Letter to the Editor
Health Economics
Alireza Ghorbani
Abstract
AbstractThe right to health is a fundamental human right, an imperative underscored by the World Health Organization’s rights-based approach to healthcare. In many developing countries, part of the essential health commodities—including medicines and medical equipment— are provided ...
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AbstractThe right to health is a fundamental human right, an imperative underscored by the World Health Organization’s rights-based approach to healthcare. In many developing countries, part of the essential health commodities—including medicines and medical equipment— are provided through imports. Unilateral economic sanctions, often imposed for political objectives, can have severe indirect consequences on the health systems of targeted countries. Among the most alarming outcomes is the restriction of patient access to vital medications and essential medical devices. This not only constitutes a public health crisis but also represents a clear violation of international human rights and humanitarian principles. To mitigate patients' suffering and preserve their human dignity, measures such as establishing secure financial channels for medical imports, facilitating transfers through humanitarian institutions, and implementing international monitoring of healthcare in sanctioned countries are critically needed.
Letter to the Editor (Policy Brief)
Gyneocology
Mohammad Habibi Alleyabad; Narjes Forouhar; Mahboubeh Neamatshahi; Vahideh MoghaddamHosseini
Abstract
AbstractSexual dysfunction is a highly prevalent yet often neglected consequence of breast and gynecologic cancers, significantly affecting patients’ quality of life, marital satisfaction, and treatment adherence. A recent cross-sectional study conducted in Sabzevar (2023) involving 223 women with ...
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AbstractSexual dysfunction is a highly prevalent yet often neglected consequence of breast and gynecologic cancers, significantly affecting patients’ quality of life, marital satisfaction, and treatment adherence. A recent cross-sectional study conducted in Sabzevar (2023) involving 223 women with breast and gynecologic cancers revealed that over 93% experienced sexual dysfunction. This policy summary integrates national and international guidelines to formulate practical recommendations. The proposed policy framework recommends integrating educational and screening programs into oncology services, facilitating referrals, and ensuring financial coverage for sexual healthcare during and after treatment. Implementation requires a multi-faceted approach: designing culturally adapted programs to overcome barriers, securing sustainable funding and specialized training from an organizational standpoint, and support through national clinical guidelines and legislation to ensure lasting change.
Original Article
Microbiology
Mahrokh Rajaee Behbahani; Maryam Moghadam; Reza Khashei
Abstract
Introduction: Carbapenem-resistant Gram-negative bacilli (CR-GNB) pose a significant global therapeutic challenge, particularly in intensive care units (ICUs), due to resistance to most antibiotics, including carbapenems. This study aimed to investigate the risk factors for fecal colonization and acquisition ...
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Introduction: Carbapenem-resistant Gram-negative bacilli (CR-GNB) pose a significant global therapeutic challenge, particularly in intensive care units (ICUs), due to resistance to most antibiotics, including carbapenems. This study aimed to investigate the risk factors for fecal colonization and acquisition of CR-GNB among inpatients admitted to the ICUs of Shiraz Namazi Hospital.Materials and Methods: This study was conducted between 2021 and 2022. Rectal swabs were collected from 78 inpatients within 48 hours of ICU admission and again within 24 hours of discharge. Specimens were analyzed using bacteriologic techniques to determine fecal carriage (colonization) and acquisition rate of CR-GNB. Risk factors for both colonization and acquisition were evaluated.Results: The rate of CR-GNB colonization was 20.5% (16/78), and the rate of acquisition was 21.6% (11/51). Klebsiella pneumoniae was the most common isolate in both groups, displaying 100% resistance to ampicillin. The median time to CR-GNB acquisition during hospitalization was 13.36 days. Prior hospitalization and a history of stroke were significant risk factors for colonization (P < 0.003). Diabetes mellitus, chronic kidney disease, and the duration of ICU stay were risk factors for acquisition (P < 0.002). No statistically significant difference in antibiotic resistance was observed between CR-GNB colonized and those acquired during hospitalization.Conclusion: This study reveals a high prevalence of CR-GNB colonization and acquisition among ICU inpatients. These findings underscore the critical need for stringent infection control measures to limit the dissemination of CR-GNB in hospital settings.
