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Background: Threatened abortion (TA) is associated with adverse pregnancy outcomes. Despite the attention paidto the adverse outcomes of obstetrics, only a few studies have been conducted on the psychological status of womenwith threatened abortion. This study aimed to compare the symptoms of depression and anxiety in women with TAand those without threatened abortion.Materials and Methods: In a case-control study, 136 women with TA (the case group) and 136 women without TA(the control group), were matched with the case group in terms of gestational age, education level, age, and numberof pregnancies, were examined from Obstetric clinics of Babol University of Medical Sciences. Demographic informationand pregnancy history were obtained from all participants. Additionally, the women filled out the BSI-18questionnaire. Statistical analysis was performed using SPSS version 22 software.Results: The results showed that in women with threatened abortion, the likelihood of experiencing depressionsymptoms was 1.9 times higher [odds ratio (OR)=1.91, 95% confidence interval (CI)=1.13-3.23, P=0.015], anxietysymptoms were 1.8 times higher (OR=1.83, 95% CI=1.08-3.10, P=0.024), and somatization was 2.6 times higher(OR=2.65, 95% CI=1.61-4.37, P

Testicular torsion, as one of the medical emergencies, needs prompt diagnostic and treatment measures. This cross-sectional study aimed to assess the clinical and paraclinical findings and the treatment measures performed in the community of hospitalized patients who underwent surgery in Shahid Beheshti Hospital of Babol from 2012 to 2021 with the initial diagnosis of testicular torsion. The research sample was selected via the convenience sampling method. The necessary information was collected from patients' medical records in the form of a checklist. Thereafter, the data were analyzed in SPSS software (version 22) using descriptive and graphical indicators, as well as Chi-square and Fisher's exact tests at a significance level of 0.05. The findings demonstrated that 197 patients with a mean age of 18.91 years were included in the study. The majority of them (n=121; 61.42%) had torsion on the right side. More than 98% of patients experienced pain, while most of them did not have fever (n=160; 81.22%) and vomiting (n=153; 77.66%). In 148 (75.13%) patients, the final diagnosis was testicular torsion, and in 101 (68.24%) patients, the testicle was preserved. Moreover, the result of the surgery had a significant relationship with the degree of rotation and the duration of the onset of symptoms until hospitalization and from hospitalization to surgery (P>0.001, 0.001 and 0.026, respectively). It can be concluded that an understanding of clinical characteristics of testicular torsion cases and as a result, informing the treatment staff involved in the treatment process, reduce the duration of delay in surgery and leads to more appropriate clinical treatment and improved results in testicular torsion patients.

Background and Purpose: Success in orthodontic treatment is achieved by using devices and techniques to minimize patient discomfort. This study was designed to investigate the relationship between treatment motivation and pain intensity reported by the patient in the early stages of orthodontic treatment. Materials and Methods: In this cross-sectional study, 194 orthodontic candidates for fixed treatment were included. In the first part, the patients’ motivation was measured using a 27-item researcher-made questionnaire with 5 sections related to the patient’s motivation. In the second part, patients’ pain intensity was recorded using a pain visual analog scale (VAS). The obtained data were analyzed using SPSS software, version 26. Results: Findings suggested that the highest and lowest motivation scores were related to the importance of occlusion (91.75±12.79) and the degree of understanding of the problem (66.39±22.44), respectively. No statistically significant difference was observed between the components of motivation by gender, marital status, employment status, age, and smoking (P>0.05). Moreover, there was no significant association between the intensity of dental pain and any treatment motivation components. However, there was a statistically negative correlation between the intensity of mucosal pain and the understanding of the treatment process. Conclusion: No significant relationship between treatment motivation and pain intensity was reported by patients in the early stages of orthodontic treatment. Orthodontists are encouraged to increase their flexibility and patient management skills to avert their patients’ desire to cease their therapy due to intrusive factors such as pain.

Background: Treatments for acute bronchitis is usually a supportive care to relieve upper respiratory symptoms. This study aimed to evaluate the effect of Plantago major syrup (PMS) on cough severity in acute bronchitis. Methods: Patients (20-75 years-old) referred to the clinic of infectious diseases in Ayatollah Rouhani Hospital, Babol, Iran with a complaint of cough and the Bronchitis Severity Scale (BSS) ≥5 entered the study. The patients randomly received PMS or placebo 30 ml/day for 10 days. Patients were visited before treatment and on days 5 and 10 after treatment. The primary outcome was BSS score and secondary outcome was the life quality that was measured by means of the Persian version of the Leicester Cough Questionnaire (LCQ) at the first visit and on the 10th day. Results: Of the 121 patients diagnosed with acute bronchitis, 80 eligible patients (42.87±11.75 years-old) were randomly divided into PMS and placebo groups. The BSS score in the PMS group after 10 days was significantly lower than that of the placebo group (P=0.001). Frequency of cough (P=0.001), sputum production (P=0.005), and chest wall pain (P=0.008) were significantly lower in the PMS group than in the placebo group. In terms of quality of life, all items, including psychological, physical, and social domains, as well as total scores, were altered significantly in the PMS group compared to placebo. During monitoring of side effects, no significant adverse effects were stated in either group. Conclusion: The study indicates the palliative effects of PMS in relieving the symptoms of acute bronchitis and improving quality of life.

Cockroaches are widely recognized as vectors for transmitting pathogenic microorganisms in hospital and community environments due to their movement between contaminated and human-occupied spaces. Staphylococcus aureus (S. aureus), particularly methicillin-resistant Staphylococcus aureus (MRSA), is a primary global health concern because of its capacity to cause a wide range of infections and its resistance to many antibiotics. Despite efforts to control nosocomial infections, the role of cockroaches in disseminating antibiotic-resistant bacteria has not been fully explored. This study aims to investigate the antibiotic resistance patterns, biofilm formation, and genetic characteristics of S. aureus isolated from cockroaches in hospital environments. Understanding the role of cockroaches as vectors of drug-resistant S. aureus can contribute to developing more effective infection control strategies in healthcare settings. This study examined 386 cockroaches, including 230 American and 156 German cockroaches. Antibiotic sensitivity, inducible resistance, and biofilm formation were evaluated. The presence of mecA, ermA, ermB, ermC, msrA, icaA, icaB, icaC, icaD, SCCmec, mupA, mupB, and iles-1 genes was determined. Randomly amplified polymorphic DNA typing was performed to determine genetic relatedness. Fifty S. aureus isolates were identified, with 48 % confirmed as MRSA. No isolate exhibited constitutive resistance to clindamycin. However, 96 % of the isolates displayed inducible clindamycin resistance (iMLSB phenotype) when tested using the D-test. The prevalence of icaA, icaB, icaC, and icaD genes were 34 %, 8 %, 0 %, and 0 %, respectively. So, 29.1 %, 16.6 %, 12.5 %, and 8.3 % of isolates had SCCmec gene cassettes of types I, II, III, and IV, respectively. The prevalence of ermA, ermB, ermC, and msrA genes was found to be 18 %, 16 %, 58 %, and 4 %, respectively. Seven different clusters were found in the RAPD-PCR, with cluster A (5 isolates) being the most common. These results show that cockroaches are important in transmitting resistance factors as mechanical vectors. Therefore, taking sanitary measures to control the insect population is unavoidable.

IntroductionNorthern Iran is one of the regions of the country most affected by COVID-19. The aim of the current study was to examine the demographics, clinical characteristics, and outcomes of suspected and laboratory-confirmed patients

Background: Prenatal and postnatal depression (PND) is associated with adverse outcomes for mother, fetus, andchild. The aim of study was to examine the prevalence and risk factors of prenatal and postnatal depressive symptoms.Materials and Methods: This was a cross-sectional and hospital-based survey of 2305 pregnant women and post-partumwomen (18-48 years) that was registered in the Babol Pregnancy Mental Health Registry (BPMHR) database from June2020 to March 2021. Two questionnaires, including demographics and depression, were analyzed in this study. Also, theEdinburg Postnatal Depression Scale (EPDS) was used to assess the depressive symptoms. Independent t test and theanalysis of variance were used to compare the means. Multiple logistic regressions were used to determine risk factors fordepressive symptoms.Results: According to the EPDS scale, the prevalence of depressive symptoms was 19.8% in the pregnant womangroup in comparison with the postpartum period (11.6%). Risk factors for antenatal depressive symptoms were parity(women with parity ≥ 4 vs. 1 parity, ß=1.808, P=0.020), two groups of gestational age (gestational age ≤12 weeks vs.28 weeks, ß=1.562 P=0.030) as well as (gestational age 21-27 weeks vs. 28 weeks (ß=1.586, P=0.033), and high-riskpregnancy (high-risk vs. low-risk pregnancy, ß=1.457, P=0.003). For postnatal depressive symptoms, none of the factorswere a significant risk.Conclusion: Prenatal and postnatal depressive symptoms should be screened, particularly for women in the first andsecond trimesters, with high parity, and those with a high-risk pregnancy, as recommended by the present study.

