Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 62 4 2024 12 30 173 181 Seyed Ahmad Seyed Alinaghi Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Mahdi Roozbahani Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Behnam Farhoudi Social Determinants of Health Research Center, Amir Al-Momenin Hospital, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran. Seyed Ali Dehghan Manshadi Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Shayesteh Jahanfar Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, United States . 2024 12 30 2024 12 30 The HIV epidemic continues to disproportionately affect young and active individuals in developing and low-income countries, including Iran. Among high-risk populations in Iran, HIV prevalence peaks at 3.5% among people who inject drugs and 2.5% among men who have sex with men. Despite progress in achieving the UNAIDS 95-95-95 targets for HIV diagnosis, treatment, and viral suppression, significant gaps remain in early detection and reaching vulnerable populations, including pre-exposure prophylaxis and targeted outreach to key populations. Education and awareness campaigns are crucial for preventing the spread of HIV, particularly among young people. However, there is a need to improve education and access to information and HIV services for key populations. Expanding HIV testing and counselling services is vital for early diagnosis and treatment. Addressing the issue of late diagnosis, which can negatively impact treatment outcomes and mortality rates, is essential. Integrating HIV services into primary healthcare can improve access and outcomes. A holistic and multi-sectoral approach, encompassing education, prevention, treatment, and care, is necessary to curb the spread of HIV and improve the quality of life for individuals affected by HIV infection in Iran. https://acta.tums.ac.ir/index.php/acta/article/view/11442

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 62 4 2024 12 30 182 187 EN Ali Tadayon Department of Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Javad Moayedi Central Research Laboratory, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Mohamad Ali Nazarinia Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Mahyar Malekzadeh Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Sara Kazemi Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran Maryam Mardani Department of Oral and Maxillofacial Medicine, School of Dentistry, Oral and Dental Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. 2023 02 15 2024 10 14 Systemic sclerosis (SSc) is a rare immune-mediated rheumatic disease in which the skin, muscles, blood vessels, and internal organs are damaged through chronic inflammation. Interleukin-17 (IL-17) is a potent pro-inflammatory cytokine produced by T helper 17 (Th17) cells, and plays a critical role in many inflammatory conditions. This study aims to assess the salivary IL-17 levels in Iranian patients with SSc. In this cross-sectional study, unstimulated saliva samples were collected from patients with SSc (n=80) and age- and sex- matched healthy individuals (n=80). The salivary levels of IL-17 in all samples were measured using a commercially available enzyme–linked immunosorbent assay (ELISA) kit. The mean salivary levels of IL-17 in patients with SSc were significantly higher than the control group (199.6±38.9 pg/mL vs. 112.7±39.4 pg/mL, P<0.0001). IL-17 in the patient group had a significant positive correlation with anticentromere antibody (ACA) concentration (r=0.875, P<0.0001). The salivary levels of IL-17 showed no significant differences between males and females. Based on the results, salivary levels of IL-17 could be considered a good marker to differentiate patients with SSc from healthy subjects. Considering the role of this inflammatory cytokine in tissue inflammation and its association with ACA concentration, IL-17 might be involved in the pathogenesis of SSc; however, further comprehensive studies are needed to confirm our findings. https://acta.tums.ac.ir/index.php/acta/article/view/10559

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 62 4 2024 12 30 233 235 Hamid Khederlou Department of Cardiology, Zanjan University of Medical Sciences, Zanjan, Iran. Reza Hassanzadeh-Makoui Department of Cardiology, Zanjan University of Medical Sciences, Zanjan, Iran Vanoushe Azimi Pirsaraei Student Research Committee, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran 2024 02 02 2024 11 16 Clopidogrel, a selective thienopyridine, is used for secondary prevention of major adverse cardiovascular events. Some studies have reported inflammatory arthritis as a rare adverse effect of Clopidogrel. A 47-year-old male underwent percutaneous coronary intervention and was subsequently prescribed a 600 mg loading dose of Clopidogrel, followed by a daily dose of 75 mg. After six days of taking Clopidogrel, the patient presented to the emergency department with right knee pain. The knee joint exhibited swelling, warmth, and tenderness, although there was no redness or crusting. After two and six days of hospitalization, despite receiving antibiotics and Indomethacin, he developed arthritis of the metacarpophalangeal and metatarsophalangeal joints, respectively. According to the laboratory investigation, cultures, synovial fluid analysis, and imaging, infectious, rheumatologic, and crystallopathy diseases were ruled out for the patient. Clopidogrel was discontinued, and the patient was switched to ticagrelor 90 mg twice daily. All symptoms and signs of joint inflammation had improved within five days of stopping the Clopidogrel. After one week and one and six months of follow-up, there has been no recurrence of symptoms. https://acta.tums.ac.ir/index.php/acta/article/view/10956