Original Article
Nursing
Ali asghar Jesmi; Maedeh Hamrah Siyani; Shakiba Mozari
Abstract
Introduction: Electrolyte imbalances and altered consciousness are common complications of traumatic brain injury (TBI) that significantly impact patient recovery. This study aimed to determine the prevalence of electrolyte disturbances and their association with decreased consciousness in TBI patients.Materials ...
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Introduction: Electrolyte imbalances and altered consciousness are common complications of traumatic brain injury (TBI) that significantly impact patient recovery. This study aimed to determine the prevalence of electrolyte disturbances and their association with decreased consciousness in TBI patients.Materials and Methods: This descriptive-analytical study included 300 ICU patients with TBI from 2022 to 2025. Blood samples (sodium, magnesium, potassium, calcium) were measured using an EasyLyte analyzer. Data were analyzed with SPSS 24.Results: Electrolyte disturbances occurred in types of traumatic brain injury. All patients with diffuse axonal injury (DAI), intracerebral hemorrhage (ICH), and intraventricular hemorrhage (IVH) had a Glasgow Coma Scale (GCS) score <8. A statistically significant association was observed between serum sodium (p = 0.029) and magnesium levels (p = 0.047) with decreased levels of consciousness. However, no significant relationship was found between potassium (p = 0.182) and calcium levels (p = 0.660) and reduced consciousness.Conclusion: Electrolyte disturbances, particularly hypokalemia and hypocalcemia, are prevalent in TBI patients. Early detection and correction may reduce complications and mortality.
Original Article
Health and environment
Reza Nemati; Mokhtar Mahdavi; Narges Hakimi; Nahid Rashidi; Ali Vahedi Gandomani
Abstract
Introduction: The Kaveh Industrial Estate spans 3,000 hectares near Saveh and operates continuously. A residential area housing over 2,500 inhabitants is situated directly adjacent to it. Assessing and mapping environmental noise exposure is critical for understanding exposure levels and supporting urban ...
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Introduction: The Kaveh Industrial Estate spans 3,000 hectares near Saveh and operates continuously. A residential area housing over 2,500 inhabitants is situated directly adjacent to it. Assessing and mapping environmental noise exposure is critical for understanding exposure levels and supporting urban planning and environmental management. This study aimed to evaluate and spatially analyze noise pollution in the adjacent residential zone during the fall and winter of 2024–2025.Materials and Methods: Following a preliminary assessment based on ISO 1996-1:2016 guidelines, 49 measurement locations were selected. The equivalent continuous A-weighted sound pressure level (Leq) was measured at each site using a TES-1358 sound level meter. Data were processed in Excel and analyzed spatially using ArcGIS Pro.Results: Spatial analysis revealed that 88% of the residential area exceeded 65 dB during the day, and 96% exceeded 55 dB at night. The mean Day-Night Sound Level (DNL) was 71 dB. Only a minimal portion of the area exhibited nighttime levels near or below the 45 dB permissible limit.Conclusion: The findings indicate that the residential area adjacent to Kaveh Industrial Estate is exposed to noise levels exceeding standard limits in most locations, particularly at night when sound levels in many zones surpassed 65 dB. The uneven spatial distribution of noise indicates the influence of local sources and a lack of effective sound barriers. These results underscore the need for environmental reconsideration of industrial areas and the implementation of control measures such as noise walls, green buffers, nighttime operation limits, and continuous monitoring.
Original Article
Health Education
Hossein Ajam Noroozi; Fatemeh Abdoli; Razieh Khosrorad; Masomeh Hashemian; Mohamad Hasan Rakhshani; Ali Mehri; Reza ShahrAbadi; zahra Joveini; Hamid Joveini; Hamidreza Mohaddes hakak
Abstract
Background and objective: Human papillomavirus (HPV) is a common, high-risk sexually transmitted infection globally. Identifying factors that predict preventive behaviors against HPV is crucial for reducing associated cancers. This study aimed to determine the predictors of HPV preventive behaviors ...
