Medical Journal of the Islamic Republic of Iran最新文献

Background: Laptops are ubiquitous tools in today's society; however, their prolonged use often leads to discomfort and musculoskeletal disorders due to their nonergonomic design. This study aimed to evaluate the effectiveness of an innovative adjustable laptop stand in enhancing comfort and productivity during typing tasks.

Methods: A 2-phase experimental design was employed. Phase 1 involved the development of a novel laptop stand considering ergonomic principles and expert recommendations. In Phase 2, a total of 25 office workers-13 men and 12 women-participated in 3 randomized sessions of a 2-hour typing task. They used the newly designed stand, adjusted their laptop height using conventional methods, or completed the task without any height adjustment (control). The Local Subjective Discomfort Questionnaire (LPD), the Rapid Upper Limb Assessment (RULA), and speed and error rates were used to measure postural risk, subjective discomfort, and typing performance, respectively, during each session. SPSS Version 26 (IBM) was used for the analysis, and P ˂ 0.05 was considered statistically significant.

Results: The RULA scores were significantly lower with the newly designed stand compared with the other conditions. When using the stand, perceived discomfort in specific regions significantly decreased (P < 0.05). Moreover, the number of typing errors significantly reduced with the stand (P < 0.05), while no significant difference was observed in typing speed (P = 0.371).

Conclusion: The novel adjustable laptop stand significantly reduced discomfort and improved typing accuracy during typing tasks, suggesting its potential to enhance user comfort and productivity. However, further longitudinal studies are needed to assess the long-term effects of this intervention.

Background: The identification of the determinants of health literacy is an essential prerequisite for developing health literacy promotion programs. While these factors have been reported in previous studies, there is a lack of a comprehensive review specifically focused on the Iranian population. Therefore, this review aimed to identify the factors related to health literacy in Iran.

Methods: This scoping review used the Arksey and O'Malley methodological framework and the Joanna Briggs Institute framework. A search was performed in English-language databases-Web of Science, Scopus, and PubMed-using the MeSH keyword of "health literacy," and in Persian-language databases-Magirean and SID-using the related keywords. A narrative synthesis was conducted to describe all included studies' characteristics and explore factors associated with health literacy.

Results: A total of 76 studies were included. Based on the results of the study, related factors included personal factors-including sex, age, education level, field of study, parents' education level, marital status, occupation, work experience, employment status, ethnicity, income, socioeconomic status, medical history, duration of disease, addiction, number of children, media literacy, information literacy, computer literacy, and self-efficacy-situational factors-including use of the internet, use of social networks, social support, source of information, and participation in health education classes-and societal and environmental factors-including place of residence and type of insurance.

Conclusion: Modifiable factors identified in this study were self-efficacy, social support, information sources, media literacy, information literacy, computer literacy, internet or social networks, and participation in health education classes. Planners can consider these factors when developing interventions to promote health literacy.

Background: Amyloid-beta (Aβ) production is a normal physiological process, and an imbalance in Aβ production/excretion rate is the basis of the plaque load increase in AD. LRP1 is involved in both central clearance of Aβ from the CNS and transport of Aβ toward peripheral organs. In this study, the effect of silymarin combination compared to rosuvastatin and placebo on neuro-metabolites and serum levels of LRP1 and Aβ1-42 proteins and oxidative stress enzymes and lipid and cognitive tests of Iranian AD patients.

Methods: In this double-blind placebo-controlled study, thirty-six mild AD patients were divided into groups (n=12) of silymarin 140mg, placebo, and rosuvastatin 10mg. Medications were administered 3 times a day for 6 months. Clinical tests, lipid profile (TG, HDL, TC, and LDL), Aβ1-42, and LRP1 markers were measured at the beginning and end of the intervention. Magnetic resonance spectroscopy (MRS) was used to measure metabolites. Using SPSS software a one-way ANOVA test was used to compare the means of the quantitative variables and Pearson and Spearman's correlations to measure the correlation. GraphPad Prism software was used for drawing graphs. P < 0.05 was considered a significant.

