Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 11 2024 07 11 646 653 Mahdi Shooraj Student Research Committee, Amol School of Paramedicine, Mazandaran University of Medical Sciences, Sari, Iran. Kiarash Fekri Department of Preclinical, Amol Campus of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. AND Department of Paramedicine, Amol School of Paramedicine, Mazandaran University of Medical Sciences, Sari, Iran. Noushin Mousazadeh Department of Nursing, Amol School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran. Seif Ali Mahdavi Department of Preclinical, Amol Campus of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. AND Department of Paramedicine, Amol School of Paramedicine, Mazandaran University of Medical Sciences, Sari, Iran. 2023 07 19 2024 02 14 - Pharmacology is the cornerstone of health science courses the same as biomedical programs in educational setting. New educational intuitions and methodical progresses in teaching and learning, as well as recent findings in pharmacology research, can help pharmacology educators reconsider and regulate their teaching approaches. Thus, the aim of this article is to review existing studies on the different methods of teaching pharmacology and investigate different outcomes in this regard. In the present investigation, recent articles in the databases of Web of Science, PubMed, Scopus, Embase, Google Scholar, IranDoc and Scientific Information Database (SID) were examined, and the delegated documents were reviewed. The gathered data showed that students’ cognitive, metacognitive, and cooperative learning besides collaborative skills are effective factors for teaching. Additionally, application of blended learning or flipped instruction via technologies such as computer ameliorates the process of teaching and learning pharmacology in academic setting. Consequently, to overcome the difficulties in managing the data overload, it sounds necessary to introduce new teaching methods in academic context. Therefore, the current investigation is useful for practitioners, curriculum designers and educational administrators in medical and paramedical educational context. https://acta.tums.ac.ir/index.php/acta/article/view/10739

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 11 2024 07 11 654 659 Ali Shahriari Anesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran. Masoomeh Nataj-Majd Anesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran. Majid Akrami Anesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran. Maryam Khooshideh Department of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mahsa Soleimani Department of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2024 04 21 2024 04 27 Epidural analgesia (EA) is an effective and common method of pain relief during labor. However, EA may also have some adverse effects like prolonged labor, increased risk of operative delivery, and some unwanted complications. It's unclear how maternal position affects the outcomes of natural birth with EA. This study aimed to compare mode of delivery and maternal and neonatal outcomes between recumbent and upright positions in nulliparous women with EA. This randomized clinical trial involved 540 women who received EA at cervical dilatation of 4 to 6 cm. During the second stage of labor, they were instructed to adopt upright or recumbent position. The main outcome was the mode of delivery. The secondary outcomes included duration of labor, pain intensity, the Apgar score, and other maternal and neonatal complications. Finally, 528 women were included in the final analysis. The upright group had a higher rate of cesarean section than the recumbent group. The duration of the labor stages did not differ between the groups. The pain intensity in the second stage was higher in the upright position. The Apgar score at 1 and 5 minutes was higher in the recumbent group. There was no difference in terms of other outcomes between the groups. Recumbent positions are beneficial in the case of rate of cesarean, mother’s pain, and Apgar score in women with EA. So, adopting a recumbent position during the second stage of labor may be preferable for women with EA.   https://acta.tums.ac.ir/index.php/acta/article/view/11086

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 11 2024 07 11 660 666 Parisa Khosravi Social Determinants of Health Research Center, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran. Soheila Pirdadeh Beiranvand Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran. Farzad Ebrahimzadeh Nutritional Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran. Arefeh Tadayon 1 Social Determinants of Health Research Center, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran. Maryam Hasani Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran. 2023 11 24 2024 02 17 This study aims to determine the effect of gestational hypertension on neonatal hemoglobin levels. This cohort study was performed on 150 pregnant women, 60 of whom had gestational hypertension and 90 were healthy. Participants were selected using sequential and quota non-probability sampling methods, respectively. The data were collected from interviews and examination forms. The newborns’ umbilical cords were clamped 30-60 sec after the delivery in both groups. Umbilical cord blood samples were taken to determine neonatal hemoglobin levels and sent to the laboratory immediately. Independent t-test was used to compare the two groups in terms of mean hemoglobin; general linear model with an identical link function was used to compare the two groups in terms of mean hemoglobin, considering the effect of confounding variables. SPSS software version 25 was used for the statistical analysis of the data. The statistical significance level in this study was considered to be 0.05. The mean neonatal hemoglobin level in women with gestational hypertension was significantly higher than that in the healthy group (16.73±1.81 gr/dl vs. 15.56±1.79, P<0.001). This difference remained significant after adjusting for demographic and background variables as well as medical records of the participants (P=0.008). The results revealed the hemoglobin level of newborns of mothers who had gestational hypertension, was higher than newborns of healthy mothers. Therefore, performing proper screening tests and knowledge of the hemoglobin level in these infants routinely helps the healthcare staff to prevent, decide and provide more and more useful services. https://acta.tums.ac.ir/index.php/acta/article/view/10882