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Background and objective: Human papillomavirus (HPV) is a common, high-risk sexually transmitted infection globally. Identifying factors that predict preventive behaviors against HPV is crucial for reducing associated cancers. This study aimed to determine the predictors of HPV preventive behaviors among married women based on the Theory of Planned Behavior (TPB).Materials and Methods: This cross-sectional study included 80 married women aged 10 to 54 years in Jajarm City, selected using a multi-stage cluster sampling method. Data were collected using a researcher-made questionnaire that covered demographic information and TPB constructs. Data were analyzed using Descriptive and analytical statistics in SPSS version 27.Results: Among participants, 45% had a university education, 77.5% were housewives, 74% had an income exceeding 8 million Tomans, 95% had children, and 55% had undergone a Pap smear test. While all TPB constructs significantly predicted HPV preventive behaviors, perceived behavioral control (p<0.001, β=0.51) and subjective norms (p<0.001, β=0.51) demonstrated the greatest predictive power.Conclusion: The Theory of Planned Behavior is an appropriate framework for predicting HPV preventive behaviors. Interventions focusing on enhancing perceived behavioral control and subjective norms may be particularly effective.
Original Article
Biophysics & Radiotherapy
Hamid-Reza Sadoughi; Pooya Vahabi-Nasiri; Parastoo Amiri; Seyed Alireza Javadinia; Ruhollah Ghahramani-Asl
Abstract
Background: External beam radiotherapy is a cornerstone in the management of rectal cancer. Due to the anatomical proximity of critical pelvic structures to the radiation fields, accurate dosimetry is essential. This study aimed to quantify and analyze the radiation dose delivered to healthy organs in ...
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Background: External beam radiotherapy is a cornerstone in the management of rectal cancer. Due to the anatomical proximity of critical pelvic structures to the radiation fields, accurate dosimetry is essential. This study aimed to quantify and analyze the radiation dose delivered to healthy organs in patients with rectal cancer undergoing beam radiotherapy.Materials and Methods: In this retrospective cross-sectional study, we analyzed the dosimetric records of 66 patients with rectal cancer treated at Vasei Hospital Radiotherapy Department in Sabzevar between 2019 and 2021. Demographic data and dosimetric parameters —including the mean and maximum equivalent dose in 2-Gy fractions (EQD2) to the clinical target volume (CTV), planning target volume (PTV), and organs at risk (bladder, femoral heads, penile bulb)— were extracted from the IsoGray treatment planning system. Data were analyzed using SPSS v22 with independent t-tests, Pearson correlation, and ANOVA.Results: The mean radiation doses to the organs at risk (OAR) were as follows: bladder, 47.96 ± 5.83 Gy; left femoral head, 26.40 ± 6.68 Gy; right femoral head, 25.66 ± 7.40 Gy; and penile bulb, 17.75 ± 13.27 Gy. Although femoral head doses were higher in males and bladder doses in females, these differences were not statistically significant. A weak positive correlation was observed between patient age and penile bulb dose. No significant association was found between BMI and OAR doses.Conclusion: Demographic variables did not significantly influence dose distribution to adjacent healthy organs. Treatment planning should emphasize tumor anatomy and the adoption of advanced radiotherapy techniques for optimal dose conformity and organ sparing.
Original Article
Gyneocology
Sara Hajiseyedi; Behnaz Souizi
Abstract
Background: Postoperative pain is the most common postoperative complaint following cesarean section. While gabapentin reduces acute post-cesarean pain, evidence for its efficacy remains limited. This study aimed to investigate the effect of gabapentin in reducing post-cesarean section pain.Materials ...
