Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 12 2024 08 22 709 715 Shahruz Naseri Department of Anesthesiology, Beasat Hospital, School of Medicine, AJA University of Medical Sciences, Tehran, Iran Reza Eslami Aerospace and Sub-Aquatic Medical Faculty, Aja University of Medical Sciences, Tehran, Iran Shahram Samadi Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Iran. ANDAnesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran. Babak Hassanlouei Department of Biostatistics and Epidemiology, Medical School, Urmia University of Medical Sciences, Urmia, Iran 2024 04 21 2024 06 09 Sleep deprivation negatively affects a person's emotions, cognition, and performance and ultimately reduces safety. The main purpose of this systematic review is to study and report the evidence on the effect of sleep deprivation on the performance of pilots. This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. International databases including PubMed, Web of Science (WOS) and Scopus were considered for the search of English articles up to April of 2023. Keywords were sleep deprivation, pilot, flight, performance, airline, air force, flight safety, fatigue, pilot performance, flight performance, eye movement, workload, motion, visual, attention, errors, cognition, sleep quality, and circadian rhythm. In this systematic review, 12 studies consisting of 259 subjects remained. Most of the studies have reported the negative effects of sleep deprivation in a different way, and the decrease in performance was expressed as one of the important issues following sleep deprivation. As various studies show, any type of sleep deprivation in pilots can have negative effects on their performance, and this decrease in performance can have irreparable consequences. https://acta.tums.ac.ir/index.php/acta/article/view/11085

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 12 2024 08 22 716 721 Sedigheh Ebrahimi Department of Medical Ethics and Philosophy of Health, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Amirhossein Kamyab Faculty of Medicine, Fasa University of Medical Sciences, Fasa, Iran. 2024 03 07 2024 06 24 Human beings are faced with numerous behavioral options in different situations, but they can only choose a limited number of them. Ethical beliefs, values, and principles guide individuals in decision-makings. This study focuses on medical residents' perspectives towards four ethical principles (Deontology, Utilitarianism, Virtue, and Principlism) in various clinical situations. This descriptive-analytical study was performed cross-sectional basis among a population of medical residents of Shiraz University of Medical Sciences. Data were gathered by multi-stage cluster sampling method using a researcher-made questionnaire including demographic information and five different clinical scenarios. The data were analyzed using the Chi-square test and descriptive and inferential statistics in SPSS22. The results of this study showed that there was no significant relationship between gender, specialty, year of study, and the four ethical principles mentioned in the participants. However, a significant correlation was observed between the types of scenarios and their alignment with a particular type of decision or ethical theory. The ethical philosophy of medical residents has been evolving gradually over time, even before entering the residency period. Therefore, focusing on practical ethics training and the commitment of residents to implementing the principles and values of professional ethics can shape the ethical philosophy of residents towards professional ethics and humanity. https://acta.tums.ac.ir/index.php/acta/article/view/10984

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 12 2024 08 22 722 727 EN Shahin Nosratzehi Department of Internal Medicine, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran Mahin Nosratzehi Department of Internal Medicine, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran. Ebrahim Alijani Department of Immunology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran Abolfazl Payandeh Infectious Diseases and Tropical Medicine Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran Tahereh Nosratzehi Department of Oral and Maxillofacial Medicine, School of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran Abdulmannan Charvaei School of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran. 2024 02 12 2024 08 05 Hashimoto's thyroiditis (HT) is one of the common causes of hypothyroidism. Although various factors are involved in its development, recently the role of oxidative stress in its pathogenesis has been known. The present study aimed to investigate the level of total antioxidant capacity (TAC), catalase (CAT), and salivary superoxide dismutase (SOD) in patients with HT compared with the control group. The present case-control design included patients aged 18-80 years suffering from HT referred to the endocrine clinic. Eligible patients were selected by the available sampling method. Complete unstimulated saliva was collected under a rest state in a comfortable room between 10:00 AM and 12:00 AM and a checklist was used to collect data. The chi-square, t-test, and Mann-Whitney U tests were used for data analysis using SPSS 22 software. The mean age of the participants was 36.55±9.37 years (range: 20-56). The two groups were the same in terms of age and gender (P>0.05). The findings indicated that the difference in the means CAT between the two groups was 22.63 which was strongly and statistically significant (P<0.001). In this study, the level of TAC and SOD in Hashimoto's thyroid patients was decreased and the level of CAT was increased. These initial findings show that oxidative stress can be associated with Hashimoto's thyroid disease or the possibility of developing this disease increase. https://acta.tums.ac.ir/index.php/acta/article/view/10968

