working in hospitals in Sabzevar.
Materials and Methods:This descriptive-analytical study was conducted on 421 nurses employed in Sabzevar hospitals. Stratified sampling was carried out from October to December 2024. Data were collected using a demographic information questionnaire, the revised Negative Acts Questionnaire (NAQ-R), and a headache screening questionnaire to assess tension-type headache. Data were analyzed using SPSS software version 26.
Results: The mean age of the nurses was 33.57 ± 6.84 years. A total of 127 individuals (30.2%) had experienced workplace bullying. Moreover, 164 nurses (39%) reported probable tension-type headache, and 34 (8.1%) reported definite tension-type headache. Logistic regression analysis revealed that factors such as age, work unit, monthly income, and average working hours per month significantly predicted the occurrence of workplace bullying.
Conclusion:The results indicated that individuals with fewer working hours, less work experience, and higher income levels were more likely to become victims of workplace bullying. Higher income level and older age were associated with increased likelihood of victimization.
Original Article
Nursing
seyed hossein hosseini; Rezvan Rajabzadeh; Mostafa Rad
Abstract
Background: Military service is a critical transitional period for newly graduated male nurses, often accompanied by psychological stress and role challenges that may affect their professional performance, including compassionate care delivery.This study aimed to determine the association between military ...
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Background: Military service is a critical transitional period for newly graduated male nurses, often accompanied by psychological stress and role challenges that may affect their professional performance, including compassionate care delivery.This study aimed to determine the association between military service and compassionate nursing care in selected teaching and therapeutic hospitals in Mashhad and Sabzevar iran in 2025.
Methods:This descriptive-analytical cross-sectional study was conducted with 305 novice male nurses (work experience ≤48 months) working in clinical wards of selected hospitals. Participants were recruited using multi-stage cluster sampling. Data were collected using a demographic questionnaire and the validated Compassionate Care Questionnaire. Data analysis was performed using SPSS version 23, employing Kolmogorov-Smirnov, Kruskal-Wallis, Mann-Whitney U,and Spearman correlation tests.A p-value <0.05 was considered statistically significant
Results:A statistically significant difference was found in the mean compassionate care score based on military service type (p<0.001). The "Health Ministry Ambassador" group achieved the highest scores across all dimensions (professional performance, continuous follow-up, patient-centered performance, and empathetic communication), followed by the "Exempt from Service" group. The lowest scores were observed in the "Conscripted Soldier" and "Garrison Nurse" groups. No significant relationship was found between compassionate care and educational level or marital status. However, a significant negative correlation was observed between work experience and patient-centered performance (rho = -0.15, p=0.01).
Conclusion: The type of military service significantly influences compassionate care among novice nurses. Addressing the psychological and supportive needs of conscripted nurses and designing targeted educational programs may facilitate successful transition to clinical practice and enhance compassionate care quality
Review article
Health and environment
hadi lotfi; Faeze karimi-moghadam; Ashin Dowlatabadi; Mohsen Yazdani-aval; Mehdi Jafarzadeh Fakhari; mohammad miri
Abstract
Background and Aims
Air pollutants play a crucial role in public health, as they are related to increased risk of cancers, such as cervical cancer. Objective: To evaluate the association between environmental pollutant exposure and cervical cancer risk: a systematic review.
Materials and Methods
MATERIAL ...
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Background and Aims
Air pollutants play a crucial role in public health, as they are related to increased risk of cancers, such as cervical cancer. Objective: To evaluate the association between environmental pollutant exposure and cervical cancer risk: a systematic review.
Materials and Methods
MATERIAL AND METHODS The study was performed by reviewing indexed databases including PubMed, Scopus, Web of Science, and ProQuest. Literature was reviewed from January 1st, 2010, to October 16th, 2024, and included keywords matching MESH terms. Inclusion criteria included observational studies regarding environmental pollutants and cervical cancer. After screening 2803 articles, nine eligible studies were included. Analyses were conducted according to PRISMA guidelines.
