Letter to the Editor
Health System
Ali Taj
Abstract
AbstractAs one of the most devastating human phenomena, war not only threatens the security and economy of countries but also endangers the physical and mental health of millions of people. The experience of military crises in various countries, including in the Middle East region, has once again confirmed ...
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AbstractAs one of the most devastating human phenomena, war not only threatens the security and economy of countries but also endangers the physical and mental health of millions of people. The experience of military crises in various countries, including in the Middle East region, has once again confirmed the bitter reality that in the absence of preparedness, health infrastructure will be the first victim on the battlefield. In this regard, health management in the war crisis is a vital necessity that should be prioritized in health policymaking.Health management in war situations requires planning at various levels, including prevention, intervention, treatment, and rehabilitation. It is suggested that the following strategies be considered as part of a national and regional strategy to improve health management in war crises: 1) Developing a comprehensive health plan for crises with the participation of security, military, health, and civil society institutions; 2) Increasing the resilience of health infrastructure by strengthening passive defense, strategic drug storage, and equipping medical centers; 3) Training and empowering health human resources to deal with crises and relief efforts; 4) Utilization of new technologies, including early warning systems, digital health, and telemedicine networks; 5) Promote international and regional cooperation to coordinate and synergize resources and relief efforts. Health management in war is a subject that goes beyond medicine. It is a strategic, social, and human challenge that requires solidarity, preparedness, and collective commitment. It is hoped that with serious attention and action, the catastrophic consequences of war on human health can be prevented.
Letter to the Editor (Policy Brief)
nurse education
Mojtaba Rad; Hamidreza Hkankeh; Masoud Fallahi-khoshknab; farahnaze Mohammadi; kian nourozi
Abstract
AbstractBackground: The COVID-19 pandemic, as an unprecedented crisis, placed enormous pressure on healthcare systems, with nurses facing unprecedented frontline challenges. This study aimed to develop strategies for improving nursing care for patients with emerging respiratory diseases in intensive ...
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AbstractBackground: The COVID-19 pandemic, as an unprecedented crisis, placed enormous pressure on healthcare systems, with nurses facing unprecedented frontline challenges. This study aimed to develop strategies for improving nursing care for patients with emerging respiratory diseases in intensive care units based on lessons learned from the COVID-19 pandemic.Materials and Methods: This policy brief was derived from a qualitative grounded theory study. Data were collected through semi-structured interviews with 24 intensive care nurses in selected Iranian hospitals using purposive maximum-variation sampling. Data were analyzed using the Strauss and Corbin (2015) approach, and trustworthiness was established based on Lincoln and Guba’s criteria. In the second phase, findings were validated through a Delphi technique involving 15 experts, and final strategies were developed. Ethical Code: IR.USWR.REC.1400.265.Results: Nurses’ main concern was “providing beneficial and safe care,” shaped by four contextual factors: pervasive fear, resource shortages, unfamiliarity with the disease, and inadequate support. Three main strategies emerged: comprehensive and empathetic care, tolerating difficult and complex care, and striving for adaptation. Consequences included compassion fatigue, characterized by psychological and physical exhaustion, and professional empowerment through enhanced clinical skills and professional growth. Four strategic domains were developed: health system preparedness, human resource empowerment, organizational support, and resource management.Conclusion: Improving nursing care for emerging respiratory diseases requires structural measures beyond short-term responses. Lessons learned from COVID-19 can inform intensive care preparedness guidelines, nurses’ education and training, organizational support systems, and resource management at hospital and Ministry of Health levels, thereby strengthening health system resilience to future pandemics.
Review article
Health and environment
Hadi Lotfi; Faeze karimi-moghadam; Afshin Dowlatabadi; Mohsen Yazdani-aval; Mehdi Jafarzadeh Fakhari; Mohammad Miri
Abstract
Background and Objective: Air pollutants play a crucial role in public health, as they are related to increased risk of cancers, such as cervical cancer. The present study aimed to evaluate the association between air pollution exposure and the risk of cervical cancer in a systematic review.
Materials ...
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Background and Objective: Air pollutants play a crucial role in public health, as they are related to increased risk of cancers, such as cervical cancer. The present study aimed to evaluate the association between air pollution exposure and the risk of cervical cancer in a systematic review.
