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.
Letter to the Editor (Policy Brief)
nurse education
mojtaba rad; hamidreza hkankeh; masoud fallahi-khoshknab; farahnaze Mohammadi; kian nourozi
Abstract
Background and Objective: The COVID-19 pandemic, as an unprecedented crisis, placed immense pressure on healthcare systems, particularly ICUs. Frontline nurses faced unprecedented challenges. This study aimed to explore the nursing care process for COVID-19 patients in ICUs and provide practical strategies ...
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Background and Objective: The COVID-19 pandemic, as an unprecedented crisis, placed immense pressure on healthcare systems, particularly ICUs. Frontline nurses faced unprecedented challenges. This study aimed to explore the nursing care process for COVID-19 patients in ICUs and provide practical strategies for effective management of similar future crises.
Methods: This qualitative study used a Grounded Theory approach. Data were collected through semi-structured interviews with 24 nurses in ICUs of selected Iranian hospitals. Purposive sampling with maximum variation was employed. Data were analyzed using Strauss and Corbin's coding method (open, axial, and selective). Lincoln and Guba's criteria ensured trustworthiness. In the second phase, findings were validated via Delphi technique with 15 experts, and final strategies were developed.
Results: Nurses' primary concern was "providing beneficial and safe care," shaped by four contextual factors: pervasive fear, resource shortages, disease uncertainty, and insufficient support. Nurses employed three main strategies: compassionate comprehensive care, tolerating difficult complex care, and striving for adaptation. Consequences included compassion fatigue (psychological and physical burnout) and professional empowerment (enhanced clinical skills and growth). Based on findings, four strategic domains were developed: health system preparedness, human capital empowerment, organizational support, and resource management.
Conclusion: Investing in nurses and strengthening supportive and managerial structures is a strategic necessity for health system resilience in future crises. Developing and implementing a national action plan based on this study's lessons is recommended.
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