Background and Objective: Three-Stage Theory explains development of suicidal ideation and suicidal attempt. According to Three-Stage Theory, high levels of pain and high levels of hopelessness lead to suicidal ideation. Belongingness plays a protective role against suicidal ideation and individual's suicide capacity predicts suicidal attempt. The purpose of this research was to investigate the relationship between pain, hopelessness, belongingness with suicidal ideation and attempt. Materials and Methods: In this cross-sectional study, 224 patients hospitalized in psychiatric department of Shahid Yahya Nejad Hospital with suicidal ideation were selected through convenience sampling between March to August 2021. All participants completed suicidal attempt question of Self-Injurious Thoughts and Behaviors Interview, Beck Scale for Suicide Ideation, Scale of Psychache, Beck Hopelessness Scale, Interpersonal Need Questionnaire and Suicidal Capacity Scale-3. Pearson's correlation, t-tests, hierarchical regression, analysis of variance and logistic regression were used to analyze the data and data were analyzed using SPSS software version 27. Results: There was a significant interactive effect between pain and hopelessness in predicting suicidal ideation (P< 0.01, t = 5.01). Additionally, belongingness and burdensomeness had significant interactive effects in predicting suicidal ideation (P< 0.01, t = 2.16). Pain and hopelessness accounted for 63.6% of the variance of suicidal ideation, while belongingness and burdensomeness explained 49.8% of variance in suicidal ideation. According to logistic regression, psychological pain (P

Background and purpose: The classification of prostate cancer patients based on the criteria of the European Urology Association, based on the level of a prostate-specific antigen, digital rectal examination, and Gleason score, is one of the golden criteria for the prognosis of the disease. On the other hand, it seems that in aggressive forms of the disease, cancer cells can spread along nerve cells, which is called perineurial invasion. The relationship between prostate cancer classification criteria and disease recurrence or survival is well known, but the importance of perineurial invasion in the prognosis of the disease is less discussed and investigated, so this study aims to compare two groups of positive and negative perineurial invasion. It is based on the EAU risk classification to investigate the difference between the two groups in terms of disease prognosis. Materials and methods: This retrospective study was conducted on 200 prostate cancer patients who underwent radical prostatectomy in Babol University of Medical Sciences affiliated hospitals between 1396 and 1400. Inclusion criteria included prostate cancer and, the presence of clinical and pathology test results. The exclusion criterion was the patient suffering from all types of prostate cancer, other than adenocarcinoma. All the demographic, paraclinical, clinical, and pathology data of the patients were obtained using the data recorded in the patient's pathology file as well as the hospital's archive department. Patients' information was extracted from patient files using a checklist including age, results of PSA, DRE, TNM, and Gleason scores, as well as the patient's condition in terms of peripheral nerve invasion. Gleason score is the standard criterion for histological differentiation of prostate cancer, which is graded from 2 to 10 points. A score less than 7 indicates better differentiation, a score of 7 indicates moderate differentiation, and a Gleason score of 8, 9, or 10 indicates poor differentiation of prostate cells. The study data were analyzed using SPSS version 20 software. was analyzed. Chi2 and Fisher Exact tests were used to analyze the data, and independent t-test (to compare two groups) and ANOVA (to compare more than two groups) were used to compare the mean of quantitative variables. Results: The average age of the subjects under study was 67.13±5.91. By classifying patients according to EAU risk groups, and comparing the risk class between patients with positive and negative perineurial invasion based on PSA, DRE, TNM, and Gleason score statistically significant differences were seen between the two groups. In almost all classifications based on clinicopathological scales, patients with positive perineurial invasion were at higher risk in terms of EAU criteria than patients with negative perineurial invasion. Conclusion: The results of the study showed that positive perineurial invasion in prostate cancer patients can be considered as a poor prognosis of the disease. The presence of cancer cells in the perineurial space can be an early sign of cancer progression

Background: Coronavirus disease 2019 (COVID-19) is a pandemic outbreak of RNA coronaviruses (SARS-CoV-2), associated with acute respiratory distress syndrome, multiple organ failure, and death. The surface electrocardiogram is the first line assessment of cardiac electrical system. We aimed to interpret classically the electrocardiographic parameters at admission and during hospital course and association of them with prognosis in patients admitted with diagnosis of infection with SARS-CoV-2. Methods: Surface electrocardiograms (ECG) were obtained from 180 patients with SARS-CoV-2 infection at a large tertiary referral university hospital at north of Iran in Babol. The electrocardiographic waves, intervals and segments in addition to supraventricular and ventricular arrhythmias were depicted. Our cohort included two groups: discharged alive and dead during the hospital course. We compared the ECG characteristics of patients who died vs. survived ones. Results: Some ECG parameters of 180 hospitalized patients were significantly associated with mortality, like heart rate (p< 0.001), bundle branch block (P= 0.035), fragmented QRS (P= 0.015), ST elevation (P= 0.004), T p-e duration (P= 0.006), premature atrial and ventricular complexes (P= 0.030, P= 0.004) and atrial fibrillation (P= 0.003). Conclusion: The SARS-CoV-2 infection had several impacts on cardiac electrical system which may monitored with a simple and easily accessible tool like ECG. This tool also helpful in the risk stratification of patients.

Background: The normal reference values for the thyroid uptake of radioactive iodine and Tc-99m pertechnetate in euthyroid patients vary by geographical location as well as the amount of iodine intake in the diet. The present study examines the normal reference values for thyroid uptake of Tc-99m pertechnetate in the North of Iran. Methods: The participants of this study were 64 patients (all over 20 years of age) who had referred to the Nuclear Medicine Center of the Shahid Beheshti Hospital for thyroid scan over the period between March 2018 and May 2020. It is worth mentioning that relying on laboratory test results, only patients with normal thyroid function were included in this cross-sectional study. Results: The median, the 5th and 95th percentiles and thyroid uptake range of 99mTc-pertechnetate in euthyroid patients were 0.9, 0.6 to 1.8% and 0.54 - 1.80%, respectively. Conclusion: The percentage of uptake in the thyroid gland in each geographical area varies based on race and diet content, so it is necessary to determine the percentage of uptake in each specific region and even check it periodically.

Abstract Background Internet addiction causes a variety of social, interpersonal, psychological, and physical issues. We are confronting a worldwide crisis about internet addiction and its effects. Objectives Utilizing five questionnaires to survey university students during the COVID‐19 epidemic, the current study sought to evaluate internet addiction and associated risk variables. Methods At the University of Medical Sciences in North Iran, a cross‐sectional analytical investigation was carried out. The sample was done among 318 students, selected through the random cluster sampling method. Data collection was done during August and September 2021. Results Based on our findings, the prevalence of internet addiction was 28.9% (92/318). Our results revealed that women are at twice the twice the risk of internet addiction as men (p = 0.028). Students in the medicinal field (p = 0.043; students with a positive history of mental illness in the family) p = 0.001 (and students with a fear of COVID‐19) p = 0.002 (recognized in the risk of Internet addiction, thus depression) p

