Letter to the Editor
Health System
Roghayeh Zardosht
Abstract
The twelve-day war between Iran and Israel (June 13–24, 2025), initiated by sudden attacks on Iran’s key military and nuclear sites, caused numerous casualties among senior military officials, nuclear scientists, and civilians. This letter reviews crisis management effectiveness in ...
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The twelve-day war between Iran and Israel (June 13–24, 2025), initiated by sudden attacks on Iran’s key military and nuclear sites, caused numerous casualties among senior military officials, nuclear scientists, and civilians. This letter reviews crisis management effectiveness in Iran’s healthcare system during the conflict. Crisis management in the health system is a complex and critical process that requires collaboration and coordination among all stakeholders. Its primary goals include protecting the health of personnel and patients, minimizing casualties and damages, and ensuring a rapid return to a normal state. In Iran, crises are not limited to wartime conditions; rather, they encompass pandemics (e.g., COVID-19), natural disasters (such as earthquakes and floods), chemical or radiological incidents, and terrorist attacks. However, evidence suggests that our current preparedness within the healthcare sector remains inadequate, particularly in responding to severe crises such as war. The existing structures do not appear to be fully responsive or resilient under such extreme conditions. In this letter, the challenges and opportunities observed in the Iranian health system during the recent 12-day war are examined.
Original Article
Nursing
Somaie Bojani; , Ezat Samadipour; Nazanin Fekri; Mostafa Rad
Abstract
Background: Infection control in the emergency department is of paramount importance but no study has been conducted on the impact of FMEA on infection control in emergency departments. This study aimed to determine the effect of implementing the FMEA method on the level of adherence to infection control ...
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Background: Infection control in the emergency department is of paramount importance but no study has been conducted on the impact of FMEA on infection control in emergency departments. This study aimed to determine the effect of implementing the FMEA method on the level of adherence to infection control guidelines by nurses in the emergency department.Materials and Methods: A quasi-experimental study was conducted using a convenience sampling method on 40 nurses working in the emergency department. The data collection tool was a checklist assessing infection control practices. A four-hour brainstorming session was held to gather expert opinions on improving, and enhancing strategies for infection control were approved and implemented. Nurses’ infection control behaviors were evaluated using the checklist both before and two weeks after the intervention. Data were analyzed using frequency, mean, standard deviation, and paired t-test.Results: The prioritized risks were handwashing, use of mask and goggles, adherence to safety precautions, gown usage, and glove usage, in a descending order. The mean age of participants was 32.10 ± 6.94 years. Hand rub was 23.02 ± 3.94, and 22.12 ± 3.88 before and after intervention respectively; but the difference was not statistically significant (P = 0.09). Significant improvements were observed in adherence to safety precautions and glove usage before and after the intervention (P < 0.05).Conclusion: The interventions had a significant effect on improving adherence to safety precautions and glove usage. Therefore, it is recommended that healthcare centers adopt the FMEA approach alongside conventional methods to enhance infection control practices.
Original Article
dentistry
Mohammad Mehdizadeh; Akram Mehrandasht; Mohammad Baghdadi
Abstract
Background: The use of bisphosphonates, anti-adsorption and anti-angiogenic drugs during the treatment process of chemotherapy patients can increase the likelihood of developing Bisphosphonate-Related Osteonecrosis of the Jaw. The present study was conducted to determine the percentage of lesion incidence ...
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Background: The use of bisphosphonates, anti-adsorption and anti-angiogenic drugs during the treatment process of chemotherapy patients can increase the likelihood of developing Bisphosphonate-Related Osteonecrosis of the Jaw. The present study was conducted to determine the percentage of lesion incidence in different areas of the jaw considering the duration and type of chemotherapy drugs used.Materials and Methods: In this cross-sectional study, a total of 749 files of patients aged 18-92 years were coded and selected by simple random sampling, considering the inclusion criteria. Patients with a mean age of 56.05 ± 13.85 years were selected using simple random sampling, considering inclusion criteria and variables such as cancer diagnosis type, presence or absence of metastasis, etc. The extracted data were analyzed using SPSS version 22.Results: The highest frequency of patients with different types of cancer was related to breast cancer with 301 patients and the average duration of treatment was 1.12 ± 0.46 years. The highest frequency in terms of drug use in patients was related to Alendronate with 391 patients; and 45 patients had metastases. No significant relationship was observed between the association of BRONJ incidence with different variables, but a significant association was observed between the BRONJ incidence, the severity of the disease and the location of BRONJ.Conclusion: The incidence of BRONJ in the patients, the severity of bronzing and its area can vary. The highest incidence of BRONJ was in the posterior jaw area; and its incidence decreased with increasing disease grade.
