Medical Journal of the Islamic Republic of Iran最新文献

Background: Dental caries is a serious health condition in children. Poor diet, poor oral hygiene, and unique anatomy of the primary teeth can all contribute to the development of caries in primary teeth. Developmental structural defects in teeth during the fetal period and the first year after birth are believed to increase caries susceptibility. This study aimed to assess the correlation of the Apgar score with dental caries in 3- to 5-year-old Iranian children.

Methods: This retrospective, descriptive, cross-sectional study was conducted at the Pediatric Dental Clinic of Tehran Dental School in 2022. A total of 123 eligible children between 3-5 years were enrolled. The parents were requested to fill out a checklist regarding the information of demographics, birth and infancy condition and Apgar score of children. The children underwent clinical dental examination, and their dmft was recorded. Data were analyzed by the Pearson and regression tests. P values < 0.1 were considered statistically significant.

Results: The Pearson test showed that the 1-minute (P = 0.000) and 5-minute (P = 0.000) Apgar scores had a significant correlation with dmft. The regression analysis of demographic and birth factors revealed significant correlations between duration of breastfeeding (P = 0.066) and age of initiation of toothbrushing (P = 0.019) with dmft. Also, birth weight (P = 0.026) and mother's educational level (P = 0.090) had significant correlations with the Apgar score.

Conclusion: The results indicated a significant correlation between the Apgar score and dental caries. Thus, newborns with lower Apgar scores are recommended to receive more regular oral and dental care services.

Background: Various studies have shown that individuals with autism spectrum disorder (ASD) experience significant cognitive impairments during childhood. Individuals often experience various language disorders that can manifest in different ways. There are also studies indicating that these impairments persist into adulthood for individuals with ASD. This study aimed to evaluate and identify cognitive impairments among Persian-speaking adults with ASD.

Methods: This research is of a quantitative nature and has been conducted using an experimental method in which two subtests from the Persian Version of the Montreal Protocol for the Evaluation of Communication (P.M.E.C.), including the Metaphor Interpretation and Speech Act Interpretation subtests, were utilized. Thirteen Persian-speaking men with ASD participated in this research, with ages ranging from 25 to 44 years (mean age 32.84, standard deviation 4.17), whose educational levels varied from primary school to 20 years of formal education. The control group consisted of 26 healthy Persian-speaking men who were matched in terms of age and educational level with the ASD group. The Kolmogorov-Smirnov test and a paired t-test were used to compare the two groups.

Results: The results indicated that the ASD group performed significantly poorer in both the Metaphor Interpretation subtest (P < 0.001) and the Speech Act Interpretation subtest (P = 0.033) compared to the healthy control group, suggesting cognitive impairments in their abilities.

Conclusion: The findings of this research can be valuable for assessment and intervention purposes in rehabilitation centers, as well as in academic and research settings.

Background: It is becoming increasingly important to study pathology at the knee and spine because of their role in causing pain and deformity in one another. Compression of the lumbar nerve root can disrupt innervation to the thigh muscles, cause an imbalance of muscle and result in varus deformity. In this study, we try to figure out the relation between lumbar spine disorders and genu varum and realize if lumbar spine disorders can cause varus deformity in a patient.

Methods: In this cross-sectional study, the number of 53 patients with knee varus greater than 20 degrees who visited the orthopedic clinics of Rasoul Akram and Moheb Mehr hospitals affiliated to Iran University of Medical Sciences between 2020 and 2022 were investigated in terms of association with lumbar disorders. The demographic characteristics and clinical findings of the patients were recorded and collected using a checklist by referring to the patient's medical profiles. Radiographic findings were evaluated by referring to the imaging department and using the Pacs system. The diagnosis of the patients was based on the history and findings of the knee graph, which was measured with a goniometer to measure the knee angle. The frequency of lumbar disorders caused by pressure on the lumbar nerves in patients with genu varum deformity including canal stenosis, osteoarthritis, spondylolisthesis, and disc herniation was investigated. To investigate lumbar problems, patients' history and radiographic images as well as lumbosacral and knee MRI of patients were used.

Results: The mean age was 66.3 ± 7.66 years. 40 (75.5%) cases were female and 13 (24.5%) cases were male. Lumbar canal stenosis with 28(52.8%) and disc herniation with 32(60.4%) were the most common lumbar disorders in patients with knee varus more than 20 degrees. The mean age of patients with varus of more than 20 degrees with lumbar disorders was significantly higher than that of patients without lumbar disorders. (P: 0.001) There was no significant difference between gender distribution and lumbar disorders in patients with varus more than 20 degrees. Significant positive correlation between genu varum with lumbar canal stenosis (r: 0.53, P: 0.001), osteoarthritis (r: 0.38, P: 0.004), spondylolisthesis (r: 0.39, P: 0.002) and disc herniation (r: 0.46, P: 0.001) was reported2.