Results
The studies under review suggested that exposure to environmental contaminants like particulate matter (PM2. (b) Air pollution exposure from PM2.5, PM10), nitrogen oxides (NOx), and polycyclic aromatic hydrocarbons (PAHs) is associated with an increased risk of cervical cancer. Most notably, one study found a positive relationship between PM2. 5 susceptibility and higher mortality in cervical cancer patients. For example, one study found that each order of 100 µg/m³ increase in NOx increased the risk of cervical cancer with an Odds Ratio of 2.45.
Conclusion
A large-scale epidemiological study has shown: cervical cancer risk significantly associated with air pollution exposure Prevention of this disease is effective through environmental policies, reduction of exposure to pollutants, and increasing hedonic awareness. Further research is warranted towards the recommendation of standardizing exposure assessment and towards understanding carcinogenic mechanisms.
Original Article
Anatomy, Histologyو Embryology
amir raoofi; Auob Rustamzadeh; Seyyed Mohammad Bahreini; Enam Alhagh Gorgich; mohammad hosseinzadehhesari
Abstract
Introduction: Ancient human remains are among the most valuable nonrenewable sources for reconstructing the biological, cultural, and social history of humanity. Although traditional invasive methods have provided important scientific information, they may cause irreversible damage to historical materials ...
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Introduction: Ancient human remains are among the most valuable nonrenewable sources for reconstructing the biological, cultural, and social history of humanity. Although traditional invasive methods have provided important scientific information, they may cause irreversible damage to historical materials and raise legal and ethical concerns. Advances in noninvasive medical imaging technologies, including radiography, CT, micro-CT, and MRI, have significantly transformed archaeological, forensic, and cultural heritage studies. Methods: This systematic review was conducted using scientific databases including Scopus, ScienceDirect, Web of Science, Google Scholar, and SID. Relevant studies were identified using keywords related to human remains, cultural heritage, medical imaging, legal regulations, and destructive analysis. Results: Findings demonstrated that noninvasive imaging techniques minimize physical damage caused by excavation and sampling while enabling detailed examination of internal structures, analysis of hard and soft tissue pathology, and differentiation between antemortem trauma and postmortem alterations associated with preservation processes. CT imaging also plays a major role in authenticity assessment, dating, and scientific restoration of historical objects without physical destruction. Conclusion: Noninvasive imaging represents not only a technical innovation but also an ethical and strategic approach for balancing scientific advancement, cultural heritage preservation, and respect for human dignity. The sustainable application of these technologies requires comprehensive interdisciplinary legal and ethical frameworks.
Original Article
Surgery
Rahman Khosravi; Hatef Alizadeh; Farshad Marouie Milan
Abstract
Background: Circumcision is one of the most common surgical procedures in children and may be associated with early and late complications. This study aimed to determine the incidence, pattern, and associated factors of post-circumcision complications in children attending Motahari Hospital, Urmia, Iran.
Methods: ...
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Background: Circumcision is one of the most common surgical procedures in children and may be associated with early and late complications. This study aimed to determine the incidence, pattern, and associated factors of post-circumcision complications in children attending Motahari Hospital, Urmia, Iran.
Methods: This retrospective observational study included 300 boys who underwent circumcision using either the Plastibell or sleeve technique during the first half of 2025 and were followed for at least 6 months. Complications were classified as early or late according to the time of onset and graded using the Clavien-Dindo system. Propensity score matching was used to compare the two surgical techniques, and multivariable logistic regression was performed to assess factors associated with complications.
Results: Overall, 29 children (7.9%) experienced at least one postoperative complication. Of these, 18 events (6.0%) occurred within the first 30 days and 11 events (3.7%) occurred after 30 days. Structural complications were the most common type. Most complications were graded I to IIIb, and no grade IV or V complications were recorded. After matching, no significant differences were found between the Plastibell and sleeve techniques regarding overall, early, late, or severe complications. Age and body mass index were not significant predictors of complications.