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 62 4 2024 12 30 188 194 Fatima K. Naeam Department of Maternal and Neonatal Nursing, College of Nursing, University of Thi-Qar, Thi-Qar, Iraq. Amer Abdullah Sachit Department of Maternal and Neonatal Nursing, College of Nursing, University of Thi-Qar, Thi-Qar, Iraq Hayfaa M. Mones Ministry of Health, Thi Qar Health Office, Bint Al-Huda Maternity and Children Teaching Hospital, Thi-Qar, Iraq 2024 09 16 2024 10 11 Breastfeeding (BF) is the natural way for infants’ nutrition, it provides the ideal nutrients they need for healthy development and growth. The purpose of this study was to evaluate mothers' knowledge and practice of BF and its determinants and to determine the association between knowledge and certain characteristics. 200 moms who were patients at the Bint Al-Huda teaching hospital between November 1, 2021, and February 1, 2021, were chosen at random with their consent for this cross-sectional study, and their answers to a standardized questionnaire were analyzed. Of the 200 women, 26% were between the ages of 20 and 25, with a mean and SD of 29.24±7.829 and 24.5% having completed elementary school. Prior to our study, nearly (67%) mothers had received education on BF. A mother who practices breast cancer has a low risk of developing the disease (62.5%). Proper positioning is also important for achieving effective breast cancer (68.5%). Breastfeeding should begin within 30 minutes of delivery (62%), and once the baby begins taking complementary foods (54.5%), mothers can combine breastfeed and formula feeding. We found that most mothers had engaged in exclusive BF and knew only a moderate amount about its benefits. Better educational initiatives are required to raise public awareness of its long-term benefits for the nation's health status. https://acta.tums.ac.ir/index.php/acta/article/view/11259

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 62 4 2024 12 30 195 202 Ali Jafari-Khounigh Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Alireza Razzaghi Children Growth Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran. Hamid Sharifi HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman, Iran Shahram Habibzadeh Department of Infectious Disease, Ardabil University of Medical Science, Ardabil, Iran. Seyed Taghi Heydari Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Rasool Entezarmahdi School of Medicine, Social Determinant of Health Research Centre, Urmia University of Medical Sciences, Urmia, Iran. Mostafa Farahbakhsh Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran Alireza Ansari Moghaddam Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran Mahdi Rezaei Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Mohammad Saadati Khoy University of Medical Sciences, Khoy, Iran. Ehsan Sarbazi Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Morteza Haghighi Department of Public Health, Arak Branch, Islamic Azad University, Arak, Iran. Mina Golestani Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Homayoun Sadeghi-Bazargani Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute (JBI) Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran. 2023 08 27 2024 10 27 To perform effective prevention programs, we need to know how well people follow prevention protocols, like mask use and social distancing, measuring using standard tools. This study aims to develop and validate a brief questionnaire to assess the compliance with prevention protocols against infectious respiratory diseases pandemics including COVID-19 in pedestrians. This cross-sectional study was conducted using convenience sampling method in May and June 2021. Construct validity of the questionnaire was assessed using Exploratory Factor Analysis (EFA). Content validity was evaluated by quantitative method, thus, Content Validity Ratio (CVR) and Content Validity Index (CVI) were calculated. For reliability of the questionnaire, the internal consistency using Cronbach’s alpha, and test-retest reliability using Spearman-Brown correlation coefficient were assessed. A total of 324 persons from three provinces of Iran participated in this study. The mean age (SD) of participants was 41.5 (16.7). The CVR values resulted in the elimination of two questions. The Scale level CVI/Average (S-CVI/Ave) was equal to 0.992; and Scale level CVI/Universal Agreement (S-CVI/UA) was 0.889. One factor with five items emerged from principal component factor analysis accounting for 51.99% of the variance. Cronbach’s alpha coefficient equal to 0.76 indicated an acceptable internal consistency and the Spearman-Brown correlation coefficient of 0.939 depicted stability of the questionnaire. This questionnaire is a brief tool with acceptable validity and reliability to evaluate the compliance with preventive protocols during infectious respiratory diseases outbreaks in order for policy-makers to make effective interventions to slow down the spread of disease. https://acta.tums.ac.ir/index.php/acta/article/view/10795