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 12 2024 08 22 728 735 EN Yasaman Kheirandish Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Oral and Maxillofacial Radiology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Mehrdad Panjnoush Department of Oral and Maxillofacial Radiology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Ehsan Babri School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Reza Dehpour Department of Pharmacology, Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2024 02 10 2024 02 18 Statins affect the bone metabolism. Considering the role of nitric oxide (NO) in many physiological processes, this study assessed the effects of atorvastatin (ATOR) and NO on the mandible and skull bone density (BD) in ovariectomized rats. This study evaluated 48 female Sprague-Dawley rats in 6 groups (n=8). Groups 1 and 2 underwent sham surgery. Group 1 (sham) did not receive any medication, but group 2 (sham/ATOR) received atorvastatin. Groups 3 to 6 underwent ovariectomy. Group 3 (OVX) did not receive any medication, group 4 (OVX/ATOR) received atorvastatin, group 5 (OVX/L-NAME) received L-NG-nitro arginine methyl ester (L-NAME), and group 6 (OVX/ATOR/L-NAME) received both atorvastatin and L-NAME. Atorvastatin (40 mg/kg) was gavaged and L-NAME (3 mg/kg) was administered intraperitoneally for 4 weeks. All rats underwent lateral cephalometry before and after the interventions, and BD was measured at 2 points in the mandible and skull before and after the intervention by a digital densitometer. Data were analyzed by t-test, ANOVA, and Sidak test (alpha=0.05). The change in BD was 26.5±10.17 in the mandible and 22.17±9.45 in the skull in OVX group. These values were 25.63±5.55 and 28±8.59 in OVX/ATR, 1.5±7.78 and -1.88±4.39 in OVX/L-NAME, and 6.63±7.37 and 4.33±6.35 in OVX/ATOR/L-NAME, respectively. OVX/ATOR showed no significant difference (P=1), but OVX/L-NAME (P<0.001) and OVX/ATOR/L-NAME (P<0.001) groups showed significant differences with OVX group. The present findings indicated that atorvastatin had no significant effect on BD, but administration of L-NAME prevented osteoporosis in ovariectomized rats. https://acta.tums.ac.ir/index.php/acta/article/view/10966

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 12 2024 08 22 736 742 Effat Rafiei Department of Pulmonary Medicine, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran Omalbanin Paknejad Department of Pulmonary Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Negar Eftekhar Department of Anesthesiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Oveis Salehi Department of Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Parisa Rashidi Department of Medicine, Nezam Mafi Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Marsa Gholamzadeh Department of Medical Informatics, School of Medical Informatics, Tehran University of Medical Sciences, Tehran, Iran Mehrnaz Asadi Gharabaghi Department of Pulmonary Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2024 05 22 2024 07 21 Flexible bronchoscopy is employed to diagnose a range of respiratory disorders. Local airway anesthesia is mandatory to facilitate tracheal intubation. It is commonly done by injection of diluted lidocaine through working channel of bronchoscope via Spray-as-you-go (SAYGO) method. Other methods such as airway nerve block (ANB) by direct injection of lidocaine are also used to increase patient comfort. The aim of this study was to compare patient and physician satisfaction during bronchoscopy in two groups receiving SAGO alone versus combination of SAYGO and ANB. In a double-blinded randomized clinical trial, 68 patients undergoing bronchoscopy were divided into two groups. The first group received local anesthesia solely through the SAYGO method, while the second group received a combination of SAYGO and ANB. Both groups received intravenous sedation. The anesthesia level was assessed using Ramsay score. Patient and physician satisfaction with bronchoscopy was evaluated on a numeric scale of 1 to 5. Combination of ANB and SAYGO resulted in significantly higher satisfaction score both in physician [3.4±1.6 and 4.6±0.8] and patients [3.5±1.3 and 4.9±0.4] (P<0.001). Thirteen individuals (38.2%) in the SAYGO and four individuals (11.8%) in SAYGO+ANB experienced a drop in oxygen levels (P=0.023). Additionally, sedation levels (Ramsay sedation scale score) were significantly higher in the first group (4) compared to the second group (3) (P=0.001). Combining ANB with SAYGO resulted in higher patient and physician comfort during bronchoscopy in comparison to SAYGO alone with no increase in complications. https://acta.tums.ac.ir/index.php/acta/article/view/11113