Original Article
Psychology
Azade Rezayati; Soodabeh Bassaknejad; Zabihollah Abbaspour
Abstract
Background: Infertility, especially when accompanied by repeated treatment failures, can lead to severe psychological distress and suicidal ideation. This study aimed to examine the effectiveness of Mindfulness-Based Self-Compassion Therapy (MSCT) in reducing feelings of failure, social rejection, and ...
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Background: Infertility, especially when accompanied by repeated treatment failures, can lead to severe psychological distress and suicidal ideation. This study aimed to examine the effectiveness of Mindfulness-Based Self-Compassion Therapy (MSCT) in reducing feelings of failure, social rejection, and perceived burdensomeness among infertile women with suicidal thoughts.Materials and Methods: This research employed a single-subject design with multiple baselines. The study population included infertile women with suicidal ideation who visited infertility treatment centers in Tehran during the first half of 2024. Based on the inclusion criteria, six participants were selected. Data were collected at baseline, during the intervention, and follow-up stages using three instruments: the Suicidal Behaviors Questionnaire-Revised (SBQ-R), the Failure Scale, and the Interpersonal Needs Questionnaire (INQ). Data analysis was performed using SPSS and Excel, including visual graphs, the Reliable Change Index, and percentage improvement.Results: The percentage improvement in feelings of defeat was 34.7% after treatment and 38.16% at follow-up. Social rejection demonstrated the greatest improvement: 57.18% after treatment and 63.33% at follow-up. Perceived burdensomeness also decreased by 42.15% after treatment, amounting to 44.83% at follow-up. Differences were observed among participants in their level of responsiveness to the intervention.Conclusion: The results suggest that Mindfulness-Based Self-Compassion Therapy is an effective intervention for reducing psychological risk factors associated with suicidal ideation in infertile women. By enhancing emotional resilience, strengthening social bonds, and fostering self-compassion, MSCT helps reduce feelings of failure, isolation, and burdensomeness.
Original Article
Nursing
Hosein Shahri; Mohammad Abbasinia; Zahra Abedini; Ashraf Khoramirad
Abstract
Background: Desirable social tendencies are among factors influencing the quality of nursing care. This study aimed to investigate the relationship between moral identity and desirable social tendencies among nursing students at Qom University of Medical Sciences, Iran.Materials and Methods: This ...
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Background: Desirable social tendencies are among factors influencing the quality of nursing care. This study aimed to investigate the relationship between moral identity and desirable social tendencies among nursing students at Qom University of Medical Sciences, Iran.Materials and Methods: This descriptive analytical cross-sectional study was conducted on 195 undergraduate nursing students at Qom University of Medical Sciences, Iran in 2024 using stratified sampling. Data were collected via Black and Reynolds Moral Identity Questionnaire and the Revised Desirable Social Tendencies Questionnaire by Carlo et al. Data analysis was performed in SPSS version 26 using multiple linear regression; the significance level was set at 0.05.Results: Multiple regression analysis showed that overall moral identity scores significantly predicted anonymous and emergency prosocial tendencies, accounting for 6.5% and 6.4% of their variance, respectively. The “moral self” dimension was significantly associated with overall desirable social tendencies, accounting for 13.1% of the variance, and also significantly predicted altruistic (4.2%), emotional (3.3%), and compliant (4.7%) prosocial tendencies (P < 0.05).Conclusion: The findings indicated that moral identity was significantly associated with desirable social tendencies, and predicted these behaviors among nursing students. Interventions aimed at fostering moral identity may enhance social tendencies and ultimately improve the quality of nursing care.