Materials 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 reviewed studies suggested that exposure to environmental contaminants like particulate matter from PM2.5 and PM10, nitrogen oxides (NOx), and polycyclic aromatic hydrocarbons (PAHs) was 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: Evidence indicates a significant association between exposure to air pollution and an increased risk of cervical cancer. Reducing exposure to pollutants through environmental policies and raising public awareness can play an effective role in preventing this disease. Future studies should focus on standardizing exposure assessment methods and investigating the mechanisms of carcinogenesis.
Original Article
Anatomy, Histologyو Embryology
Seyyed Mohammad Bahreini; Enam Alhagh Gorgich; Auob Rustamzadeh; Mohammad Hosseinzadehhesari; Amir Raoofi
Abstract
Background and Objective: Ancient human remains are invaluable, non-renewable resources for reconstructing human biological, cultural, and social history. Non-invasive imaging techniques, including radiography, computed tomography (CT), and microCT, enable detailed anatomical and morphological assessment ...
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Background and Objective: Ancient human remains are invaluable, non-renewable resources for reconstructing human biological, cultural, and social history. Non-invasive imaging techniques, including radiography, computed tomography (CT), and microCT, enable detailed anatomical and morphological assessment while preserving these irreplaceable materials. This study aimed to explore their utility in investigating ancient human remains while considering the legal and bioethical issues surrounding the imaging of human remains and historical objects.Materials and Methods: This study was conducted as a narrative review. Relevant articles were collected and analyzed from Scopus, ScienceDirect, Web of Science, Google Scholar, and SID databases using keywords related to human remains, cultural heritage, medical imaging, and legal issues.Results: The findings demonstrated that non-invasive imaging methods reduce physical damage caused by sampling and excavation while enabling detailed evaluation of internal structures, pathological analysis of hard and soft tissues, and differentiation between antemortem injuries and postmortem alterations. CT scanning also plays a significant role in authenticity assessment, dating, and scientific restoration of historical artifacts without physical destruction.Conclusion: Non-invasive imaging represents a scientific, ethical, and strategic approach for balancing knowledge production, preservation of cultural heritage, and respect for human dignity. Sustainable application of these technologies requires the development of coherent legal and ethical frameworks.
Original Article
Psychology
ebrahim nameni
Abstract
Background and Objective: Identifying and quantifying the factors influencing quality of work life and well-being at work among nurses is essential. Therefore, the present study aimed to examine the structural model of the relationship between job stress and both quality of work life and occupational ...
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Background and Objective: Identifying and quantifying the factors influencing quality of work life and well-being at work among nurses is essential. Therefore, the present study aimed to examine the structural model of the relationship between job stress and both quality of work life and occupational well-being among hospital nurses in Sabzevar, Iran, with a focus on the mediating role of psychological well-being.
Materials and Methods: This study employed a descriptive-correlational design. The statistical population included all nurses working in Sabzevar hospitals during the spring of 2024, from which 170 individuals were selected using a convenience sampling method. Data were collected using the Nursing Stress Scale by Gray-Toft and Anderson, Walton’s Quality of Work Life Questionnaire, the Work Well-Being Questionnaire by Schaufeli and Bakker, and Ryff’s Psychological Well-Being Scale. Data analysis was conducted using structural equation modeling with Smart PLS 3 software.
Results: The results of the structural model indicated that job stress had a significant direct effect on both quality of work life and work-related well-being (p < 0.05). Furthermore, psychological well-being significantly mediated the indirect relationship between job stress and quality of work life (p < 0.05). However, no significant mediating effect for psychological well-being was found in the relationship between job stress and occupational well-being (p > 0.05).
Conclusion: Based on the findings, improving nurses’ work life quality requires efforts to reduce job stress and enhance psychological well-being. Therefore, strengthening psychological well-being should be considered a strategic priority for hospital managers and healthcare policymakers.
Original Article
Physical Education
Mehdi Azadmanjiri; Mohamed reza Hosein abadi; Ameneh Barjaste Yazdi; Mehdi Zarei
Abstract
Background and Objective: Low-volume high-intensity interval training (LV-HIIT) may represent a time-efficient strategy for improving factors associated with the progression of type 2 diabetes mellitus (T2DM). The present study aimed to investigate the effect of eight weeks of LV-HIIT on body composition ...