Background. Various methods have been proposed to treat plantar fasciitis. Among these, autologous blood transfusion has been discussed and investigated in the past few years, the findings indicate its effects in the medium term, and in some studies, better results were observed compared to corticosteroids. This study was conducted with the aim of comparing the effect of two therapeutic methods of local injection of autologous blood and corticosteroid with the control group in the treatment of plantar fasciitis. Methods. In this prospective study that took place in Shahid Beheshti Hospital, Babol, during 2020–2021, 90 plantar fasciitis patients were examined in two treatment groups by corticosteroid injection or autologous blood. Their levels of pain and satisfaction were recorded during three and six months by the visual analog scale (VAS) and the Roles and Maudsley Scale (RMS). The data were described and analyzed by SPSS-22 using descriptive indices and statistical analysis tests at a significance level of 0.05. Results. There was no significant difference in pain and satisfaction during the third month of steroid and autologous blood transfusions. However, in the sixth month, the patients in the autologous blood group had significantly less pain than those in the steroid group (P= 0.001), and their level of satisfaction was significantly higher than that of patients in the steroid injection group (P= 0.018). The mean pain intensity based on VAS in six months was 5.40 ± 1.37 and 3.76 ± 1.87 in the steroid and autologous blood groups, respectively (P< 0.001). Based on the Wilcoxon test, the VAS score increased significantly in the steroid group in the sixth month compared to the third month (P= 0.011), while it decreased in the autologous blood group (P< 0.001). Conclusion. Based on the findings, autologous blood injection in plantar fasciitis over six months had significant pain-reducing effects and satisfaction versus corticosteroid injection. However, after three months, these effects were not significant compared to corticosteroids. Practical Implications. Based on the findings, autologous blood injection in plantar fasciitis over six months had significant pain-reducing effects and satisfaction versus corticosteroid injection. However, after three months, these effects were not significant compared to corticosteroids.

Background and Objective: One of the most important steps in the treatment of patients with mediastinal lymphadenopathy is the definitive diagnosis using tissue sampling of the intra-mediastinal lesion. Mediastinoscopy is one of the methods used for this purpose. In this regard, this study aims to investigate the role of mediastinoscopy in determining the cause of mediastinal lymphadenopathy in patients referred to Shahid Beheshti Hospital in Babol, Iran. Materials and Methods: This cross-sectional study was conducted on 36 patients with mediastinal lymphadenopathy who were admitted to Shahid Beheshti Hospital in Babol (April 2009-March 2020) and underwent mediastinoscopy. Recorded medical information of all patients without known lung cancer under mediastinoscopy was reviewed. Mediastinoscopy was performed by a specialist doctor for all patients and the biopsy sample was sent to Shahid Beheshti Hospital Pathology for final diagnosis. Descriptive data were analyzed using SPSS25 software at a significance level of 0.05. Results: The mean age of the patients was 47.97±11.04 years (range: 28-76 years). The majority of patients were women (n=27; 75.00%). According to the pathology results, the final diagnosis for 33 people (91.67%) was benign, and 3 people (8.33%) were diagnosed with malignant. The most common pathology result was sarcoidosis with 23 cases (63.90%), active infection in 4 cases (11.11%), and squamous cell carcinoma in 3 cases (8.33%). Other benign results were reported with the frequency of one case (78.2%). Pathology findings had no significant relationship with the age and gender of patients (P

Abstract Background Understanding the disease and its acceptance significantly influence adherence to prescribed medications, a critical aspect in managing coronary artery disease (CAD). This study is designed to explore the multifaceted factors influencing medication adherence specifically in CAD patients. Of particular interest is investigating the interconnectedness between medication adherence, the perception of illness, and the level of acceptance of the illness itself among these individuals. Methods This cross-sectional study involved 280 confirmed CAD patients who were selected through a convenience sampling method adhering to predefined inclusion criteria. The study was conducted between March and September 2023. Three primary parameters—medication adherence, illness perception, and acceptance of illness—were evaluated using standardized tools: The Morisky Medication Adherence Scale-8, Illness Perception Questionnaire-Brief, and Acceptance of Illness Scale. Statistical analyses using SPSS (version 25) were used to analyze the data. Results Patients had moderate illness perception (51.82 ± 7.58) and low acceptance to illness (16.98 ± 4.75), and 61.8 of them adhered to their medication regimen. A positive relationship between acceptance of illness and medication adherence (r = 0.435, p-value

Background and purpose: Prostate cancer is the most common male urogenital malignancy in many regions of the world, which has been increasing in recent years all over the world, including Asian countries, as well as in Iran. The relative risk of prostate cancer for those who have a family history of this disease in close relatives is almost 2 to 3 times, and the incidence rate increases with the increase in the number of affected relatives. Although family history of prostate cancer is a proven risk factor for this disease, few studies have investigated the relationship between the presence of family history of prostate cancer and the degree of prostate cancer risk. The purpose of this study is to investigate the relationship between the existence of a family history of prostate cancer and the degree of prostate cancer risk at the time of diagnosis. Materials and methods: This case-control study was conducted on 322 patients available prostate cancer patients referred to medical centers affiliated with Babol University of Medical Sciences. Patients were divided into two groups: case (family history of prostate cancer) and control (no family history of prostate cancer). Information about family history, Gleason score, PSA, and clinical stage was extracted from all patients. It was extracted through the file and phone call. A positive family history of prostate cancer is defined as follows: patients who have at least two of their first-degree relatives with prostate cancer at any age. Also, patients who have one first-degree relative and at least two second-degree relatives at any age with prostate cancer. In hereditary prostate cancer, at least 3 first-degree relatives have prostate cancer, or prostate cancer occurs in three consecutive generations of the same family (paternal or maternal). At least two first- or second-degree relatives had early onset prostate cancer under the age of 55. The relationship between the existence of a family history of prostate cancer first-degree relatives include: father, brother, and child, and second-degree relatives include: grandfather, uncle and cousin. the degree of prostate cancer in three groups (Low risk with PSA20 or Gleason score>7) at the time of diagnosis was investigated. Results: The average age of patients when diagnosed with prostate cancer was 67.23±8.97 years, who were in the age range of 43-93 years. 23.3% of the studied patients had a family history of prostate cancer and 1.9% had a hereditary family history of prostate cancer. With the increasing age of diagnosis, the degree of risk of prostate cancer increased, which is statistically significant. Thus, 63.9% of patients who were diagnosed with prostate cancer at the age of 71 years had high-risk prostate cancer, which shows that the risk level of prostate cancer should increase as the age of prostate cancer diagnosis increases (P=0.001). Between the ages of 61 and 70 years, 62 people (44.9%) were at a high risk level, while at the age of 60 years, 33 people were at a high risk level (P

Background: One of the most effective treatments for patients with acute ischemic stroke (AIS) is intravenous recombinant tissue plasminogen activator (rtPA) which can minimize mortality and morbidities. In this historical cohort study, we investigate the factors affecting clinical outcomes after IV thrombolysis for AIS. Methods: We included 87 patients with acute ischemic stroke who were treated with rtPA between 2015 and 2019. Demographic and clinical data were recorded. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the clinical outcomes. Results: 36 patients showed lack of improvement at discharge. In unadjusted model, hypercholesterolemia was the only predictor of lack of improvement (P= 0.043; OR=0.304; CI= 0.096-0.963). After adjusting, hypertension (P= 0.018; OR= 0.18; CI= 0.043-0.749) and hypercholesterolemia (P= 0.008; OR= 8.68; CI= 1.773-42.54) were independent determinants of lack of clinical response. To evaluate risk factors in association with the duration of hospitalization, we found variables which lengthened hospitalization span including; age over 60 years (HR= 0.42 P= 0.002), hypercholesterolemia (HR= 2.19 P= 0.031), Angiotensin-converting enzyme (ACE) Inhibitors consumption (HR= 1.87 P= 0.022), and type of infarction (non-lacunar) (HR= 0.51 P= 0.026). Results indicated no considerable relationship between dose of rtPA and the appropriate response to treatment (OR=8.686 P= 0.324). Conclusion: The closer dose of rtPA goes up to standard range, the more chance of improvement will gain without increasing the risk of symptomatic intra-cerebral hemorrhage (SICH). Determining factors involved in intravenous reperfusion outcomes help physicians to identify the patients who benefit the most from rtPA.