Original Article
Microbiology
Sadaf Ataei alamdari; Mohammad Arjomandzadegan; Mona Nassaj Manizani; Azam Ahmadi
Abstract
Background: Biofilm formation is one of the most important mechanisms of survival and pathogenicity of Escherichia coli, especially in antibiotic-resistant isolates. Beta-lactamase-producing isolates (ESBL) can pose a serious threat to patients with colorectal cancer due to increased drug resistance ...
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Background: Biofilm formation is one of the most important mechanisms of survival and pathogenicity of Escherichia coli, especially in antibiotic-resistant isolates. Beta-lactamase-producing isolates (ESBL) can pose a serious threat to patients with colorectal cancer due to increased drug resistance and the ability to form biofilms. This study aimed to investigate the biofilm production of ESBL isolates and the pattern of drug resistance.Materials and Methods: A total of 46 stool samples from colorectal cancer patients were collected. The isolates were identified using standard biochemical tests. The production of ESBL was phenotypically identified using the Disk diffusion method according to CLSI guidelines. Phenotypic identification of biofilm was performed using the microtiter plate method. The presence of fimH and Luxs1 genes was assessed using polymerase chain reaction (PCR).Results: The results showed that 65.2% were capable of forming biofilms. Based on optical density in the microtiter plate test, 19.5% formed strong biofilms,19.5% formed moderately strong biofilms, and 26% formed weak biofilms. Additionally, 34.7% were unable to form biofilms. In the genotypic analysis using PCR, the fimH and luxs1 genes were evaluated, and the results indicated that a total of 46 isolates possessed the fimH and luxs1 genes.Conclusion: The results of this study indicated that biofilm formation in ESBL-producing E. coli isolates in colorectal cancer patients is common and may play an important role in increasing antibiotic resistance.
Original Article
Microbiology
Hossein Elyasi
Abstract
Background: Leishmaniasis is considered one of the major health problems in Iran. Given that epidemiological analyses play an important role in disease control and preventive measures, this study was conducted with the aim of epidemiological analysis of cutaneous leishmaniasis in the North Khorasan Province ...
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Background: Leishmaniasis is considered one of the major health problems in Iran. Given that epidemiological analyses play an important role in disease control and preventive measures, this study was conducted with the aim of epidemiological analysis of cutaneous leishmaniasis in the North Khorasan Province of Iran.Materials and Methods: This descriptive-analytical study was conducted on the data of patients with cutaneous leishmaniasis between years 2014 and 2022. The demographic and epidemiological data recorded in the disease surveillance system of the Health Deputy of North Khorasan Province were extracted and analyzed using SPSS software by the Chi-square test.Results: The number of patients with cutaneous leishmaniasis during these 8 years was 2243 cases. Considering the population of the region (863,000 people), the overall incidence of the disease during these few years was 32.5 per 100,000 people. Out of the patients, 62.2% were male; 51.1% were rural residents. Most cases were in the age groups of children under 10 years old. In terms of occupation, the highest frequency occurred among the two groups of students and children (P<0.05). The majority of wounds (76.6%) were exudative.Conclusion: The prevalence of the disease in the North Khorasan Province lies in the middle of the frequency spectrum of endemic diseases of Iran, which is higher than the national average incidence. Considering the high incidence of the disease among the two groups of children and students, the need for necessary education in disease prevention and increasing the level of health literacy is suggested.
Original Article
Health Education
leila roodaki; Davood Shojaeizadeh; Zahra Saboohi
Abstract
Background: Hepatitis B virus is a potentially fatal viral infection that can lead to acute and chronic liver disease such as cancer and cirrhosis. The present study was conducted with the aim of determining the effect of an educational intervention based on the health belief model on the promotion of ...
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Background: Hepatitis B virus is a potentially fatal viral infection that can lead to acute and chronic liver disease such as cancer and cirrhosis. The present study was conducted with the aim of determining the effect of an educational intervention based on the health belief model on the promotion of hepatitis B preventive behaviors in medical students of Saveh, Iran.