Conclusion: An association between lumbar disorders and varus more than 20 degrees was found to be considerable.

Background: Acquiring a thorough understanding of the expenses linked to the education of health sciences students is crucial for effective university planning, budgeting, and overall preparedness. This systematic review aimed to identify and compare the per capita costs associated with educating medical and other health science students internationally-particularly emphasizing the context of Iran.

Methods: A systematic review was conducted in 2023 according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search covered the period from January 1, 2000, to November 11, 2022, using MeSH and EMTREE terms. Databases such as PubMed, Scopus, Web of Science, Embase, and Iranian databases were searched. Manual searches were performed using Google and Google Scholar.

Results: The study retrieved 1336 publications from bibliometric databases and, following thorough screening, included 8 relevant articles from 5 countries (Australia, Iran, United States, Thailand, and Vietnam). An additional 17 relevant articles from Iranian databases were also included. Based on USD purchasing power parity (PPP) 2019, the results show that the mean per capita cost of training a medical student for 1 academic year in Iran is $61,493.86 (range, $28,102-$133,603; standard deviation, $35,476.03). In comparison, the cost of training a medical student for 1 year is $263,305 in the United States and $44,674 in Australia. In Thailand and Vietnam, a 6-year medical program costs is $284,058 and $69,323, respectively. Moreover, according to most studies, training students in other health sciences in Iran for 1 academic year generally costs ˂$20,000 (PPP 2019).

Conclusion: The study reveals that the costs associated with medical student education in Iran exceed that of most countries, second only to the United States. These findings highlight the importance of such data in improving the efficiency, sustainability, and informed resource allocation of global medical education programs for future planning and budgeting.

Background: Death in the place that the patient has selected and feels comfortable remaining in for the remainder of their life is one of the main objectives of palliative care for terminally ill cancer patients. Nevertheless, this problem is constantly disregarded. The goal of the present study was to look at variables that affected cancer patients' decisions about their place of death.

Methods: A descriptive cross-sectional study was conducted from May to August 2018. Using a continuous sampling method, 631 patients who had passed away between 2011 and 2017 were selected among the patients with a history of cancer and hospitalization at the Firoozgar Hospital in Tehran. A self-made 3-section questionnaire with 21 questions was completed by phone calls made to the families who confirmed their patients' deaths due to cancer. Data were managed by SPSS software Version 13, and descriptive statistics were used in data analysis.

Results: Based on the results, among 631 deceased patients, only 157 (24.9%) chose their place of death, and 474 (75.1%) had not spoken about it during their lifetime. Among the examined variables, age, sex, education, insurance status, duration of disease, activities of daily living, awareness of disease progression, and receiving home care had a significant association with this choice in people who died of cancer.

Conclusion: Despite the importance of the choice of place of death by the patient in the final days of life, the possibility of having an option is not provided for most cancer patients. Patients who understand how their disease is progressing at this point are probably going to want to select where they pass away. Consequently, the healthcare system must be ready to grant cancer patients the option to choose their final resting place and ensure a comfortable and respectable passing. Future research can be built upon the results of this study.

Background: Melatonin, a tryptophan product, has anti-inflammatory and virucidal effects. A study evaluated whether melatonin is more effective than placebo in critically ill COVID-19 patients.

Methods: The present study used a double-blind, randomized clinical trial in patients with COVID-19 hospitalized in the intensive care unit of Rasool Akram Hospital, Tehran. Iran. Melatonin 10 mg and placebo were given to the patients at night before bed. Patients were randomly divided into 2 groups. The first group was given melatonin with a therapeutic dose of 10 mg daily, and the second group was given a placebo with the same dose of 10 mg daily. Patients received melatonin or placebo for 7 days.The chi-square or Fisher exact test was used to compare qualitative variables. The study analyzed the mean of the variables under investigation by conducting a 2-factor repeated measures analysis of variance at 3 different time intervals in those administered medication or placebo.

Results: The study analyzed 44 melatonin patients and 42 placebo groups. The mean intensive care unit (ICU) hospitalization days were 11.23 ± 4.73 days in the melatonin group and 11.90 ± 6.52 days in the placebo group (P = 0.582). The mean days of hospitalization in the melatonin group were 19.70 ± 8.77 days and 21.48 ± 10.85 days in the placebo group (P = 0.407). The mean oxygen saturation before and after discharge from ICU in the melatonin group was 81 ± 6.73%, 91.02 ± 1.17%, and in the placebo group, 83.36 ± 8.27%, 91.21 ± 1.26, respectively (P = 0.467 and P = 0.150).

Conclusion: Melatonin can significantly reduce inflammation and oxidative stress markers in patients, making it a promising therapeutic option for COVID-19 patients. Further research is needed to determine the optimal treatment dosage and duration. Nonetheless, these results offer a promising avenue for future research and clinical practice.