Abstract Background The aim of the present study was to compare the epidemiological patterns of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infections, hospitalizations, deaths, and duration of hospitalization during the fourth, fifth and sixth epidemic waves of coronavirus disease 2019 (COVID-19) in Iran. Methods A multicenter retrospective observational study was conducted on hospitalized patients in four hospitals in the Babol district of northern Iran. The study periods were during the fourth, fifth, and sixth waves of the epidemic in Iran, (March 2021 to March 2022). A total of 13,312 patients with suspected COVID-19 were included. Patient demographics, medical history, length of hospital stay, and clinical outcomes were obtained from the hospital information system. Data on the cycle threshold (Ct) and SARS-CoV2 variant were collected for SARS-CoV2-positive cases. Results The highest number of hospitalized patients was reported during the fifth (Delta) wave (5231; 39.3%), while the lowest number of hospitalized patients was reported during the sixth (Omicron) wave (2143; 16.1%). In total, 6459 (48.5%) out of 13,312 hospitalized patients with suspected COVID-19 had a positive rRT-PCR result. The fifth (Delta) wave had the highest number of SARS-CoV2 rRT-PCR-positive hospitalized patients (3573, 55.3%), while the sixth (Omicron) wave had the lowest number (835, 12.9%). Moreover, 238 (3.7%) patients with laboratory-confirmed COVID-19 died. The hospital mortality rate was 6.8% in the fourth (Alpha) wave, which reduced to 2.7 and 3.5% in the fifth (Delta) and sixth (Omicron) waves, respectively (p

Background and purpose: Colonoscopy is a standard method for the diagnosis and treatment of colorectal diseases. The aim of the present study was to compare the analgesic effect of oral oxycodone and intravenous fentanyl in patients undergoing colonoscopy. Materials and methods: This study was conducted as a randomized clinical trial in 80 patients aged 20 to 69 years who were candidates for colonoscopy in two equal groups. Patients in the first group received oral oxycodone and intravenous normal saline, while the second group received oral placebo and 50 micrograms of intravenous fentanyl. 0.5 mg/kg propofol was administered intravenously to both groups. If pain occured, 10 mg propofol was injected. Data on age, gender, vital signs, satisfaction of the endoscopist and pain intensity of the patients were recorded using a numerical rating scale. The data were analyzed using the chi -square test and t-test and SPSS software, with a P˂0.05 value considered significant. Results: The two groups were similar in terms of age (P=0.64) and gender (P=0.055).The mean pain score in the oxycodone group was 3.22±1.78 and in the fentanyl group 2.00±1.43 (P= 0.001). The need for a propofol rescue dose during colonoscopy was higher in the oxycodone group than in the fentanyl group (P= 0.56). There were no significant differences between the two groups in terms of heart rate, respiratory rateand colonoscopist satisfaction (P>0.05). Conclusion: Considering that oral oxycodone has a good analgesic effect compared to intravenous fentanyl, this drug can be used as an analgesic for patients undergoing colonoscopy. (Clinical Trials Registry Number: IRCT20181216041991N1)

Abstract Since the first report of coronavirus disease 2019 (COVID-19) in Iran, our country has experienced several waves of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Northern Iran was one of the most affected regions of the country by COVID-19. In the current study, the demographic and clinical characteristics and outcomes of hospitalized patients were determined over a 2-year period (during six waves of SARS-CoV-2). This is a large cohort study investigating hospitalized patients with suspected and probable, and confirmed SARS-CoV-2 infection in Babol district, northern Iran, during the two years of COVID-19. The study population included patients admitted to four hospitals affiliated with Babol University of Medical Sciences between March 7, 2020 (start of the first wave) and March 20, 2022 (end of the sixth wave). Epidemiological and demographic characteristics, real-time PCR, cycle thresholds, clinical data and outcomes of COVID-19 were analyzed in 24,287 hospitalized patients. A total of 24,287 hospitalized patients were included in the study: 13,250 (46.6%) patients were suspected of having COVID-19, 11037(45.4%) were confirmed COVID-19 cases. The mean age of confirmed COVID-19 patients was 54.5 ± 18.9 years and 5961 (54%) were female. The median length of hospitalization for COVID-19 survivors and non-survivors was 5 (interquartile range [IQR] 4-8) and 7 (IQR 3-15) days, respectively. Of the patients with confirmed COVID-19, 714 (6.5%) died during hospitalization. In addition, the mortality rate from the first to the sixth wave was 22.9%, 8.1%, 9.9%, 6.8%, 2.7% and 3.5% in confirmed COVID-19 patients. The patients in the fifth wave were significantly younger than the others (mean age and SD of 51.1 ± 17.4 versus 59.2 ± 16.9, 54.7 ± 19.9, 58.4 ± 17.9, 53.5 ± 16.8 and 58.5 ± 25.1 years; p

Background and purpose: Urinary tract anomalies are responsible for urinary tract infection (UTI) in more than 30% of children. The present study was carried out to determine the prevalence of urinary tract anomalies in children with pyelonephritis referred to Amirkola Children Hospital during 2010-2020. Materials and methods: In this cross-sectional study, all children with UTI admitted to Amirkola Children Hospital during 2010-2020 were enrolled. The inclusion criteria were children aged between 2 months and 18 years, positive signs and symptoms of UTI, and positive urine culture with reliable sampling. Children with a positive history of surgery on the urinary tract were excluded. Imaging studies included ultrasonography, DMSA, DTPA, VCUG, RNC, and IVP for the diagnosis of anomalies in the urinary tract. Results: Among 381 children with pyelonephritis, the mean age was 37.1+41.3 months, and 337 (88.5%) children were girls. One hundred forty-nine (39.1%) children had urinary anomalies. The most anomalies were VUR, ureterovesical junction obstruction, Ureterocele, and ureteral duplication in 112(75.16%), 11(7.38%), 9(6.04%), and 8(5.36%) of children, respectively. A significant difference was observed between age and anomaly prevalence (P=0.04), but there was no significant difference between sex and prevalence of anomaly (P=0.3). Conclusion: The results of the study showed that about 39% of children with UTI had urological anomalies, the most common cause of which was VUR, and other urological anomalies (about a quarter) such as ureterovesical junction obstruction, Ureterocele. In addition to vesicoureteral reflux, paying attention to other urological anomalies in these children is recommended

Background: A high percentage of pregnant women experience anxiety symptoms. A review of recent studies shows that current psychological interventions have not focused on pregnancy. Therefore, considering the importance of investigating anxiety disorders during pregnancy and the impact of these disorders on the mental health system, the evaluation of anxiety disorders should be considered in controlled clinical studies. Aims: The aim of this study was to investigate the effect of computer-based cognitive-behavioral psychotherapy (ECBT) on emotion regulation in pregnant women with anxiety. Method: This study was quasi-experimental. The studied population consists of pregnant women from 13 to 30 weeks pregnant, singletons, and suffering from anxiety disorders in Babol city. In a pre-test and post-test design, 84 pregnant women at 13-30 weeks of pregnancy were divided into two experimental groups (n = 42) and control (n = 42). The participants in both groups completed Garnevsky's (2002) cognitive emotion regulation questionnaire in two pre-test and post-test series. The data were analyzed using variance analysis of repeated measurements and SPSS 26 software. Results: The results of this study showed that ECBT is able to improve emotion regulation in pregnant women (p

Abstract Background Psychological distress (PD) is a significant issue during pregnancy and postpartum, adversely affecting both children and mothers. This study aims to determine PD's prevalence and risk factors in a large Iranian population sample during pregnancy and postpartum. Methods A cross-sectional study was conducted using data from the Babol Pregnancy Mental Health Registry (located in the north of Iran) between June 2020 and March 2021. A total of 2305 women were included, with 1639 during pregnancy and 666 during postpartum. Psychological distress was assessed using the Brief Symptoms Inventory (BSI-18), and data were analyzed using independent t-tests and multiple logistic regressions. Results The prevalence of psychological distress, defined by a cut-off score of BSI ≥ 13, was 19% during pregnancy and 15% during postpartum. Multivariate logistic analysis revealed that high-risk pregnancy was the leading risk factor for psychological distress during the antenatal period (β = 1.776, P

Background and purpose: Patients admitted at the intensive care unit (ICU) need blood draws for chemistry analytes and arterial blood gas (ABG) analysis. Repeated blood drawing is one of the most common causes of anemia in these group of patients. Measurement of analytes only by ABG analyzer can be beneficial for preventing anemia. The aim of this study was to compare the biochemical analytes in venous and ABG samples in ICU patients. Materials and methods: This cross-sectional study was performed in 223 patients hospitalized in the ICU. These patients undergoing ABG analysis and simultaneous venous sampling. The value of Ca, Na, K, Hct, and glucose were measured in venous samples with a laboratory auto-analyzer and in arterial samples with an ABG analyzer. Results: The mean age of patients was 61.14±16.96 years. The mean difference between ABG and serum samples was 1.12 mEq/L for sodium, -0.29 mEq/L for potassium, -0.98 mg/dl for calcium, 0.33 mg/dl for glucose, and 4.39%% for hematocrit. In addition, 95% limit of agreement was -12.3 to 9 for sodium, -0.7 to 1.29 for potassium, -1.31 to 3.8 for calcium, -39.13 to 40.32 for glucose, and -13.5 to 8.5 for hematocrit. Conclusion: Because of acceptable agreement for sodium, potassium, and hematocrit, ABG analyzer can be used in ICU patients and emergency situations. There is a remarkable bias between the ABG-measured and laboratory-measured calcium and glucose, so the calcium and glucose measurement by the ABG analyzer are not reliable.