Conclusion: Post-circumcision complications in this center were infrequent and mainly mild to moderate. Given the notable proportion of late complications, follow-up for at least 6 months is recommended, and the choice of surgical technique may be guided by the child’s clinical condition and surgeon experience.
Original Article
Surgery
Negar Shadabmehr; Fatemeh Ghardashi; Abolfazl Shakiba; Yaser Tabarraie; Mahtab Khajeh
Abstract
Introduction: Surgical site infection (SSI) is one of the most important postoperative complications of surgical procedures, associated with increased length of hospital stay and increased treatment costs. The aim of this study was to determine the prevalence of surgical site infection and its associated ...
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Introduction: Surgical site infection (SSI) is one of the most important postoperative complications of surgical procedures, associated with increased length of hospital stay and increased treatment costs. The aim of this study was to determine the prevalence of surgical site infection and its associated factors in hospitalized patients.
Materials and Methods: This cross-sectional descriptive-analytical study was conducted in the teaching hospitals of Sabzevar in 2024. Sampling was performed using a census method, and data were collected from the hospital infection control unit and review of medical records of patients with surgical site infection. The data collection tool was a checklist of demographic variables and infection characteristics. Data analysis was performed using statistical tests including t-test, chi-square, and logistic regression.
Results: Out of a total of 14,329 surgical procedures performed, 218 cases of surgical site infection were reported. The analyses showed that factors such as advanced age, prolonged hospital stay, high preoperative blood glucose levels, and high body mass index were all significantly associated with greater severity of infection. Additionally, alcohol and cigarette consumption, as well as preoperative anemia, increased the risk of infection. Underlying diseases such as diabetes, hypertension, kidney problems, and immunosuppression also played a prominent role in exacerbating infection.
Conclusion: Although the prevalence of infection in this center is relatively low, focusing on blood glucose control, management of underlying diseases, and avoidance of prolonged antibiotic use can be effective strategies for reducing this complication.
Original Article
Nursing
mojtaba rad; nasymeh setayesh
Abstract
Abstract
Background: Military crises place considerable psychological and organizational demands on nurses. Understanding their experiences is essential for improving preparedness and support strategies during emergencies.
Methods: This qualitative study was conducted using a conventional content analysis ...
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Abstract
Background: Military crises place considerable psychological and organizational demands on nurses. Understanding their experiences is essential for improving preparedness and support strategies during emergencies.
Methods: This qualitative study was conducted using a conventional content analysis approach. Data were collected through semi-structured interviews with nurses who provided care during the 12-day military crisis in a teaching Hospital in Tehran. Interviews were transcribed verbatim and analyzed inductively. Trustworthiness was established through member checking and peer review.
Results: Seven themes emerged: managerial and organizational challenges, work–family role conflict, psychological burden of war, human resource challenges, organizational injustice, perceived support, and professional resilience. Participants reported shortages of resources, increased workload, security concerns, emotional distress, and persistent worries about family safety. Perceived inequity and insufficient managerial support reduced motivation. However, support from colleagues and family, professional commitment, teamwork, and resilience helped nurses maintain patient care despite adverse conditions.
Conclusion: Nurses experienced significant psychological, organizational, and family-related challenges during the military crisis. Nevertheless, resilience, social support, and professional commitment enabled them to sustain care delivery. Strengthening crisis preparedness, organizational support, and resilience-building interventions may improve healthcare workforce performance during future military emergencies.
Original Article
Mostafa Roshanzadeh; Ali Taj
Abstract
Introduction: Ethical decision-making is the most fundamental component of the professional performance of health professionals. It faces serious and conflicting challenges in war situations. Therefore, the aim of the present study is to explain the experiences of health professionals of the challenges ...