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 12 2024 08 22 743 748 Bita Malekianzadeh Department of Anesthesiology, Pain Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Saghar Samimi Sadeh Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran Babak Eslami Department of Anesthesiology, Pain Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Abbas Ostadalipour Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Parastou Ariana Department of Anesthesiology, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran Nima Nazari Anesthesiologist, Assistant professor of anesthesiology and critical care 2024 04 21 2024 04 27 With the increasing number of pediatric surgeries and the transfer of caregiving roles to parents, appropriate preparation and reduction of their stress levels for proper care of children before and after surgery is essential. If parental anxiety can be reduced through various methods, not only can it improve parental performance and their comfort, but it can also prevent the impact of anxiety on the child. Therefore, we aimed to investigate the effect of educational film presentation on the anxiety level of mothers visiting the obstetric anesthesia clinic at the Children's Medical Center in 2020. This study was a randomized double-blind controlled trial conducted as an intervention. Sampling was done randomly, and the study population consisted of two groups of 38 individuals, whose children were candidates for MRI. The intervention group watched the educational film, while the second group served as the control group. Subsequently, their anxiety levels were assessed and compared using the Beck Anxiety Inventory. The data were entered into SPSS Ver. 21 software and analyzed accordingly. The mean age of mothers in this study was 33.41 years with a standard deviation of 7 years. The mean age of children was 3.79 years with a standard deviation of 3.4 years. Among the children, 30 were girls (39.5%) and 46 were boys (60.5%). The mean age of girls was 4.35 years with a standard deviation of 4.16 years, while the mean age of boys was 3.433 years with a standard deviation of 2.787 years. Overall, 39 participants (50.6%) watched the educational film, while 38 participants (49.4%) were in the control group. The mean score of anxiety level according to the Beck Anxiety Inventory (BAI) was 9.47 with a standard deviation of 9.77. The level of anxiety was significantly higher in the intervention group who watched the educational film compared to the control group (P=0.012). The results of the present study indicated that parental anxiety increased after watching the educational video on anesthesia methods. It is recommended that alternative strategies be considered for reducing parental anxiety in future studies. https://acta.tums.ac.ir/index.php/acta/article/view/11087

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 12 2024 08 22 36 42 Ehsan Sadeghian Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Aidin Yaghoobi Notas Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Reza Eslamian Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Ali Ghorbani Abdehgah Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammadreza Mohajeri Tehrani Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Shariati Hospital, Tehran 2021 09 09 2023 01 27 Surgical site infection (SSI) is one of the most important complications of surgery and is known in quality improvement programs as a very important indicator for evaluating the performance of surgeons and hospitals. In recent studies, interesting effects for vitamin D such as antimicrobial effects, wound healing, immune regulation, etc. have been considered and the effectiveness of this vitamin on the above has been proven in laboratory environments and animal models. Therefore, the present study was designed and performed to evaluate the effect of vitamin D tablets before surgery on surgical site infection in patients referred to Shariati Hospital. This study was performed as a randomized controlled trial (RCT) on 200 patients who underwent surgery in Shariati Hospital in Tehran and in the general surgery department between 1397 and 1398. Patients were randomly assigned to two groups of 100 persons, including intervention and control. In all patients, vitamin D levels were measured and recorded 15 days before surgery. The intervention group included patients who received 2 tablets of fifty thousand units of vitamin D seven to ten days before the operation. The second group also included patients who did not undergo any intervention and only in order to maintain blindness of the same size and simultaneously with the first group. They received a placebo. Finally, all patients were followed at intervals of one, three, seven and thirty days after surgery and then compared to the extent of infection at the site of surgery and other desired variables. In this study, 200 persons with a mean age of 47.78 years were examined. 57.5% (115 persons) were female and the rest were male. Overall, 19 (9.5%) of the patients studied underwent surgery at the site of follow-up within one month of follow-up (14 in the control group and 5 in the intervention group). Detection between the two groups was observed in terms of infection (P=0.030). In general, based on the results of the analysis, in the present study, there was a statistically significant relationship between surgical site infection with low serum vitamin D level, increase in the number of hospital days, female gender, wound classification, ASA class of patients and vitamin D consumption before surgery. (P<0.05). The results of this study showed that there is a significant relationship between surgical site infection and consumption of edible vitamin D as well as serum vitamin D levels before surgery so that vitamin D deficiency can be considered as an independent risk factor for infection. Hospitals were considered, including surgical site infections. Therefore, performing preoperative tests as well as performing the required interventions can be very effective in improving this index and reducing surgical site infections. https://acta.tums.ac.ir/index.php/acta/article/view/9656