Results: The levels of LRP1 and Aβ1-42 in the silymarin group were significantly increased compared to the other groups (P < 0.05). NAA/mI in the silymarin group had a significant increase compared to both placebo and rosuvastatin groups (P < 0.05). Right and left hippocampal mI/Cr directly correlated with TG (r = 0.603, P = 0.003 and r = 0.595, P = 0.004, respectively). NAA/Cr of the right and left hippocampus was inversely related to TG (r = -0.511, P = 0.0033, and r = -0.532, P = 0.0021, respectively). NAA/Cr and NAA/mI of bilateral hippocampi directly correlated with HDL (P < 0.05). An inverse correlation was observed between the Aβ1-42 and mI/Cr of the right and left hippocampus (r = -0.661, P = 0.000 and r = -0.638, P = 0.000, respectively).

Conclusion: Donepezil and silymarin improved lipid profile associated with increased NAA/Cr, and decreased mI/Cr, in AD patients. Biomarker NAA/mI can be clinically significant in examining AD pathology. Measurement of the lipid factors and neurometabolites can be a suitable method for monitoring this disease.

Background: Meniscal injury is a common problem that can lead to knee pain and dysfunction. Meniscal repair and meniscectomy are two treatment approaches for meniscal injury, but the latter may increase the risk of osteoarthritis. We aimed to compare the 3-year outcomes of a new method of meniscal suturing with meniscectomy among patients with meniscal injury.

Methods: This retrospective cohort study compared meniscal repair (treatment group) and meniscectomy (control group) in patients with meniscal injury. We evaluated the outcomes of 134 patients. under treatment with these approaches based on the Lysholm scale, which measures knee function and symptoms. The study used the chi-square test and the Mann-Whitney U test to compare the proportion of patients with different outcomes and the Lysholm scale scores between the treatment and control groups. The study also conducted subgroup analyses based on gender and age using the Mann-Whitney U test. The level of significance was set at P < 0.05 for all statistical tests.

Results: The treatment group had a higher proportion of patients with excellent results, although the difference was not statistically significant (17.2% in the treatment group vs. 10.0% in the control group, P = 0.223). However, a comparative analysis of the proportion of patients with good results revealed statistically significant differences, with 67.2% of patients in the treatment group achieving good outcomes compared to 45.7% in the control group (χ2 = 6,256, df = 1 P = 0.012, HR 1,470 95%CI 1,081-1,999). The average score on the Lysholm scale was significantly higher in the treatment group (87.48, 95% CI 85.1-89.7, SD = 9.2) compared to the control group (81.73, 95% CI 78.4-84.9, SD = 13.7) (U = 1609, Z = -2.813, P = 0.005). Subgroup analyses based on gender and age also showed significant differences in the Lysholm scale scores.

Conclusion: The study demonstrates that meniscal repair is more effective than meniscectomy in improving patient outcomes, with a higher proportion of patients achieving excellent and good results and higher scores on the Lysholm scale. These findings support the use of meniscal repair as a preferred treatment approach for patients with meniscal injuries.

Background: Studies examining narrative production skills in children with autism spectrum disorder (ASD) have demonstrated variable and inconsistent results. This study aimed to investigate to what extent narrative difficulties in children with ASD reflect difficulties with language.

Methods: Accordingly, the spoken narrative skills of 16 children with ASD were compared with those of their 16 chronological age-matched (CAM) and 16 language-matched (LM) peers. A Kruskal-Wallis non-parametric test was then used to examine the differences between groups in regard to NTC, NSG and SI variables .For other studied variables (NTW, number of T-units, ATL and total score), one-way analysis of variances (ANOVA) was also used.

Results: At the level of microstructure, the results showed that productivity (number of total words, total clauses, and T-unites) and syntactic complexity (average of T-unit length and subordination index) were predominantly similar in ASD and LM children. However, children with ASD scored lower than their CAM counterparts (P < 0.001). At the macrostructure level, we found that the total score of story grammar elements and the number of story grammars in the narrative production of children with ASD were lower than those in both CAM and LM children (P < 0.001).