Background: Urinary stress incontinence occurs due to weakness of the urethral sphincter and/or weakness of the pelvic floor muscles. The purpose of this study is to investigate the complications of TOT surgery in the treatment of women with stress urinary February. Methods: This is a cross-sectional study that was conducted on women suffering from stress urinary incontinence who underwent TOT surgery in Rohani and Mehregan Hospitals of Babol between March 2010 and February 2019. In order to record early complications, the medical records available in the clinic were referred to for the examination of patients one week and two months after the operation. The late complications of the operation were also investigated at the time of entering the study. Also, satisfaction with the procedure was scored using a visual scale (score 0 to 100). SPSS version 26 software was used in this study. Also, the significance level is less than 0.05. Results: The study included 59 patients, the majority of whom were housewives (91.5%), had an education level below high school (74.6%), and were menopausal (71.2%). The average age of the participants is 54.92±9.40 years. The most common postoperative complications were Dyspareunia (20.3%), lower urinary symptoms (13.6%), and incontinency (10.2%). Also, the rarest complications were intraoperative injury to the urethra or bladder (1.7%), mild Vaginal erogenous (1.7%), pain at the operation site (3.4%), and need for adjuvant treatment (3.4%). In response to the question of whether you would recommend this surgery to others who have the same problem, 53 people (83.89%) responded positively. The average level of patients' satisfaction with the operation (on a scale of 0 to 100) was 88.64±23.44. According to the T-test, there is a statistically significant relationship between the incidence of postoperative complications and the level of patient satisfaction (P

Background: Mizaj is an individualized viewpoint in Persian Medicine (PM) that is used for the prevetion of diseases and also treatment. Evaluating Mizaj in the two domains of hotness-coldness, and wetness-dryness, 10 criteria have been introduced, most of them are qualitative. To achieve valid and reliable questionnaires, the weight of these criteria must be determined in assessing the Mizaj. Methods: In a cross-sectional study with Delphi method, 10 indices were extracted from PM references and sent to PM experts via e-mail. They were asked to score the weight of each index in determining the Mizaj from 0 to 10. The scores ranked and comparing previous preliminary studies, criteria of major and minor were proposed. Results: Out of 147 invited PM experts, 122 completed the tables. Based on scores, physical functions, physique, and responsiveness of organs obtained the highest scores in the field of hotness-coldness. In wetness-dryness muscle/fat mass and sleep/wakefulness received the highest scores from the viewpoint of experts. Conclusion: Physical functions, physique (Anthropometry), responsiveness of organs and psychic function can be used as major criteria in Mizaj assessment methods in the hotness-coldness field. In the field of wetness-dryness, muscle/fat mass, sleep/wakefulness, tactile condition and physique (anthropometry) can be considered as major criteria.

BackgroundOne of the common concerns of healthcare systems is the potential for re-admission of COVID-19 patients. In addition to adding costs to the healthcare system, re-admissions also endanger patient safety. Recognizing the factors that influence re-admission, can help provide appropriate and optimal health care. The aim of this study was to assess comorbidities that affect re-admission and survival in COVID-19 patients using a joint frailty model.MethodsThis historical cohort study was done using data of patients with COVID-19 who were re-hospitalized more than twice in a referral hospital in North of Iran. We used the joint frailty model to investigate prognostic factors of survival and recurrence, simultaneously using R version 3.5.1 (library "frailtypack"). P-values less than 0.05 were considered as statistically significant.ResultsA total of 112 patients with mean (SD) age of 63.76 (14.58) years old were recruited into the study. Forty-eight (42.9%) patients died in which 53.83% of them were re-admitted for a second time. Using adjusted joint model, the hazard of re-admission increased with cancer (Hazard ratio (HR) = 1.92) and hyperlipidemia (HR = 1.22). Furthermore, the hazard of death increased with hyperlipidemia (HR = 4.05) followed by age (HR = 1.76) and cancer (HR = 1.64). It Also decreased with lung disease (HR = 0.11), hypothyroidism (HR = 0.32), and hypertension (HR = 0.97).ConclusionConsidering the correlation between re-admission and mortality in the joint frailty model, malignancy and hyperlipidemia increased the risk of both re-admission and mortality. Moreover, lung disease probably due to the use of corticosteroids, was a protective factor against both mortality and re-admission.

ObjectiveTo assess the reporting quality of published RCT abstracts regarding patients with endometriosis pelvic pain and investigate the prevalence and characteristics of spin in these abstracts.MethodsPubMed and Scopus were searched for RCT abstracts addressing endometriosis pelvic pain published from January 1st, 2010 to December 1st, 2023.The reporting quality of RCT abstracts was assessed using the CONSORT statement for abstracts. Additionally, spin was evaluated in the results and conclusions section of the abstracts, defined as the misleading reporting of study findings to emphasize the perceived benefits of an intervention or to confound readers from statistically non-significant results. Assessing factors affecting the reporting quality and spin existence, linear and logistic regression was used, respectively.ResultsA total of 47 RCT abstracts were included. Out of 16 checklist items, only three items including objective, intervention and conclusions were sufficiently reported in the most abstracts (more than 95%), and none of the abstracts presented precise data as required by the CONSORT-A guidelines. In the reporting quality of material and method section, trial design, type of randomization, the generation of random allocation sequences, the allocation concealment and blinding were most items identified that were suboptimal. The total score for the quality varied between 5 and 15 (mean: 9.59, SD: 3.03, median: 9, IQR: 5). Word count (beta = 0.015, p-value = 0.005) and publishing in open-accessed journals (beta = 2.023, p-value = 0.023) were the significant factors that affecting the reporting quality. Evaluating spin within each included paper, we found that 18 (51.43%) papers had statistically non-significant results. From these studies, 12 (66.66%) had spin in both results and conclusion sections. Furthermore, the spin intensity increased during 2010-2023 and 38.29% of abstracts had spin in both results and conclusion sections.ConclusionOverall poor adherence to CONSORT-A was observed, with spin detected in several RCTs featuring non-significant primary endpoints in obstetrics and gynecology literature.

Background: The purpose of this study was to determine the distribution of intraocular pressure (IOP) and assess its association with age, sex, systemic blood pressure, diabetes mellitus, body mass index (BMI) and tobacco smoking in Iranian elderly population. Methods: This cohort-based, cross-sectional study assessed elderly individuals aged 60-90 years in Amirkola, northern Iran, in 2016-2017. Past medical history, blood pressure, diabetes mellitus, BMI and tobacco smoking were recorded through an interview and physical examination. IOP was assessed using non-contact tonometry. Results: Total of 1377 individuals participated in this study, out of which 1346 IOP measurements were included for the final analysis. The mean age of participants was 69.4 ± 7.1 years and mean IOP was determined to be 16.7 ± 3.2 mmHg. Majority of the participants were males (56.1% vs 43.1%), 73.8% of participants were overweight or obese, 6.1% smoked tobacco, 28.9% had diabetes mellitus and 84.9% had higher than normal blood pressure. Through multiple regression analysis, it was determined that age (β=-0.132, p

Background: The aim of this study was to find the causes of failure of natural childbirth in late-term pregnancy that can be useful for managing childbirth in these pregnant mothers and to design a solution to increase natural childbirth. Methods: This cross-sectional study was conducted in the community of pregnant women with a late-term pregnancy of more than 41 weeks. The studied sample includes 148 pregnant mothers who were referred to Ayatollah Rouhani Hospital in Babol from March 2018 to February 2020. Mother's age, Body Mass Index, gestational age, number of pregnancies, number of deliveries, length of hospitalization, the state of the cervix and preparation method of the cervix for termination of pregnancy were extracted and recorded from patients' files. Data were compared in two groups of pregnancy termination methods (natural childbirth and cesarean delivery). Statistical analysis was done using SPSS software, version 22 (IBM SPSS, Armonk, NY, USA) and Chi-square test and Student’s t-test statistical tests and logistic regression model fitting. P-value less than 0.05 was considered significant. Results: In this study, 167 pregnant women with late-term pregnancy were studied. The age of pregnant women is reported with mean of 26.03 and standard deviation 5.98 of years. The high Bishop variable, with odds ratio of 0.44, is a variable protective factor for cesarean delivery (P=0.001). Higher body mass index with odds ratio of 1.09, is also known as a risk factor for cesarean delivery (P=0.01), so that for each unit of increase in Bishop score, the chance of cesarean delivery decreases by 56% and for each unit of increase in body mass index, the chance of cesarean delivery increases by 9%. Conclusion: This study showed that nearly half of cases of late pregnancies lead to normal delivery. High body mass index reduces the chance of normal delivery in late term pregnancies. But a higher Bishop score can be effective in the success of natural delivery.