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Background: Postoperative pain is the most common postoperative complaint following cesarean section. While gabapentin reduces acute post-cesarean pain, evidence for its efficacy remains limited. This study aimed to investigate the effect of gabapentin in reducing post-cesarean section pain.Materials and Methods: This randomized, double-blind clinical trial study, was conducted on women scheduled for elective cesarean section under spinal anesthesia at Mobini Hospital. Participants were randomly assigned to receive either a single 300 mg gabapentin capsule (intervention group) or a placebo capsule (control group) administered the drug orally after cesarean section. Postoperative pain intensity was assessed using a Visual Analog Scale (VAS) at 2, 4, 6, 12, and 24 hours postoperatively. Data were analyzed using SPSS version 20, with a significance level set at p < 0.05.Results: Patients in the gabapentin group reported significantly lower pain scores over the first 24 hours compared to the placebo group (p = 0.043). No significant difference was observed in the requirement for supplemental opioid analgesics between the two groups.Conclusion: A single preoperative dose of 300 mg gabapentin is effective in reducing acute postoperative pain in patients undergoing elective cesarean section.
Original Article
Nursing
Hamidreza Zeraatkhah; Fatemeh Sharififard; Houshang Kadivarian; Leila Ghanbari-Afra
Abstract
Background: The rising prevalence of diabetes among women and its adverse effects on sexual function and overall quality of life, this study aimed to evaluate sexual function and its associated factors in women with diabetes.Materials and Methods: In this descriptive cross-sectional study, 204 ...
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Background: The rising prevalence of diabetes among women and its adverse effects on sexual function and overall quality of life, this study aimed to evaluate sexual function and its associated factors in women with diabetes.Materials and Methods: In this descriptive cross-sectional study, 204 women with diabetes were recruited using convenience sampling from the Diabetes Clinic of Qom University of Medical Sciences during the summer and autumn of 2024. Data were collected using a demographic and occupational checklist and a self-reported female sexual function scale. Descriptive statistics and Spearman’s correlation coefficient were used to analyze the relationship between sexual function scores and demographic/occupational variables. Statistical significance was set at p < 0.05.Results: The mean age of participants was 45.72 ±12.83 years, and the mean duration of diabetes was 7.57 ±SD = 5.85 years. The mean female sexual function score was 20.11± 5.96. Sexual function showed a significant negative correlation with age, spouse’s age, employment status, number of children, and diabetes complications. A significant positive correlation was observed with income, marital status, and education level.Conclusion: Diabetes is associated with sexual dysfunction in women, influenced by several factors, including age, spouse’s age, marital status, educational level, employment, income, and diabetes-related complications. Integrating regular screening and monitoring of sexual health issues into routine diabetes care, particularly in specialized clinics, is recommended.
Original Article
immunology & Biochemistry
Kazem Abbaszadeh goudarzi; Zahra Moradi; Mahdi Tadayonfar; Mahsa Asghari; Maryam Nabavifard; Amir Raoofi; Roghayeh Zardosht; Saeideh sadat Shobeiri; Mohammad Shafi Mojadadi
Abstract
Introduction: Serum cortisol concentration correlates with anti-spike antibody levels in vaccinated individuals, suggesting cortisol may be a marker of vaccine immunogenicity. This study aimed to investigate the relationship between serum cortisol levels and anti-SARS-CoV-2 spike protein antibody response ...
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Introduction: Serum cortisol concentration correlates with anti-spike antibody levels in vaccinated individuals, suggesting cortisol may be a marker of vaccine immunogenicity. This study aimed to investigate the relationship between serum cortisol levels and anti-SARS-CoV-2 spike protein antibody response following vaccination.
Materials and Methods: In this cross-sectional study, 80 staff members from Sabzevar University of Medical Sciences who had received a second dose of either the Sinopharm or Sputnik V vaccine were included. Serum cortisol and anti-spike IgG antibody levels were measured using enzyme-linked immunosorbent assay (ELISA). Data were analyzed with SPSS version 22, employing ANOVA and Pearson's correlation.
Results: The mean age of participants was 34.81 ± 7.62 years. Significant differences were found in both anti-spike IgG titers and serum cortisol levels based on vaccine type (P < 0.001). Recipients of the Sputnik V vaccine demonstrated significantly higher antibody levels (mean ± SD: 138.2 ± 65.1 AU/mL) and cortisol levels (7.8 ± 2.5 µg/dL) compared to Sinopharm recipients (69.0 ± 60.3 AU/mL and 5.1 ± 1.8 µg/dL, respectively). No significant differences in antibody or cortisol levels were observed based on age or gender. Furthermore, no significant correlation was found between individual serum cortisol concentration and anti-spike IgG titer (P > 0.05).