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 11 2024 07 11 667 676 Fatemeh Sarhadi kholari Department of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Mitra Nourbakhsh Department of Clinical Biochemistry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. AND Metabolic Disorders Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Golsa Shekarkhar Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran . Ahmad Reza Dehpour Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Abolfazl Golestani Department of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2022 01 12 2024 01 28 Cirrhosis is the consequence of chronic liver injury Considering the crucial role of oxidative stress in the progression of liver cirrhosis, we aimed to investigate the ameliorative effect of NTX against oxidative stress in carbon tetrachloride (CCl4)-induced cirrhotic rats. Eighty-four male Wistar rats were randomly assigned into 4 groups (21 rats /group I) receiving CCl4; (II) NTX+CCl4; (III) mineral oil (M) (as the control); (IV) NTX+M. The animals in each group were sacrificed in 3 different time-points 2 weeks, 6 weeks (early cirrhosis) and 8 weeks (advanced cirrhosis). Liver function tests, NO metabolites, GSH level, as well as the activity of antioxidant enzymes including superoxide dismutase (SOD), catalase (CAT), glutathione peroxides (GPX), and hexokinase (HK) were assessed. NTX was able to ameliorate liver injury, revealed by attenuation of ALT activity, which was significantly enhanced due to cirrhosis induction, as well as pathological evaluation. HK was also increased significantly after treatment with CCl₄ while NTX moderated this increase. Although CCl4 treatment did not have a significant effect on GSH levels, NTX was able to considerably increase GSH in blood. The activity of CAT and SOD as well as NO levels were all augmented by NTX in CCl4-treated rats. Naltrexone demonstrates antioxidative effects in liver cirrhosis and may confer a protective effect against hepatic cirrhosis through modulation of oxidative stress.   https://acta.tums.ac.ir/index.php/acta/article/view/9922 https://acta.tums.ac.ir/index.php/acta/article/download/9922/5869

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 11 2024 07 11 677 684 EN Sara Monjezi Department of Neurology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Shahram Rafie Department of Neurology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Ebrahim Behzad Department of Neurology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Shooka Mohammadi Department of Neurology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 2024 01 31 2024 06 15 Precise categorization of the causes of ischemic stroke (IS) is crucial for optimizing stroke treatment and assessing the prognosis of patients. This cross-sectional study aimed to determine the risk factors and various subcategories of IS in Iranian patients. The study included all patients with IS referred to Golestan Hospital (Ahvaz, Iran) for one year. Their demographics and clinical data were collected. The etiology of IS was classified based on the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria. A total of 1100 patients with IS were evaluated, 658 were male and 442 were female. They had an average age of 66 years (ranging between 20 and 99 years). The majority of them were in the 61-80 age group. The prevalence of risk factors for IS included hypertension (HTN) (71.4%), diabetes (50.4%), smoking (42.4%), history of previous stroke (28%), dyslipidemia (15.4%), and cardiovascular disease (22.5%). Three months after admission, the mortality rate was 10.7% and the majority of patients exhibited a lower level of disability based on the modified Rankin Score (mRS) compared to the time of admission. The frequency of all risk factors, except for HTN, differed significantly between genders (P<0.05). Furthermore, the prevalence of risk factors varied significantly among different stroke etiologic subgroups (P<0.05). The most common etiological factors identified by TOAST classification were associated with large artery atherosclerosis (LAA) and small artery occlusion (SAO). Significant variations were observed in the prevalence of different etiologic subtypes of stroke among genders and across different age groups. https://acta.tums.ac.ir/index.php/acta/article/view/10955