Abstract Background and Aims Studies regarding the risk factors of prenatal anxiety disorders are inconclusive and sometimes contradictory. The current study aimed to define the prevalence and risk factors for anxiety disorders in women during pregnancy. Methods This is a cross‐sectional and hospital‐based survey of two public hospitals (Ayatollah Rohani and Yahyanejad) of inpatients/outpatients, obstetric wards/clinics, and four private outpatient obstetric clinics in the city of Babol. Convenience sampling was utilized to recruit 432 pregnant women. A trained clinical psychologist conducted the Structured Clinical Interview for DSM‐5 (SCID‐5) to diagnose anxiety disorders. In addition, the Brief Symptom Inventory 18 (BSI‐18) was completed by the participants to assess the severity of psychological distress. Results Of 432 pregnant women, 132 (30.5%) were diagnosed with anxiety disorders. Anxiety disorders included 61 cases of pregnancy adjustment disorder (47.7%), 52 cases of generalized anxiety disorder (40.6%), and 15 cases of specific phobia (to delivery) (11.7%). The logistic regression results showed that the age, pregnancy, education, parity, and high‐risk pregnancy variables predicted 28% of the variance of anxiety disorders. Furthermore, as the age (β = 0.94, p = 0.003) and gestational age (β = 0.9, p

Background: One of the principles of Persian medicine (PM) is the individualized approach that is presented with the concept of Mizaj. In this viewpoint, Mizaj is determined for every person based on 10 criteria, which is a result of the Mizaj of the main organs, including the brain, liver, and heart. There is no standard diagnostic tool for Mizaj assessment in the elderly. The purpose of this study is to explain the method of Mizaj assessment and data analysis in the elderly in the second phase of the Amirkola health and aging project (AHAP) in Iran. Methods: In this study, a novel Mizaj assessment method in two phases is presented. In the first phase, 1541 elderly were assessed by a PM expert and typical diagnoses were determined. At the second phase, an expert panel including 5 PM experts evaluated the cases. The paraclinical and metric data of the elderly whose Mizaj agreed in the expert panel was used to assess its correlation with Mizaj. Conclusion: In the lack of valid and reliable questionnaires to assess the personalized viewpoint of PM, a new expert-based method has been introduced that can be used in similar studies. The result of the Mizaj assessment in this way will be used to obtain objective values for the Mizaj assessment.

Background and Objective: Interest and motivation in a field of study are essential for success in that field. One of the factors that influences this interest is the educational environment. The purpose of this study was evaluation of Babol dental students' interest in dentistry and it's relation with variables in the educational environment. Methods: In this analytical study, 151 students at Babol Dental School from 2013 to 2017 were selected using the census method and evaluated with a questionnaire whose validity and reliability had previously been established in other studies. Participants determined demographic characteristics, field of study interest, and educational environment factors, and by assigning scores from zero to four to the participants' responses,regression analysis was used to determine the effects of different variables on interest in their field of study and their evaluation of the academic environment. Findings: Based on Result, 86.38 % of students were interested in dentistry. In addition, 52.39 % of students believed that professors use new teaching methods in their classes. Seventy percent of students stated , their involvement in making decisions which affects their academic ability is low. Conclusion: Dental students in Babol were generally enthusiastic about their Field of study, and the faculty's teaching environment reflected positive qualities and capabilities in different fields.

Background: Cassia fistula was used traditionally as laxative in pregnant women. Nevertheless, its fetal and maternal effects in pregnancy have not been studied yet. Methods: Oral (Lethal Dose, 50%) LD50 was determined in mice. In addition, a control group, pregnant rats in other 5 experimental groups (n=12) received orally C. fistula aqueous extract (500, 1000 and 2000 mg/kg), tween80 (10%) and distilled water during pregnancy up to the delivery (21-23 days). Some serum indices were evaluated in maternal blood samples after delivery. Histopathologic and histomorphometric evaluations were performed on the selected slices of newborn rats. Results: Anthraquinone‎ content of the aqueous extract was 0.34% w/w. Oral LD50 was obtained more than 5000mg/kg. No abortions and newborn anomalies were observed in groups. The height and weight of the offspring were significantly reduced by the administration of 500, and 2000 mg/kg of extract compared to control. There was no significant change in maternal blood urea and creatinine. Higher concentration (2000mg/kg) led to ALT elevation. ALS levels decreased dose-dependency in treatment groups comparing to control. Histopathological findings showed significant lung vascular congestion, and hypertrophy of heart in group tween80, and significant hepatic parenchymal inflammation in tween80 and 2000mg/kg and 1000mg/kg groups. In all tissues of all groups, malpighian body area and bowman’s capsule space significantly increased compared to the control group. Conclusion: It seems C. fistula extract is safe in pregnancy. Because of confounding role of tween80 in histopathological finding, more research is necessary.

Background: Frequent waves of corona virus disease (COVID-19) and lack of specific drugs against that, warrant studies to reduce the morbidity and mortality of this pandemic disease. In this study, we investigated the association between influenza vaccination and the severity and outcome of COVID-19 disease in Iranian patients living in the North. Methods: This retrospective case-control study was performed on186 patients with COVID-19 infection between March and April, 2020. Patients with positive PCR were divided into two groups of case and control; Patients with moderate to severe and normal to mild lung involvement, respectively. The lung opacities in all of the 5 lobes were evaluated on chest CT images using a CT severity scoring system. The history of influenza vaccination during the fall of 2019-2020 was determined by a phone call. Statistical analysis was done using the chi-square test, student’s t-test, and logistic regression. The significance level was p

Background: Unlike some regions of the world where digestive system cancers are not considered as important health problems, these neoplasms are among the most common malignancies in the northern region of Iran. Methods: This observational analytical study was carried out based on data collected by the Cancer Registration Center affiliated to the Vice Chancellery for Health of Babol University of Medical Sciences, North of Iran, during 2008-2017. Crude incidence rate (CR), and age-standardized incidence rate (ASR) have been calculated for different GI cancers, based on the primary involved site; and have been compared in different years, patients' age, gender and place of residence. Results: Totally, 4332 records were related to digestive system cancers. Mean age of patients was 63.48±14.73 years; men (2743; 63.3%) were more affected than women (1589; 36.7%) (p

HPV is the most prevalent sexually transmitted diseases causing a variety of clinical manifestations ranging from warts to cancer. This study aimed to examine the challenges and needs of HPV-positive women. In this qualitative study, we analyzed data extracted from semi-structured face-to-face interviews with 31 Iranian HPV-positive women using a conventional content analysis approach using MAXQDA.10 software. Data were collected from her at the women’s clinic from 21 January 2022 to her 19 February 2022. The sampling process was purposeful, and the accuracy of this study was ensured according to her 4 criteria suggested by Guba and Lincoln. Four themes were identified from the interviewing of HPV-positive women that include: Needing support and counseling to adapt to the disease, needing counseling and training to improve the disease, needing a qualified health care provider, needing proper health care services. HPV-positive women had many adverse such as reproductive health challenges (Menstruation cycle, delivery type, fertility, pregnancy, and breastfeeding), low control, confusion, cancer-related concerns, relationship problems, sexual concerns, uncertainty, stigma, low trust, social impact, non-disclosure of results, idiosyncratic prevention, indirect clinical interaction, changes in sexual behavior. HPV-positive women face many challenges and seek information to address them. Therefore, at the primary level, providers need to be aware of the needs of these patients needs in order to make the necessary consultations.