Materials and Methods: In this quasi-experimental study, 92 students at Saveh School of Medical Sciences were recruited in 2018 by random sampling method in two stages. The data was collected through a researcher-made questionnaire, completed by both groups before and after the intervention after evaluating its validity and reliability. Data were analyzed in SPSS 24 software.
Results: The results showed that before the educational intervention, there was no significant statistical difference in the mean scores of the health belief model structures between the intervention and control groups (p > 0.05). However, after the educational intervention, a statistically significant difference was observed between the before and after changes across their scores in awareness, perceived sensitivity, perceived benefits, perceived self-efficacy, and hepatitis B prevention behaviors across the intervention and control groups (p > 0.05).
Conclusion: The results showed that education based on the health belief model is effective in promoting hepatitis B prevention behaviors among students. Considering the increase in scores of the related constructs, the implementation of an educational program based on the health belief model among students can improve their knowledge and performance regarding hepatitis B disease.
Original Article
Epidemiology and Statistics
Javad Moghri; Hamid Joveini; Habibollah Esmaily; Zahra Keyvanlo
Abstract
Background: Tuberculosis continues to be a significant public health challenge, especially in resource-limited areas such as Iran. The incidence of tuberculosis in Iran, especially in high-risk provinces such as Khorasan Razavi, is higher than the national average, requiring urgent public health interventions. ...
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Background: Tuberculosis continues to be a significant public health challenge, especially in resource-limited areas such as Iran. The incidence of tuberculosis in Iran, especially in high-risk provinces such as Khorasan Razavi, is higher than the national average, requiring urgent public health interventions. Therefore, this study aimed to investigate some factors affecting the outcomes of tuberculosis treatment in Khorasan Razavi during 2016-2022.Materials and Methods: This retrospective cross-sectional study used comprehensive data from the National Tuberculosis Registration System during 2016-2022, and investigated factors affecting the recovery and treatment failure of patients with tuberculosis in this North-Eastern province. Statistical analyses, including chi-square and logistic regression, were used to assess the relationships between demographic variables and treatment success rates.Results: Among 2186 patients, the treatment failure rate was 2.1%, with no statistically significant associations observed for gender, marital status, nationality, and education level. Logistic regression also revealed no significant predictors of treatment outcomes. However, treatment failure was highest among single individuals (2.8%) and those with higher education levels (3.0%).Conclusion: This study highlights the need for targeted interventions to address social determinants, including specific support provision for vulnerable groups. Disruptions caused by the COVID-19 pandemic are likely to have contributed to reduced TB case detection and treatment adherence. Strengthening TB prevention and control programs are essential to achieve global goals for eradication of the disease.
Original Article
Occupational Health
Sahar Avazverdi; Ahmad Allahabadi; Mohammad Hassan Rakhshani; Ruhollah Ghahramani asl; Majid Fallahi
Abstract
Background: Electromagnetic exposure and acoustic noise constitute significant occupational hazards in MRI facilities, with sound pressure levels typically ranging from 80 to 110 dB (A) with potentially discomfort or pain, demanding due attention to maintain the health of personnel. Thierefore, this ...
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Background: Electromagnetic exposure and acoustic noise constitute significant occupational hazards in MRI facilities, with sound pressure levels typically ranging from 80 to 110 dB (A) with potentially discomfort or pain, demanding due attention to maintain the health of personnel. Thierefore, this study was conducted with the aim of evaluating the environmental levels of static magnetic fields, electromagnetic fields, and noise in a magnetic resonance imaging center.Materials and Methods: The parameters of the static magnetic field were measured with a 3-axis Gauss meter, the electromagnetic field with a TES-92 device, and the equivalent sound level with a CEL 63-X device in the control room, waiting room, and imaging room. SPSS software and nonparametric Kruskal-Wallis tests and paired comparisons of three sections were used to analyze the data at a significance level of 0.05.Results: The highest static magnetic field value was 5.51 mT on the left side of the scanner, the electric field was 63.91 v/m in front of the scanner, 168.41 mA/m in the front of the scanner, and the Leq was 86.77 dB on the left side of the scanner. There was a significant difference between the values of the static magnetic field, electric field, and magnetic field in the control room and their values in the imaging room. Also, there was a significant difference between the average static magnetic field at a distance of one meter and two meters during different scans.Conclusion: The average levels of the static magnetic field and electromagnetic field were lower than the national standard limits of Iran. This indicates that in the MRI unit, exposure to the assessed factors is generally below the permissible level, which is considered a positive sign in terms of occupational safety.