This paper presents a unique 12-year case analysis of a girl with Penta-X syndrome, a chromosomal abnormality characterized by five X chromosomes instead of the normal two in healthy women. Pentasomy of X is a genetic, but not a hereditary disease affecting only women. Our patient demonstrated delayed mental, speech, and motor development along with physical anomalies such as craniofacial deformities, and eye pathology and was diagnosed with pentasomy of the X chromosome at the age of 3 after a cytogenetic examination. She developed epileptic seizures at the age of nine. Magnetic resonance imaging(MRI) revealed leukoencephalopathy with ventriculomegaly. The peculiarity of this observation is that the polysomy 49, XXXXX detected in the patient is characterized by a typical phenotypic presentation combined with demyelinating leukoencephalopathy, which has not been a typical feature of the disorder.

Background: A Medical Certificate of Cause of Death (MCCD) is a legal and enforceable document issued by the attending physician. However, according to the instructions, in many cases such as sudden, unexplained, and extraordinary deaths, along with some uncommon causes, such as cases suspicious of murder, the deceased patient must be referred to the Iranian Legal Medicine Organization (ILMO). Moreover, the unnecessary referral of corpses to ILMO can increase the workload of the staff, finally confronting the family of the deceased with high emotional and financial costs.

Methods: In this cross-sectional study, the medical records of all deceased patients referred from Hazrat Rasool Hospital to the ILMO (565 cases) in a three-year period from April 2016 to March 2019 were investigated and analyzed using SPSS22 software with chi-squared and T-test.

Results: Among all the patients who passed away during this time (4,239 patients), 565 were referred to ILMO, accounting for 13.3% of deaths. The most common causes of referral were car and motorcycle accidents, with a total prevalence of 27.1%, dead-on-arrival (DOA) prevalence of 21.3%, and death with an unknown cause prevalence of 15.3%. Significant correlation was also detected between causes of referral with gender, time of death, and age. For example, Car accidents and lawsuits against medical staff were more common in men and women, respectively.

Conclusion: Car and motorcycle accidents, DOA, and unknown causes were the most prevalent causes of referral in this study. In general, few studies have been conducted regarding the causes of referral of the deceased to the Legal Medicine Organization. In this study, we collected relevant variables to investigate this issue thoroughly.

Background: The survival rate in premature infants (PIs) has increased, but many have medical and developmental complications. Difficulty with sucking, swallowing, and poor nourishment are common complications. This study aimed to investigate the effects of Kinesio-tape (KT) combined with premature infant oromotor intervention (PIOMI) on feeding efficiency (mean volume intake [%MV]), oromotor skills (Preterm Oral Feeding Readiness Assessment Scale [POFRAS]), and weight gain in PIs.

Methods: In this single-subject study, 5 PIs with feeding problems were received the PIOMI-KT for 7 consecutive days. The main outcome measure was the POFRAS scale. The %MV and weight gain were the secondary outcome measures. Measurements were taken before treatment (T0), after the 4th session (T1), and after the 7th session (T3).

Results: The POFRAS scores, %MV, and weight gain improved in all infants after treatment. The maximum and minimum change in level between the baseline and treatment phase was +26 and+16 for POFRAS, +54 and, +34 for %MV, +180, and +100 for weight gain. The treatment trend was upward for all infants and shown by the directions of the slopes indicated by positive values. The feeding problems were resolved in all infants after the 7th treatment session.

Conclusion: The combination therapy of PIOMI-KT improved feeding function in PIs.

Background: Measuring socioeconomic status (SES) as an independent variable is challenging, especially in epidemiological and social studies. This issue is more critical in large-scale studies on the national level. The present study aimed to extensively evaluate the validity and reliability of the Iranian SES questionnaire.

Methods: This psychometric, cross-sectional study was conducted on 3000 households, selected via random cluster sampling from various areas in East Azerbaijan province and Tehran, Iran. Moreover, 250 students from Tabriz University of Medical Sciences were selected as interviewers to collect data from 40 districts in Iran. The construct validity and internal consistency of the SES questionnaire were assessed using exploratory and confirmatory factor analyses and the Cronbach's alpha. Data analysis was performed in SPSS and AMOS.

Results: The complete Iranian version of the SES questionnaire consists of 5 factors. The Cronbach's alpha was calculated to be 0.79, 0.94, 0.66, 0.69, and 0.48 for the occupation, self-evaluation of economic capacity, house and furniture, wealth, and health expenditure, respectively. In addition, the confirmatory factor analysis results indicated the data's compatibility with the 5-factor model (comparative fit index = 0.96; goodness of fit index = 0.95; incremental fit index = 0.96; root mean square error of approximation = 0.05).

Conclusion: According to the results, the confirmed validity and reliability of the tool indicated that the Iranian version of the SES questionnaire could be utilized with the same structure on an extensive level and could be applicable for measuring the SES in a broader range of populations.