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Background and Objective: Low-volume high-intensity interval training (LV-HIIT) may represent a time-efficient strategy for improving factors associated with the progression of type 2 diabetes mellitus (T2DM). The present study aimed to investigate the effect of eight weeks of LV-HIIT on body composition and serum spexin in men with T2DM.
Materials and Methods: This experimental study was conducted using a pre-test/post-test design with intervention and control groups. Twenty-two men with T2DM (mean body weight = 80.86 ± 6.61 kg; mean body mass index = 27.69 ± 3.16 kg/m², age = 50.11±4.58) were randomly assigned to either the LV-HIIT group (n = 11) or the control group (n = 11). Participants in the intervention group performed LV-HIIT for three sessions per week over eight weeks (consisting of two to three four-minute intervals at 85–90% of maximum heart rate (%HRmax)), interspersed with three-minute active recovery periods at 65–75% HRmax). Anthropometric measurements and blood samples were collected from all participants before and after the intervention. Serum spexin levels were measured using human-specific ELISA kits. Data were analyzed using analysis of covariance (ANCOVA).
Results: After eight weeks, no significant differences were observed between the intervention and control groups in body weight (p = 0.083) and body mass index (p = 0.072). However, eight weeks of LV-HIIT resulted in a significant reduction in body fat mass (BFM) compared with the control group (p = 0.046).
Conclusion: Given the observed reduction in BFM and improvement in serum spexin levels following eight weeks of LV-HIIT, this training protocol may be recommended as a time-efficient and practical strategy for the management of T2DM.
Original Article
Pediatric
Ezatollah Abbasi; Alireza Abdi; Fatemeh Hajihosseinlou
Abstract
Background and Objective: SARS-CoV-2 infection can lead to a wide spectrum of neurological complications in children besides respiratory manifestations. Despite growing global evidence, data regarding the neurological manifestations of COVID-19 among Iranian pediatric patients remain limited. ...
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Background and Objective: SARS-CoV-2 infection can lead to a wide spectrum of neurological complications in children besides respiratory manifestations. Despite growing global evidence, data regarding the neurological manifestations of COVID-19 among Iranian pediatric patients remain limited. This study aimed to investigate the frequency of neurological manifestations and their association with clinical outcomes among hospitalized children with COVID-19 at Motahari Hospital in Urmia, Iran.
Materials and Methods: This retrospective cross-sectional analytical study was conducted on 460 children (age <18 years) with PCR-confirmed COVID-19 who were hospitalized between March 2020 and March 2022. Census sampling was performed. Demographic variables, central and peripheral neurological manifestations, D-dimer levels, and clinical outcomes were extracted from medical records. Data analysis was performed using SPSS version 25, using multiple logistic regression modeling.
Results: Among the 460 enrolled children (mean age 4.17 ± 3.62 years; 59.78% male), the most prevalent neurological manifestations were seizure (14.13%), headache (7.39%), and dizziness (1.52%). Patients presenting with headache and dizziness were significantly older (P<0.001). The overall in-hospital mortality rate was 4.78%. Multivariate logistic regression analysis revealed that severe neurological manifestations (AOR = 2.45; 95% CI: 1.12 - 5.36; P = 0.024) and elevated D-dimer levels >1000 µg/L (AOR = 3.12; 95% CI: 1.41 - 6.88; P = 0.005) were the significant independent predictors of mortality.
Conclusion: Neurological manifestations are relatively common among hospitalized children with COVID-19. Since severe neurological complications and coagulopathy (elevated D-dimer) independently increase the risk of in-hospital mortality, careful and early neurological evaluation of pediatric patients is crucial for improving clinical outcomes.
Original Article
Surgery
Rahman Khosravi; Hatef Alizadeh; Farshad Marouie Milan
Abstract
Background and Objective: 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 ...
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Background and Objective: 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.
Materials and 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 into early or late complications according to the time of onset and were 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, but 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, and severe complications. Age and body mass index were not significant predictors of complications.
Conclusion: Post-circumcision complications were infrequent ranging from 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
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