Archives of Iranian Medicine最新文献

Background: Talented students are among the key human resources in society, and educational and university authorities bear the responsibility of addressing the potential challenges they face. Therefore, identifying these challenges is essential. Objective: This research aimed to identify the challenges experienced by talented students and to propose possible solutions to help managers and planners design effective interventions.

Methods: The participants were 50 talented students from healthcare sciences. A phenomenological approach was employed using Colaizzi's seven steps method for data collection and analysis. Structured interviews were conducted with the students selected through purposive sampling.

Results: Data analysis revealed the central theme of the "narrow alley of talents" accompanied by six main themes: "motivational slope", "striving for improvement", "uneven university path", "social lens", "family umbrella", and "the bright side of talents", each comprising several subthemes.

Conclusion: The challenges faced by talented students can be mitigated and their competencies enhanced through tailored educational opportunities and services, counseling, and engagement of external motivational and support resources.

Background: Aortic aneurysm (AA) remains a significant global cause of mortality. This study aimed at systematically revealing the distribution of AA burden and its attributable risk factors from 1990 to 2021.

Methods: Data of AA-related deaths, disability-adjusted life years (DALYs), and corresponding age-standardized rates (ASRs) were extracted from the Global Burden of Disease (GBD) 2021 study. Estimated annual percentage change (EAPC) was calculated to assess trends in the AA burden at global, regional, and national levels. The temporal trends of AA burden were analyzed, and key attributable risk factors were identified. Population attributable fractions (PAFs) were calculated to assess the impact of these risk factors.

Results: From 1990 to 2021, global AA-related deaths increased by 74.218% (95% UI: 83090‒93492 to 138413‒165739), while age-standardized death rates (ASDR) declined by 26.772% (95% UI: 2.538 to 1.861 per 100000). DALYs rose by 64.944% (95% UI: 1784177‒2006704 to 2857320‒3353858), with ASDALYR falling by 25.1% (95% UI: 48.789 to 36.543 per 100000). Regions with high or middle-high socio-demographic index (SDI) scores experienced higher AA burdens compared to lower SDI regions. Males had higher burdens, peaking at ages 70‒74 (deaths) and 65‒69 (DALYs). In regions with an SDI above 0.75, the ASRs of AA burden exhibited a downward trend. Smoking was identified as the most significant attributable risk factor.

Conclusion: From 1990 to 2021, declining trends were observed in the ASRs of AA-related deaths and DALYs, although males reported a higher AA burden than females. Efforts to control tobacco use should be prioritized as a key preventive strategy.

Doctor Badri Teymourtash (1908‒1995) was among the first Iranian lady dentists. She was one of the founders of Mashhad Dental School and one of the pioneers of modern dentistry in Iran. This paper takes a glance at the story of the life of this academic woman with its ebbs and flows.

Inpatient falls are a significant health concern, leading to increased hospital stays, costs, and potential severe injuries or death. This study aims to investigate the incidence, risk factors, and challenges of inpatient falls in Firoozgar hospital . This cross-sectional study was conducted in a tertiary care hospital in Tehran, Iran. The study included all patients who experienced a fall incident in Firoozgar hospital between April 2023 and March 2024. We included 90 patients with an average age of 57.49 years. Falls were more prevalent among men, older patients, and individuals with lower education levels. Underlying conditions such as diabetes, heart disease, and addiction significantly increased the risk of falls. Identifying the specific causes of falls in each hospital ward can facilitate the development of targeted preventive strategies. Implementing environmental modifications and fall prevention measures could substantially reduce fall risks, enhance patient safety, and lower healthcare costs.

Background: Assisted reproductive technologies (ARTs) have been implemented in Iran for nearly thirty years. However, except for embryo donation, none of the other cases, including embryo and sperm donation have not yet been legalized through parliamentary resolutions. This study aims to explore the challenges of these three types of donations from the perspective of fertility experts.

Methods: This qualitative exploratory research was conducted in Tehran in 2024. Participants consisted of 12 specialists with experience in infertility treatment or other fields related to embryo, sperm and egg donation, who were selected through purposive sampling. Data were collected via focus group discussions and analyzed based on conventional content analysis using MAXQDA 20.

Results: Data were classified into 12 categories. Eight categories describe the challenges and problems of egg, sperm, and embryo donation and 4 categories describe the solutions recommended by experts.

Conclusion: According to the study findings, sperm donation faces the most legal and medical challenges compared to egg and embryo donation. Designing a comprehensive national protocol could be the best solution proposed to Iranian health policymakers. Conducting more qualitative and mixed methods studies related to sperm, egg, and embryo donation could confirm and strengthen the findings of this study.

Background: Peripartum hysterectomy (PH) poses a notable public health challenge due to its correlation with severe maternal morbidity and mortality. Identifying the causes and risk factors associated with PH is crucial for enhancing preventive strategies and maternal health outcomes. This study investigates the indications, and outcomes of PH across healthcare settings.

Methods: This is a retrospective analysis of all PH cases between March 2021 and March 2022 in Tehran, Iran. The study included cases where gestational age was greater than 24 weeks, with PH performed during delivery or within the first 24 hours postpartum. Data, including demographic and clinical variables, were collected from the Iranian Maternal and Neonatal Network (IMaN) system.

Results: In total, 136 PH cases were identified. The average age of the women was 35.1 (±5.2) years. Cesarean section (C/S) was the predominant delivery method, comprising 93.4% of cases, with 44.9% having a medical indication, 7.4% without indications, and 41.2% performed as emergency C/S. Notably, a previous C/S was reported in 65.4% of cases. The main indications for PH were placenta abnormalities (75.6%), uterine atony (20.7%), uterine rupture (3%), and ovarian mass (0.7%). Placenta previa (42.6%) and placenta accreta (32.4%) were the most frequent placental abnormalities.

Conclusion: The findings highlight key factors influencing PH that may inform health policies to mitigate risks. A national study could offer a comprehensive view, accounting for regional, socioeconomic, and cultural differences, emergency healthcare access, and resource availability, guiding targeted public health interventions.

Background: The increasing use of imaging techniques has led to a rise in the detection of liver masses, making it crucial to accurately diagnose their nature. While advances in radiology have reduced the need for liver biopsy in hepatocellular carcinoma (HCC), biopsy remains essential fo r diagnosing various liver lesions, including metastatic tumors. This study aims to evaluate the diagnostic role of liver core needle biopsies, with a particular focus on identifying the primary tumor in cases of liver metastases with an unknown primary.

Methods: We reviewed a total of 406 liver core needle biopsies performed for liver masses between 2017 and 2022. Clinical, radiological, histopathological and immunohistochemical (IHC) data for primary and metastatic tumors were evaluated.

Results: Of the 406 liver biopsy cases, a significant portion were diagnosed as metastatic lesions, with common primary sites identified as gastrointestinal (GI), lung, and breast cancers. IHC markers showed varying positivity rates across different tumor types, with GATA-3, CDX2, and TTF1 proving particularly useful in distinguishing the tumor origin. While some markers were highly specific, others exhibited variable expression, highlighting the complexity of diagnosing metastatic tumors with unknown primaries.

Conclusion: Liver biopsy remains a crucial diagnostic tool in identification of primary and metastatic liver tumors, especially when the primary site is unknown. IHC analysis enhances the accuracy of diagnosis, though it should be used in conjunction with clinical and radiological data. This study underscores the importance of a multidisciplinary approach in managing liver masses, with further research needed to optimize diagnostic strategies and improve patient outcomes.