This study aimed to evaluate the effectiveness of a Persian Medicine-based dietary protocol (PM diet) in patients infected with COVID-19. A randomized clinical trial was performed from July 2020 to January 2021 in Tehran, Iran. Eighty patients admitted due to pulmonary dysfunction caused by COVID-19 were randomly allocated into two groups: the PM diet or the common hospital (CH) diet. Eight beds in 2 rooms were considered for each group. Patients were randomly hospitalized in these rooms and received these diets up to discharge or death. The details of the PM diet were published before (Hospital diet for COVID-19, an acute respiratory infectious disease: An evidence-based Protocol of a Clinical Trial). O2 saturation level and duration of hospitalization, the rate of mortality, duration of fever, and duration of cough were considered as the primary and secondary outcomes, respectively. O2 Saturation and fever durationwere not different between groups (P-value= 0.08, 0.312, respectively). But the duration of hospitalization and the duration of cough in the PM diet group were significantly shorter than in the CH diet (P-value= 0.002, 0.009, and HR=2.02, 1.86 respectively). The mortality rate was significantly lower in the PM diet group than in the CH diet group (Odds ratio: 0.12, P-value=0.026). PM diet caused a lower mortality rate, shorter hospital stay, and better improvement in cough, but did not have a significant effect on O2 saturation and fever.

Background. Hypertrophic cardiomyopathy (HCM) has different complications such as cardiac arrhythmia and sudden cardiac death (SCD). Insertion of an implantable cardioverter defibrillator (ICD) is recommended for HCM patients who are at high risk of SCD and malignant arrhythmias, despite having their own potential complications. Hypothesis. We aimed to investigate the prevalence of different complications of ICD insertion and the impact of the potential influential baseline characteristics in a one-year follow-up period. Methods. This was a retrospective study with a total of 71 HCM patients with ICD insertion. We evaluated the prevalence of different complications of ICD implantation and the impact of baseline characteristics on the occurrence of ICD complications using multivariate regression analysis in three 4-month periods. Results. In a one-year follow-up, 13 patients (18.3%) experienced at least one of the complications including pneumothorax, lead failure, ICD infection, inappropriate shocks, perforation, and upper limb deep vein thrombosis (DVT) with no mortality. Inappropriate shocks were reported as the most common (11.3%) complication during this period, with a gradual increase in the second (4.2%) and third (5.6%) follow-up sessions. Among all of the baseline characteristics that were investigated in this study, a positive history of hypertension was the only risk factor with significant impact on the occurrence of complications (P = 0.01). Conclusion. We demonstrated the occurrence of complications during a one-year follow-up as 18.3% in HCM patients with ICD insertion. A positive history of hypertension was the only baseline characteristic affecting the occurrence of complications, and inappropriate shocks were the most common complication.

Diabetic peripheral neuropathy is one of the most common causes of disability in diabetic patients. Applying a method to achieve the highest therapeutic effect in patients is desirable. Therefore, this study aimed to evaluate the impact of leech therapy on diabetic neuropathy of lower limbs in comparison to gabapentin as a standard method. This randomized controlled parallel-group clinical trial was conducted among 40 patients with type II diabetes who were diagnosed with lower limb diabetic neuropathy and referred to specialized outpatient clinics in Babol, Mazandaran province, Iran from 23 September 2020 to 17 March 2021. The patients were randomly divided into two groups. One group was treated with leech therapy and the other group was treated with gabapentin as the standard method. The severity of neuropathy was assessed every 15 days until the 45th day. The Visual Analog Scale (VAS), Neuropathy Symptom Score (NSS), Neuropathy Disability Score (NDS), and Nerve Conduction Velocity (NCV), and Electromyography (EMG) were used for assessing the study outcomes. The repeated measure and Friedman tests were used by SPSS.V.23. The results of our study indicated that pain (P value:0.03), numbness (P value˂0.0001), and paranesthesia (P value:0.01) significantly reduced in patients undergoing leech therapy versus patients taking gabapentin on the 45th day. The total NSS (P value˂0.0001) and total NDS (P value˂0.0001) improved significantly for patients with leech therapy over 45 days compared to the patients with gabapentin. The results of our study showed that using leech therapy for patients with diabetic neuropathy was more effective in improving clinical symptoms and the functions of lower limb muscles and nerves in comparison to gabapentin. The severity and symptoms of neuropathy greatly improved for the patients treated with leech therapy versus patients taking gabapentin.

An individualized viewpoint in Persian Medicine is introduced with the concept of Mizaj (temperament). Accordingly, every individual is placed in a unique point among a spectrum ranging from extreme hotness to extreme coldness. The whole-body Mizaj is mainly determined by three organs of heart, brain, and liver. This study investigates the relationship between whole-body and three main organ Mizajes with some hormonal and biochemical factors. In 324 healthy volunteers between the ages of 20 and 40, whole-body Mizaj and Mizajes of heart, brain, and liver were determined in two sessions with an expert panel method. Any disagreement between experts and the moderate diagnosis was excluded. Finally, 72 healthy volunteers (including 40 hot Mizaj individuals and 32 cold Mizaj) entered the second phase. In this phase, some hormonal and biochemical factors were evaluated. In whole-body Mizaj, FBS, Hgb, Hct, MCHC, WBC, and Monocytes, were higher in people with hot Mizaj than cold Mizaj. Besides, relating to the Mizaj of the liver, FBS, cortisol, TG, Hgb, Hct, MCH, MCHC in hot Mizaj were higher than cold Mizaj. Also, in the heart, MCV and MCH were higher in hot individuals and in the brain FBS, Hgb, Hct, MCV, MCH, lymphocytes were significantly higher in hot Mizaj. It seems that FBS and Hgb as the factors involved in metabolism have the most important role in the whole-body Mizaj. Also, the association between cortisol with the hotness of the liver can be suggested by increasing sympathetic activity as one of the hotness/coldness theories.

Abstract Background We aimed to investigate the association of initial chest CT scan findings with status and adverse outcomes of COVID-19 (including ICU admission, mortality, and disease severity). This retrospective cohort study was performed in three hospitals in Babol, northern Iran, between February and March 2020. Cases were confirmed by real-time polymerase chain reaction (RT-PCR). Clinical and paraclinical data of the patients were collected from their medical records. CT severity score (CSS) was calculated by a senior radiologist. Disease severity was determined based on the World Health Organization criteria. Results In total, 742 patients were included, of whom 451 (60.8%) were males and 291 (39.2%) were females. The mean age was 56.59 ± 14.88 years old. Also, 523 (70.5%) were RT-PCR-positive. Ground glass opacity was directly associated with RT-PCR positivity (odds ratio [OR] = 2.07). Also, RT-PCR-positive cases had significantly a higher CSS than RT-PCR-negative cases (p = 0.037). In patients confirmed with COVID-19, peribronchovascular distribution of lesions, number of zones involved, and CSS were associated with increased risk of ICU admission (OR = 2.93, OR = 2.10, and OR = 1.14, respectively), mortality (OR = 2.30, OR = 1.35, and OR=1.08, respectively), severe disease (OR = 2.06, OR = 1.68, and OR = 1.10, respectively), and critical disease (OR = 4.62, OR = 3.21, and OR = 1.23, respectively). Also, patients who had consolidation were at a higher risk of severe disease compared with those who did not (OR = 4.94). Conclusion Initial chest CT scan can predict COVID-19 positivity, ICU admission, mortality, and disease severity, specifically through CSS.