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Introduction: Ethical decision-making is the most fundamental component of the professional performance of health professionals. It faces serious and conflicting challenges in war situations. Therefore, the aim of the present study is to explain the experiences of health professionals of the challenges of ethical decision-making in war situations.
Materials and Methods: The present study is a qualitative study with a conventional content analysis approach. 15 health professionals (physicians, nurses, emergency medical technicians, and other healthcare workers) were included in the study through purposive sampling. Data were collected through in-depth semi-structured interviews. The duration of each interview was between 45 and 75 minutes.
Results: After analyzing the data from the interviews, 468 semantic units were extracted. These units were reduced to 123 initial codes in the initial coding stage. By comparing and merging similar codes, 20 sub-concepts were identified, which were organized into 5 main concepts. At a higher abstract level, these concepts were placed under a central theme titled erosion of professional ethics in the context of inevitable war decisions.
Conclusion: The present study demonstrated that ethical decision-making in wartime is a complex, multi-layered, and exhausting process that confronts health professionals with constant conflict between ethical principles and field realities, pressure from resource constraints, and triage challenges. These experiences leave lasting psychological and ethical consequences on individuals' professional and personal lives, leading to a redefinition of the meaning and priorities of professional ethics in the context of crisis.
Review article
Gyneocology
nasrin fazel; shohreh shahrouyan; sina shahrooyan
Abstract
Abstract
Introduction: Wars and armed conflicts are among the most critical public health crises, particularly in the field of women's reproductive health.
Objective: This study aimed to conduct a systematic review of the impact of war on women’s reproductive health and well-being.
Material ...
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Abstract
Introduction: Wars and armed conflicts are among the most critical public health crises, particularly in the field of women's reproductive health.
Objective: This study aimed to conduct a systematic review of the impact of war on women’s reproductive health and well-being.
Material and method: A literature search was conducted in PubMed, Scopus, Google Scholar, and SID databases between 2000 and 2026 using Persian and English keywords related to war, reproductive health, and sexual violence. After screening, 34 original articles with statistical data were selected for analysis.
Result: The most common consequences of war included sexual violence, unintended pregnancies, unsafe abortions, increased prevalence of sexually transmitted infections, reduced access to maternity care, and higher maternal and neonatal mortality.
Conclusion: War has profound and multilayered effects on women’s health. Strengthening care systems, establishing mobile services, and implementing gender-sensitive policies are among the key intervention priorities.
Keywords: reproductive health, pregnancy, Maternal mortality ,Infant mortality, Violence Against Women, War, Prenatal Care
Original Article
Nursing
Razieh Keyvan; samira foji
Abstract
Introduction :. Ambulance response time is an important variable in evaluating the quality of EMS services. This study aimed to determine the mean ambulance response time to trauma patients and to investigate the relationship between ambulance response time and variables related to the injured patient, ...
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Introduction :. Ambulance response time is an important variable in evaluating the quality of EMS services. This study aimed to determine the mean ambulance response time to trauma patients and to investigate the relationship between ambulance response time and variables related to the injured patient, accident scene, and prehospital emergency medical services system.
Materials and Methods: This descriptive cross-sectional study was conducted on 379 emergency medical services (EMS 115) missions involving trauma patients injured in road traffic accidents in Sabzevar County. Census sampling was performed over a three-month period, from the beginning of Tir to the end of Shahrivar 1402. Data were collected using a checklist and analyzed using Stata version 17. The Kruskal–Wallis, Mann–Whitney U, and simple linear regression tests were used for data analysis.
Results: The mean ambulance response time to the scene was 8.60 minutes, with a standard deviation of 7.64 minutes. A statistically significant relationship was observed between response time and the accident location, educational level, traffic congestion, and distance traveled. However, no statistically significant relationship was found between response time and the day and time of the accident, type of dispatched vehicle, or work experience of EMS personnel.
Conclusion: Mean ambulance response time is one of the most important factors in evaluating the quality of emergency medical services. This study showed that the mean response time in Sabzevar County was close to the recommended standard.
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