Conclusion: The present study, thus, showed that creating a coherent narrative could be more demanding for children with ASD than productivity and syntactic complexity.

Background: Research data on hospitalized coronavirus 2019 (COVID-19) survivors indicate the persistence of symptoms, radiological abnormalities, and physiological disorders months after the initial infection. Given the scale of the ongoing pandemic, a substantial number of patients with severe residual pulmonary fibrosis (PF) and oxygen dependence are anticipated. Currently, the search for risk factors associated with the development of fibrotic radiological abnormalities after moderate to severe COVID-19 is underway. Furthermore, the extent to which computed tomography (CT) data correlate with postdischarge symptoms and physical functions remains unclear. This study aimed to characterize patients experiencing persistent pulmonary consequences after hospital discharge. We examined clinical, radiological, and laboratory predictors of pulmonary fibrosis after COVID-19 infection.

Methods: We retrospectively evaluated fibrosis-like lung changes and their prognostic factors in COVID-19 survivors. Our study included 77 patients with laboratory-confirmed COVID-19 who received inpatient treatment at City Clinical Hospital No. 1 in Almaty between November and December 2020. We assessed patients during the acute phase of the disease and again 6 to 8 months after discharge using high-resolution computed tomography (CT). Patients were classified into 2 cohorts based on semi-quantitative analysis of subsequently added tomograms-those with radiological fibrosis-like abnormalities (main group) and those who had recovered (control group).

Results: Parenchymal cords, irregular interfaces, reticulation, and traction bronchiectasis were common CT findings among all COVID-19 patients. Our study focused on patients who developed pulmonary fibrosis within 1 month after the onset of the disease. After 6 to 8 months, fibrosis-like lung changes persisted in 49.35% of patients (leading group), while 50.65% showed disease resolution (control group). Age, body mass index, high interleukin-6 (IL-6) levels, low IO levels, and the need for mechanical ventilation were identified as prognostic indicators for the persistence of pulmonary fibrosis.

Conclusion: Our study revealed that pulmonary function can return to normal in over half of COVID-19 patients 8 months after infection onset. Despite advancements in COVID-19 treatment, there remains a significant knowledge gap in managing long-term effects, especially pulmonary fibrosis. Continued clinical trials and research on post COVID-19 fibrosis are essential to prevent early mortality due to the long-term impacts on these patients.

Background: Due to the prevalence of autism spectrum disorder (ASD), these children must be screened as soon as possible and receive the necessary and appropriate treatment. The purpose of this study was to examine all the ASD screening tools and examine their psychometric properties in available languages.

Methods: This was a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to review the articles published between 2000 and 2023 and were published in PubMed, EMBASE, ProQuest, and Scopus databases. English keywords were as follows: autism spectrum disorders (ASD), screening/screen, tools, psychometric properties, validity, reliability, translations, pervasive developmental disorders (PDD), and children. The COnsensus -based Standards for the selection of health Measurement Instruments (COSMIN) checklist were used to investigate the psychometric properties of the studies.

Results: Among the 476 primary studies, 35 ASD screening tools (132 articles related to the psychometric properties of 35 ASD screening tools in different languages) were identified based on our criteria, and their psychometric properties were examined. Various tools, including performance-based, direct observation, interactive play, and parent and teacher reports tools, were included in the list of tools.

Conclusion: Considering that each of these tools has advantages and limitations, they need to be selected and used according to the goals of the researchers and the therapists. Another important point is that many of these tools still need more extensive studies in relation to their psychometric properties.

Background: Total hip arthroplasty (THA) is an effective surgery for patients with end-stage hip joint degenerative arthritis. This study aimed to determine peri-operative factors that impact the length of stay (LOS) and design a formula to predict LOS in patients undergoing THA.