Abstract Background Complementary and Alternative Medicine (CAM) have recently become more popular and accepted worldwide. One principal step to identify the status and organize strategies of CAM is evaluating the manner and the prevalence of its usage among people. This study aimed to investigate the prevalence of CAM modalities usage by the people of Babol, a central city in the North of Iran, in 2018. Methods Using the original International CAM Questionnaire (I-CAM-Q), a questionnaire was redesigned in Persian (Farsi) with some changes such as adding special modalities in Iran and its validity and reliability were assessed. Six hundred households were evaluated using a cluster sampling method in 2018 spring by 12 trained interviewers. Results Finally, 1770 questionnaires were correctly completed. A total of 110 participants (6.21% of the completed questionnaires) had visited CAM therapists in the last year, 109 persons (6.15%) had received prescriptions from physicians and paramedics to use CAM, and a total of 1032 people (58.30%) used herbs and herbal medicines in the last 12 months. Also, 1265 individuals (71.46%) had used CAM throughout their lives. The most popular methods were herbal medicine (65.76%), Persian Medicine (13.78%), water therapy (10.45%) and music therapy (8.36%). The use of CAM was more popular among women. Conclusions The general use of CAM in Babol was similar to other studies, but there were fewer visits by CAM therapists and less frequent adoption of common methods including homeopathy, acupuncture, and energy therapy. It was found that CAM was mostly used for non-serious diseases such as cold and transient gastrointestinal disorders, a pattern that is different from other studies in this field.

Background: COVID-19 caused a global pandemic problem. No confident management is introduced for it yet. This study aimed to propose a dietary protocol for hospitalized patients with the diagnosis of acute respiratory infectious disease caused by COVID-19 based on Persian Medicine. Methods: This study was conducted in three phases. In the first phase, any diseases that could be matched with the clinical features of infection with COVID-19 were searched in selected PM references. In the second phase, medicinal herbs and foods that were available and could be used in the hospital diet were extracted and summarized. In the third phase, the new documentation of these pharmaceutical and food items was conducted. Results: The signs and symptoms of infectious respiratory disease caused by COVID-19 can be categorized in the field of Zato al-rieh that can mainly be matched with pneumonia. Based on the described criteria, some nutrients and medicinal materia medica have been introduced for acute respiratory infection including Cydonia oblonga, Honey, Citrus sinensis, Malus domestica, Citrus medica, Crocus sativus, Raisin, Rosa Damas Cena, D.Carota, Camellia Sinensis, Anethum graveolens dhi, Punica granatum, Petroselinum Crispum, Coriandrum sativum, Urtica dioica, Allium sativum, Sesamum indicum Conclusion: Most materia medica has documents in current articles including anti-cough suppressants, antiviral properties, anti-bacterial, anti-inflammatory, antioxidant, immunomodulatory etc. A protocol of hospital diet for patients with infectious respiratory syndrome caused by COVID-19 has been introduced in this manuscript.

Abstract Background Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood mental health disorders. Stimulant drugs as the most commonly used treatment and first-line therapy for ADHD have side effects. One of the newest approaches to select the best choices and optimize dosages of medications is personalized medicine. Methods This historical cohort study was carried out on the data taken from the period of 2008 to 2015. Eligible subjects were included in the study randomly. We used mixed-effects logistic regression models to personalize the dosage of Methylphenidate (MPH) in ADHD. The patients’ heterogeneity was considered using subject-specific random effects, which are treated as the realizations of a stochastic process. To recommend a personalized dosage for a new patient, a two-step procedure was proposed. In the first step, we obtained estimates for population parameters. In the second step, the dosage of the drug for a new patient was updated at each follow-up. Results Of the 221 children enrolled in the study, 169 (76.5%) were male and 52 (23.5%) were females. The overall mean age at the beginning of the study is 82.5 (± 26.5) months. In multivariable mixed logit model, three variables (severity of ADHD, time duration receiving MPH, and dosage of MPH) had a significant relationship with improvement. Based on this model the personalized dosage of MPH was obtained. Conclusions To determine the dosage of MPH for a new patient, the more the severity of baseline is, the more of an initial dose is required. To recommend the dose in the next times, first, the estimation of random coefficient should be updated. The optimum dose increased when the severity of ADHD increased. Also, the results show that the optimum dose of MPH as one proceeds through the period of treatment will decreased.

Functional dyspepsia (FD) is a common gastroduodenal disorder that can be long-lasting. In the present study, we aimed to investigate the effect of herbal medicine, Ghors-e-Vard (Vard), on clinical symptoms in FD patients. Seventy adult FD patients according to the Rome IV criteria and without Helicobacter pylori infection were included. Participants were randomly allocated to either Vard or placebo group for 4 weeks of intervention. Treatments were given orally in a double-blind fashion (500 mg, three times a day, and half an hour after each meal). Patients were evaluated prior to and following 2, 4, and 8 weeks after the intervention, in terms of changes in the total score of gastrointestinal symptoms rating scale (GSRS), Depression Anxiety Stress Scales (DASS-21), scores of various components of the 36-item short-form health survey (SF-36), and any reported side effects. The differences of GSRS and DASS-21 total scores from baseline to the end of intervention were significantly larger in Vard group (P

The concept of mizaj corresponds to the idea of personalized medicine and is the main diagnostic principle of Persian medicine (PM). This study aims to investigate diagnostic tools for the detection of mizaj in PM. In this systematic review of articles published before September 2022, articles were searched for in the Web of Science, PubMed, Scopus, Google Scholar, SID databases, and gray literature. The titles of the articles were screened by researchers and relevant articles were selected. Abstracts were reviewed by two reviewers to select final articles. Subsequently, the articles found were critically evaluated by two reviewers according to the CEBM method. Finally, article data were extracted. Of the 1812 articles found, 54 were included in the final evaluation. Of these, 47 articles were related to the diagnosis of whole body mizaj (WBM). WBM was diagnosed in 37 studies using questionnaires and 10 using expert panels. In addition, six articles examined the mizaj of organs. Only four of these questionnaires were found with reported reliability and validity. There were two questionnaires for assessing WBM, but neither had sufficient reliability and validity. Questionnaires that assess organs had weak designs and lacked sufficient reliability and validity.

ObjectivesHuman papillomavirus is one of the most important causes of cervical cancer. Participating in an HPV test and receiving an HPV diagnosis can create questions about the needs and preferences. The present systematic review was conducted to determine the reproductive health needs of women with HPV.MethodsWe searched PubMed, Scopus, Web of Science, Google Scholar and Magiran, SID and Iranmedex. Without language restrictions and time constraints. We also searched the grey literature and carried out forward/backward citation searches.ResultsIn the first, 1056 articles were retrieved, and, after removing them, 13 articles published were entered. The studies were qualitative (N = 9), quantitative (N = 3), and one was unclear. Most qualitative studies collected data using individual interviews (N = 7), two qualitative studies, narratives of HPV patients from a website of patient experiences and questions. Women wanted further information on different HPV viral types, transmission, implications for sexual partners, prevalence, latency and regression of HPV, their management options and the implications of infection for cancer risk and fertility. Women's experience of searching the Internet for further information about HPV was reported as difficult, anxiety provoking and contributing to the stigma of the infection because information was often located in the context of other sexually transmitted infections, with multiple sexual partners highlighted as a risk factor for infection.ConclusionSurveys showed that the majority of women had unanswered questions about their HPV test results. The information that women thought was helpful in interpreting their test results included having a high-risk type of HPV, and cancer survival statistics for the virus. Women also needed information about sexual transmission, how HPV tested positive in a long-term relationship, and the potential consequences for their partners and the risk of re-infection. Younger women had questions about whether HPV could affect fertility.

Background: Hyperbilirubinemia is a common problem in neonates that causes hospitalization. The aim of this study was to investigate the effects of concentrated pomegranate juice (CPJ) consumption by breastfeeding mothers on neonatal hyperbilirubinemia. Materials and Methods: In this open-labeled, add-on, randomized clinical trial, 86 breastfeeding mothers and their neonates were allocated into two groups. In the control group, neonates received phototherapy. Besides neonates' phototherapy in the intervention group, their mothers received CPJ (1 tablespoon [15 g] three times a day) up to discharge. The bilirubin level was the primary outcome. The duration of phototherapy, the duration of hospital stay, and the need for exchange transfusions were secondary outcomes. Results: CPJ reduced the bilirubin level of hospitalized neonates within 48 h after consumption (P = 0.048, standard mean difference = 0.648). It also resulted in reduced duration of hospital stay and faster discharge of the neonates. Furthermore, in 48 h after discharge, bilirubin was significantly lower in the CPJ group (P = 0.003, partial eta squared = 0.123). Conclusion: Compared to the control group, consumption of CPJ by lactating mothers whose infants underwent phototherapy resulted in lower bilirubin levels, shorter hospital stay, and faster discharge.