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 1 2023 03 07 43 51 Seyed-Mousa Mahdizadeh Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran . AND Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Monavvar Afzalaghaei Department of Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran. AND Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Mehrsadat Mahdizadeh Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. AND Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran 2021 09 14 2022 12 11 One of the global crises that people are dealing with today is the COVID-19 pandemic. The outbreak of this disease as a social phenomenon has affected all aspects of life. This study aimed to identify adult people's experiences during the COVID-19 outbreak. This qualitative research was performed with a conventional qualitative content analysis approach in Mashhad, Iran, from April to November 2020. twenty-five participants were selected through a purposeful sampling method with maximum diversity until data saturation was reached. Data were collected using semi-structured face-to-face interviews with open-end questions and analyzed with MAXQDA10 software. Two main categories were extracted (1) difficulties in multiple domains (psychological and informational problems, social challenges, spiritual and religious challenges, and economic problems), (2) adaptation to the epidemic (purposive self-care, ignoring the disease and health instructions, faith in God and optimism). The participants faced extensive challenges, which were made worse by the confusion and ambiguity about the information, quarantine, and social isolation. To continue living, the participants tried to adapt to situations. These results provide a guiding framework for policymaking and intervention. https://acta.tums.ac.ir/index.php/acta/article/view/9667

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 1 2023 03 07 52 56 Leili Koochakzadeh Department of Pediatrics, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammad Kajiyazdi Department of Pediatric Hematology and Oncology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Fahimeh Khoshhal Department of Pediatrics, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran Alireza Hashemi Tehran university of medical sciences Mehdi Khabazkhoob Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2021 12 16 2023 02 06 To determine the prevalence of alloantibodies in patients with thalassemia and its relationship with age, sex, and blood group. A cross-sectional study was conducted on thalassemia patients requiring a blood transfusion presenting to Children’s Medical Center and Bahmari Hospital in 2021. All patients who received blood transfusions in the first year of life were included in the study, and patients with sickle cell anemia and thalassemia intermedia were excluded. Blood samples were collected, and the level of alloantibodies was measured. One hundred and ninety-five patients were evaluated in this study, of whom 100 (51.3%) were male. The mean age of the subjects was 21.37±8.57 years (range: 1-42 years). The prevalence of alloantibody positivity was 16.41% (11.17-21.65) in all subjects, 19% (11.18-26.82) in males, and 13.68% (6.65-20.72) in females (P=0.318). The mean age of alloantibody positive and negative subjects was 18.94±9.7 and 21.85±8.29 years, respectively (P=0.079). The prevalence of alloantibody positivity was 21.88% (6.73-37.02) in Rh+ and 15.34% (9.75-20.93) in Rh- patients (P=0.364). The prevalence of alloantibody positivity was 13.46% (3.87-23.06) in blood type A, 26.67% (1.32-52.02) in blood type AB, 14.29% (3.25-25.32) in blood type B, and 17.44% (9.26-25.63) in blood type O, indicating no significant difference in this regard (P=0.625). The results showed that thalassemia patients were at risk for alloantibody positivity. Age, sex, and blood type had no significant association with the prevalence of alloantibody positivity. Considering the serious complications of these antibodies, these patients should be cont