Methods: This cross-sectional study was performed from September 2019 to January 2020. For this study, all patients who underwent THA over a period of 12 years since 2005 were included in the study. Data about the LOS and several variables including demographic variables, surgery-related variables, transfusion, intensive care unit (ICU) admission, past drug history, comorbidities, and laboratory data, were gathered. Qualitative variables are presented as numbers (%), and quantitative variables are presented as mean Mann± standard deviation. Mann Whitney test , Kruskal-Wallis test, and Spearman's rank correlation test were also used.

Results: A total of 524 patients were included in the study; 12 were excluded .261 (51%) were female and 251(49%) male. The mean age was 56.13±17.04 years. In the univariate analysis, the day of admission, surgery indication, transfusion, diabetes mellitus, oral anti-diabetic drugs, American Society of Anesthesiology (ASA) score, preoperative hemoglobin (Hb) level, and type of prosthesis showed significant relation with LOS. Significant variables entered to zero truncated negative binomial regression. Among them, the day of admission, ASA score, preoperative Hb level, and type of prosthesis showed significant relation with LOS (P < 0.05) and were used for model design.

Conclusion: Preoperative Hb level, ASA score, day of admission, and prosthesis type have an impact on LOS and can predict LOS in patients who are candidates for THA.

Background: Human immunodeficiency virus (HIV) resulted in considerable morbidity and mortality. Following antiretroviral therapy (ART), the life expectancy of HIV-infected patients increased; however, they were more at risk of developing chronic diseases such as endocrinopathies. This study aimed to determine the prevalence of dysglycemia, dyslipidemia, and metabolic syndrome among patients with HIV infection.

Methods: This cross-sectional study was conducted on HIV-infected patients referring to Loghman Hakim Hospital (Tehran, Iran) between April 2020 and April 2021. We examined demographic features, medical history, and laboratory tests indicating the metabolic status of the patients. Eventually, collected data were processed using SPSS version 23.

Results: The mean age of 68 confirmed HIV patients was 39.85±10.54 years and 64.7% were male. BMI (MD = 2.57, 95% CI = [0.25, 4.88], P = 0.035), cholesterol (MD = 22.73, 95% CI = [4.70, 40.76], P = 0.014), HDL (MD = 8.54, 95% CI = [2.06, 15.02], P = 0.011), and LDL of women was significantly higher than men (MD = 22.43, 95% CI = [7.60, 37.27], P = 0.004). Additionally, 30 patients (44.1%) suffered from metabolic syndrome. The prevalence of metabolic syndrome differed significantly between men (34.1%) and women (62.50%) (P = 0.024).

Conclusion: Dysglycemia, dyslipidemia, and metabolic syndrome are common among HIV-infected patients. Thus, periodic evaluation of the patients can be advantageous in early diagnosis and timely treatment.

Background: Determining the risk of severe course coronavirus disease 2019 (COVID-19) and its related factors in survivors of common cancers such as breast cancer is important. This study has been designed to evaluate the prevalence of COVID-19 infection in breast cancer survivors and also estimate the risk of severe disease in this population.

Methods: Out of 6134 patients in the Shiraz Breast Cancer Registry (SBCR), A total of 292 patients who elapsed less than a year from their breast cancer diagnosis were excluded. We called 5842 patients. Finally, 4135 breast cancer survivors who agreed to cooperate were screened for COVID-19 symptoms by a symptom-based questionnaire in November 2020. COVID-19 in symptomatic participants was confirmed by a polymerase chain reaction (PCR) test. The clinical and paraclinical data of the COVID-19 course were collected for patients with a positive PCR test.

Results: A total of 247 (5.9%) participants had at least reported one of the COVID-19 symptoms. Also, 17% of symptomatic participants had a positive PCR test; 83.7% had mild disease, 9.5% moderate, and 16.7% had severe conditions. Chronic cardiovascular disease, hypertension, and diabetes were related to an increased risk of severe illness ( P = 0.018, P = 0.018, P = 0.002).

Conclusion: This study suggests that breast cancer intermediate and longtime survivors without other underlying diseases are considered at low risk for developing severe/critical COVID-19.