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 62 4 2024 12 30 203 217 Iman Alizadeh Department of English Language, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran . Farideh Ebrahimi Faculty of Electrical and Computer Engineering, Babol Noshirvani University of Technology, Babol, Iran. Afsane Dehnad Department of English Language, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. 2024 04 06 2024 09 30 Although the production and use of educational materials have been accelerated, their quality and usability for students might have been overshadowed by the urgency to maintain the continuity of education at universities. Concerned with the provision of quality education, this study aimed to discover medical sciences students’ perceptions of the quality of teacher-made medical terminology flashcards used in university courses electronically. To do so, the students in the fields of laboratory sciences, radiology, anesthesia, operating room, nursing, medicine, and midwifery used the teacher-made flashcards in medical terminology and specialized English courses, and their perceptions of the quality of the flashcards were elicited in terms of appearance, content of information, and potential contribution to learning. The results showed that overall, the students evaluated the flashcards positively; they, however, indicated that the color choices, adequacy of information, and potential effects on students’ motivation for studying medical terms were three aspects of the flashcards that warranted more detailed consideration. Moreover, the students’ perceptions of the appearance of the flashcards and the potential contribution of the flashcards to learning did not differ across the disciplines; the students, however, had different perceptions of the content of information on the flashcards due to the type, degree, and specificity of the information they needed. The study concludes that how the flashcards are developed aesthetically, how exhaustively they embrace the students’ needs for information, and how potentially efficaciously they contribute to learning mattered to the students. The study recommends that although teacher-made materials can support the delivery of knowledge and continuity of education, considering students’ feedback on and perceptions of the materials can help secure the quality and usability of the materials and ensure quality teaching and learning. https://acta.tums.ac.ir/indeiversity of Medical Sciences Acta Medica Iranica 0044-6025 61 10 2024 06 08 639 645 Ehsan Golchini Department of Operating Room, School of Paramedical Sciences, Alborz University of Medical Sciences, Karaj, Iran Mohammad Abdi Department of Emergency and Critical Care, Faculty of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran. Hojjat Torkmandi Operating Room Department, Faculty of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran Akbar Pourrahimi Department of Operating Room, Faculty of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran 2022 02 03 2023 11 25 Due to the wide variety of cervical vertebral congenital anomalies, knowledge of their types and related clinical conditions can prove to be helpful for physicians and surgeons in the diagnosis and treatment of patients. The aim of this study is to report on a rare case of unstable cervical vertebral congenital anomaly in which the patient had a defect in the body of the C3 vertebra in addition to defects in the posterior arch of C1 and posterior element of C2. This type of anomaly has not been reported so far in the literature. To reduce the patient’s related neurological disorders, our treatment choice for this patient was occipitocervical fusion (OCF) surgery. At the 3-year postoperative follow-up, all sensory and motor problems related to this anomaly affecting the patient's upper and lower limbs and causing shoulder and neck pain were eliminated. In this rare type of anomaly, OCF surgery seems to be an effective choice in relieving the patient's neurological symptoms. https://acta.tums.ac.ir/index.php/acta/article/view/9971 https://acta.tums.ac.ir/index.php/acta/article/download/9971/5854

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 10 2024 06 01 614 620 Hassan Tamartash Department of Physiotherapy, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran Behrouz Attarbashi Moghadam Tehran University of Medical Sciences Kianoosh Hosseini Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Shiva Musavi Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran 2021 04 27 2022 12 11 The Kansas City Cardiomyopathy Questionnaire (KCCQ) has been developed to measure the health status of Congestive heart failure (CHF) patients. This study aimed to translate KCCQ into a Persian version and assess its validity and reliability. We used a forward-backward procedure to translate the questionnaire. In a cross-sectional study, 150 CHF patients and 50 healthy subjects over 30 years old were selected to assess the reliability and construct validity of the instrument. The face and content validity were used for the questionnaire's validity. The validity was examined on a population of patients with CHF using the Persian version of the Minnesota Living Heart Failure Questionnaire (MLHF) health survey. Calculation of the Intraclass correlation coefficient (ICC) and Cronbach's alpha was done to evaluate the questionnaire's reliability. Test-retest reliability was examined by re-administering the KCCQ after 2 weeks. Test-retest results demonstrated that the Persian version has excellent reliability (ICC for all domains was higher than 0.93, P≤0.000). Internal consistency was found by Cronbach's alpha to be 0.86 for the clinical summary and 0.87 for the overall summary, respectively. Also, the correlation between the components of KCCQ and MLHQ showed satisfactory construct validity. Good Pearson's Correlation Coefficient was seen between KCCQ and MLHF (r= -0.44, P≤0.000 for the clinical summary; r= -0.45, P≤0.000 for the overall summary). Analysing the data from 50 healthy persons and 150 patients were shown that the Persian version of KCCQ has acceptable discriminate validity for all domains except self-efficacy. The Persian version of the KCCQ had satisfactory reliability and validity for assessing health-related quality of life status for Iranian CHF patients. https://acta.tums.ac.ir/index.php/acta/article/view/9355 https://acta.tums.ac.ir/index.php/acta/article/download/9355/5849