Conclusion: While the type of COVID-19 vaccine was associated with differing levels of both antibody response and serum cortisol, no direct correlation was established between serum cortisol concentration and anti-SARS-CoV-2 spike protein IgG antibody titer
Original Article
Psychology
Saba Faraji; Sanaz Bahremand; Ahmad Foroughi; Ramyar Hariri; Masoumeh Sajadirad; Pedram Fadavi; Mona Hashemizadeh; Reyhane Bayani; Raana Ahmadian; Maryam Garousi
Abstract
Introduction: Cancer profoundly impacts multiple life domains, leading to adverse outcomes such as compromised physical health, diminished quality of life, and psychological distress. Patients face significant stressors related to diagnosis and treatment. This study aimed to investigate the relationship ...
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Introduction: Cancer profoundly impacts multiple life domains, leading to adverse outcomes such as compromised physical health, diminished quality of life, and psychological distress. Patients face significant stressors related to diagnosis and treatment. This study aimed to investigate the relationship between family support and the mental health of breast cancer patients.Materials and Methods: This cross-sectional study included 70 breast cancer patients attending Imam Khomeini and Shohada Haft Tir hospitals for radiotherapy, chemotherapy, or follow-up over six months. A standardized family support questionnaire was used to assess the structural, professional, and interactive characteristics of the family. Data analysis was performed using SPSS version 21, employing chi-square tests, correlation coefficients, and ANOVA.Results: The mean total family support score was 15.7±2.96 with a range of 9.87-21.06. Higher scores indicate poorer family functioning. Mean anxiety and depression scores were 9.68±5.34 and 8.34±4.41, respectively. Results demonstrated that higher scores on the family support questionnaire (indicating less healthy family dynamics) were significantly associated with increased levels of anxiety and depression.Conclusion: The findings indicated that higher scores on the Family Dysfunction Scale (where a higher score indicates poorer family function) were significantly associated with greater anxiety and depression. Among patients who received radiation or chemotherapy, higher family dysfunction scores were specifically associated with increased depression.
Original Article
Radiology
Matin Noroozi; Hamed Ghorani; Arash Khameneh Bagheri
Abstract
Introduction: This study aimed to evaluate the effectiveness of uterine artery embolization (UAE) in controlling fibroid-related abnormal uterine bleeding (AUB) and to assess its impact on fertility preservation and patient satisfaction.Materials and Methods: This retrospective studyincluded 17 women ...
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Introduction: This study aimed to evaluate the effectiveness of uterine artery embolization (UAE) in controlling fibroid-related abnormal uterine bleeding (AUB) and to assess its impact on fertility preservation and patient satisfaction.Materials and Methods: This retrospective studyincluded 17 women aged 21-42 years who underwent UAE between 2019 and 2022 at Shohada Tajrish Hospital. Data on demographic, menstrual patterns, number of children, length of hospital stay, complications, and post-treatment fertility status were collected from medical records. Patients were followed for 3 to 12 months through in-person visits or phone calls. Data were analyzed with descriptive and inferential statistical tests using SPSS version 25. (P<0.05).Results: Uterine fibroids were the cause of AUB (100%). The most common bleeding pattern was menorrhagia (47.1%), followed by normal menstruation (41.2%), menopause (5.9%), and metrorrhagia (5.9%). Most patients (54.2%) had two children. Most patients (64.7%) were discharged within 24 hours, while 35.3% were discharged within 48 hours. Fever was the most frequent post-procedure complication (41.2%). All patients preserved their menstruation. All patients reported preserved menstrual function at follow-up.Conclusion: Uterine artery embolization (UAE) proved to be a safe and effective treatment for fibroid-related abnormal uterine bleeding (AUB) in this study, with preservation of menstrual function observed throughout the 3–12-month follow-up period. These findings suggest that UAE may be a suitable uterus-preserving alternative to surgery. However, these results should be interpreted with caution due to the study's retrospective design and small sample size. Larger prospective studies are warranted to confirm these outcomes.