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 11 2024 07 11 685 690 Mehrdad Dargahi-Malamir Department of Pulmonology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Seyed Hamid Borsi Department of Pulmonology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Zahra Mehraban Department of Pulmonology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Fatemeh Kianizadeh Department of Internal Medicine, Faculty of Medicine. Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Hoda Mohsenikia Department of Internal Medicine, Faculty of Medicine. Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. 2024 01 21 2024 05 21 Pinen Hydronoplacton Ribonucleic acid (PHR160) medicine contains compounds that can be useful in the recovery of respiratory patients. The aim of this study was to determine the effect of PHR spray on improving lung function, severity and asthma attacks in patients with severe asthma. This study is a pioneering interventional study (pilot study) conducted during the years 2021-2022 on patients with severe asthma resistant to treatment who referred to the lung clinic of Imam Khomeini, Golestan Hospitals and the private practice of lung specialists of this academic center. The study includes two groups of patients with asthma, both groups were given the usual treatment according to the stage of the disease, in addition, the intervention group was given two puffs of PHR spray every eight hours, and the control group was given a placebo spray with the same dose. Before and after the intervention, GSK 2002 questionnaire, six-minute walk distance (6MWD) and spirometry tests were completed. Among of 60 patients, 27 (45%) were male. The mean age of the patients was 44.33±6.94 years. Based on findings, the forced vital capacity (FVC) and forced expiratory flow between 25% and 75% (FEF 25-75%) were significantly better in the intervention group than the control group (P<0.001 and P=0.019, respectively), but there was a statistically remarkable difference between the two groups in terms of forced expiratory volume (FEV1) and FEV1/FVC (P=0.505, P=0.575, respectively). In addition, the GSK questionnaire score in the intervention group was higher than the control group (P<0.001), however there is no significant difference between the two intervention groups in terms of the 6MWD test and the number of exacerbation (P=0.114 and P=0.09, respectively). It is generally concluded that PHR160 spray can lead to improvement of spirometry parameters and severity of disease in severe asthma patients by affecting small airways. https://acta.tums.ac.ir/index.php/acta/article/view/10937

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 11 2024 07 11 255 263 Paria Sadat Ramezany Department of Emergency Medicine, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mohammed Ali Shadram Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Reza Dehpour Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Razieh Mohammad Jafari Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Morteza Saeedi Department of Emergency Medicine, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mehrad Aghili Department of Emergency Medicine, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Javad Seyedhosseini Department of Emergency Medicine, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2025 01 04 2025 07 07 Renal colic, a severe pain caused by renal and urethral calculi, causes millions of patients to visit the emergency department (ED) worldwide each year. Based on international guidelines, NSAIDs are the first-line analgesics of choice for renal colic management. The second most preferred analgesic is opioids. NSAIDs and opioids have several complications and contraindications that limit their administration and necessitate the search for alternative treatments for renal colic pain. The present study aimed to assess the effect of sublingual Glycerol Trinitrate (GTN) spray, a smooth muscle-relaxing agent, on renal colic pain as an alternative treatment. In this triple-blinded randomized controlled trial, 94 patients with renal colic who visited the emergency department (ED) were included. The drug group included 48 patients who were administered sublingual GTN spray, and the placebo group consisted of 46 patients. After diagnosis, the patients' pain was assessed based on the Numeric Rating Scale (NRS), a 30-milligram dose of ketorolac was administered to all patients, and sublingual GTN/placebo spray was administrated. The pain was also recorded 5 min after spray administration. Again, 30 min after spray administration, the NRS was reassessed. 94 patients enrolled in this study, the mean age of the participants was 39.22±11.72, and 82 (87.23%) of them were male. Five minutes after GTN/placebo administration, The NRS in both groups decreased significantly compared with the NRS upon arrival (P<0.01). Furthermore, in both groups, the NRS measured at 30 minutes also decreased significantly from the NRS measured at 5 minutes (P<0.01). Nevertheless, the reduction in the NRS score between the drug and placebo groups was not significantly different (P=0.365). Our results showed no significant pain reduction with sublingual GTN spray in comparison with placebo; thus, sublingual GTN spray might not have considerable analgesic effects in patients with renal colic referred to the ED. https://acta.tums.ac.ir/index.php/acta/article/view/11454 https://acta.tums.ac.ir/index.php/acta/article/download/11454/5978

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 63 4 2025 11 17 264 266 Seyeh Hamzeh Hosseini Department of Psychiatry, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Hamed Ghazvini Department of Neuroscience, School of Advanced Technologies in Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Seyedeh Masoumeh Seyedhosseini Tamijani Department of Neuroscience, School of Advanced Technologies in Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Raheleh Rafaiee Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran . 2024 08 12 2025 07 26