Original Article
Microbiology
Kimia Makvandi; Roya Pirmoradi; Manoochehr Makvandi; Azarakhsh Azaran
Abstract
Background: Knowledge regarding prevalence of Hepatitis E Virus (HEV) can be an indicator of the public health and hygiene. HEV is the main cause of acute hepatitis in adult patients. Although the main route of its transmission is through the fecal-oral route, reports have been published about the ...
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Background: Knowledge regarding prevalence of Hepatitis E Virus (HEV) can be an indicator of the public health and hygiene. HEV is the main cause of acute hepatitis in adult patients. Although the main route of its transmission is through the fecal-oral route, reports have been published about the transmission of this virus through blood transfusion. This study aimed to determine seroepidemiology of hepatitis E virus among thalassemia major patients in Ahvaz, Iran.Materials and Methods: In this descriptive cross-sectional study, 88 patients with beta-thalassemia major admitted to Shafa Clinic in Ahvaz, Iran, to receive blood monthly in a period of 6 months in 2018, were included in the study. An ELISA kit was used to detect anti HEV IgM and IgG Ab. RT-PCR was used for RNA detection from all samples. The obtained data were statistically analyzed.Results: Out of 88 patients, 10 (11.36%) were positive for HEV IgG; and the prevalence of HEV IgM was determined in 6 patients (6.81%) with the ELISA method. RT-PCR showed that none of the samples contained the virus. There were no significant relation between anti HEV Ab and variables such as age and gender. There was a significant association between HEV infection and frequency of blood transfusion (P = 0.02).Conclusion: In this research, despite the absence of the virus in the blood, patients had hepatitis and were likely to transmit the virus through infected blood. The prevalence of the HEV in the study population is high, showing that the infection is endemic in the community.
Original Article
Educational
Mahdi Abbasi; Masoumeh Hashemian; Negar Shdab Mehr; Zahra Moradi; Mohammad Hossein Mohammadi; Sana Jafarlou
Abstract
Background: Effective communication with patients is a core skill for medical students. Traditional teaching offers limited experiential learning opportunities. This study aimed to design and implement the “Teddy Bear Hospital” program to strengthen students’ communication skills.Materials ...
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Background: Effective communication with patients is a core skill for medical students. Traditional teaching offers limited experiential learning opportunities. This study aimed to design and implement the “Teddy Bear Hospital” program to strengthen students’ communication skills.Materials and Methods: This action research was conducted at Sabzevar University of Medical Sciences in Iran. The program was developed and implemented based on the ADDIE model. During the analysis phase, a needs assessment was conducted through semi-structured interviews. In the design and development phase, educational content was created encompassing seven core competencies for effective doctor–patient communication. Learning materials included simulated clinical scenarios, multimedia resources, educational pamphlets, and stakeholder guides. The program involved 30 medical students (including six trained facilitators) and approximately 400 elementary school children. Data were analyzed using SPSS 21 and Atlas.ti v9.Results: More than 60% of students reported limited prior experience communicating with children in clinical settings. Participants indicated improvements in their communication skills and increased willingness to work in pediatric care after the program. Additionally, children’s fear of physicians and hospitals decreased following the intervention. Approximately 94% of students and 98% of children rated their satisfaction with the program as “good” or “very good”.Conclusion: The “Teddy Bear Hospital” program can enhance medical students’ communication skills with pediatric patients and their parents while reducing children’s fear of hospitals and physicians. Implementing experiential and interactive educational approaches may contribute to the development of students’ professional and communicative competencies.