Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 62 5 2025 01 27 236 246 Sayedeh Somayyeh Mousavipour Department of Health in Emergencies and Disasters, School of Nursing, Aja University of Medical Sciences, Tehran, Iran. AND Department of Health in Emergencies and Disasters, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mousa Jabbari Department of Occupational Health and Safety, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran. AND Department of Occupational Health and Safety, Workplace Health Promotion of Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mahnaz Saremi Department of Ergonomics, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Abbas Ebadi Department of Nursing Management, Behavioral Sciences of Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran. AND Department of Nursing Management, School of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran. Ehsan Shariat Bahadori Department of Parasitology, Shahid Rajai of Research Center, Iran University of Medical Sciences, Tehran, Iran Davoud Khorasani Zavareh Department of Health in Emergencies and Disasters, Safety Promotion and Injury Prevention of Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. AND Department of Neurobiology, Care Sciences and Society (NVS), H1, Division of Family Medicine and Primary Care, Huddinge, Sweden 2024 02 03 2024 08 21 One of the important issues in health care systems that affect safety-related behaviors and reduce medical errors is to improve the safety level of the hospitalized patients. The aim of this study was to evaluate the level of safety of the hospitalized patients by analyzing the patient's activities. In the present study, all activities of the hospitalized patients were considered as one job, and the occupational safety analysis technique was used. For this purpose, all the activities of hospitalized patients from the time of entering the hospital to the time of leaving the hospital were identified and by forming a team of specialists in the field of patient care, a list of all possible risks in different stages of patient activities was determined. To assess the risk, the risk matrix model, which is one of the risk assessment models, was used. Experts' opinions were used to rank the risk, and finally the risk level of the identified hazards was determined before and after the control measures. The results showed that the risks in 6 stages for the patient include the patient entering the hospital, patient admission in the ward, patient entry into the room, hospitalization in the room, patient transfer for medical and diagnostic purposes and patient discharge from the hospital. There are a total of 79 potential hazards. The results showed that by managing the four types of risks "Struck against", "Fall to below", "Fall same level", "Struck by", which are among the most important risks that threaten the hospitalized patients, more than 50% of potential risks is reduced. The findings showed that the recurrence and severity of risk and, consequently, the level of risk identified in different stages of hospitalization are different. Therefore, improving the level of management and prioritization and providing the controlling and the suggested solutions, which are the main management tasks in a hospital, can improve the safety of the hospitalized patients. https://acta.tums.ac.ir/index.php/acta/article/view/10959 https://acta.tums.ac.ir/index.php/acta/article/download/10959/5923

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 62 5 2025 01 27 247 253 Anfal Akeel Taha Department of Medical Laboratory Techniques, College of Health and Medical Techniques, Middle Technical University (MTU), Baghdad, Iraq Hind Salman Jassim Baquba Technical Institute- Middle Technical University (MTU), Baghdad, Iraq Wafaa Fadhil Hamad College of Health and Medical Techniques, Middle Technical university (MTU), Iraq 2024 09 10 2024 10 23 Breast cancer is the most common malignancy among women and a leading cause of cancer-related mortality. Early detection is crucial for improving treatment outcomes. This study investigates the roles of lysophosphatidic acid (LPA) and autotaxin (ATX) in the early diagnosis of breast cancer among Iraqi women. A case-control study was conducted involving 75 women diagnosed with breast cancer and 75 healthy controls. Blood samples were collected, and biochemical parameters, including LPA and ATX levels, were measured using the ELISA technique. Statistical analyses were performed with SPSS version 24, and receiver operating characteristic (ROC) analysis was used to evaluate diagnostic capabilities. The majority of breast cancer patients were aged 50-59 years (33.3%). Histologically, invasive ductal carcinoma was the most prevalent subtype (82.6%). Biochemical analysis revealed significant differences in alanine aminotransferase, total serum bilirubin, and alkaline phosphatase levels between patients and controls. LPA levels were significantly elevated in the patient group (868.48±142.11 pg/ml) compared to controls (212.01±54.94 pg/ml), while ATX levels were also higher (2252.20±399.46 pg/ml vs. 951.40±209.21 pg/ml). ROC analysis indicated that both LPA and ATX exhibited high diagnostic sensitivity (98%) and specificity (100%). In Iraqi women, elevated serum levels of LPA and ATX may serve as potential diagnostic biomarkers for breast cancer, highlighting their role in disease progression. Further studies are warranted to explore their clinical applications in breast cancer diagnosis and management. https://acta.tums.ac.ir/index.php/acta/article/view/11241 https://acta.tums.ac.ir/index.php/acta/article/download/11241/5924

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 62 5 2025 01 27 254 263 Kiarash Fekri Department of Paramedicine, Amol School of Paramedicine, Mazandaran University of Medical Sciences, Sari, Iran. AND Department of Preclinical, Amol Campus of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Fereshteh Araghian Mojarad Psychosomatic Research Center, Mazandaran University of Medical Sciences, Sari, Iran. Mehrrooz Alishah Department of Foundamental Nursing, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran. Seyed Robabe Babaei Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran. Tahereh Yaghoubi Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran. 2024 09 13 2024 12 29 Nursing education, requires critical attention to the science of pharmacology as well as employment of the relevant clinical skills. Therefore, the present study intends to investigate the insights of nursing students about clinical pharmacology courses. This cross-sectional descriptive study was performed on a community consisted of all nursing students who selected their clinical pharmacology course. The researcher-built questionnaire was the tool for collecting the data. Descriptive (percentage, mean and standard deviation) and analytical (t-test and Mann-Whitney non-parametric test) statistics were utilized to analyze the data using SPSS-22. The ethical considerations of the research were observed. Based on the findings, the variables of gender and the pharmacology grade achieved in the second semester predicted the level of satisfaction with clinical pharmacology course among the students as well as studying about the medicines before starting the internship. Regarding the relative satisfaction in this study, 85% of the students found the applications employed for learning clinical pharmacology contents effective to boost their skills and knowledge so that it would be recommended to use the novel educational methods for better learning of the course. https://acta.tums.ac.ir/index.php/acta/article/view/11250 https://acta.tums.ac.ir/index.php/acta/article/download/11250/5925

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 62 5 2025 01 27 264 272 Zahra Mohammad Alipour Department of Obstetrics and Gynecology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran . Farahnazsadat Ahmadi Department of Obstetrics and Gynecology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran . Sina Mohajernoei Department of Medicine, Golestan University of Medical Sciences, Gorgan, Iran. Roghaye Gharaei Department of Obstetrics and Gynecology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran. Nazanin Hojjati Department of Obstetrics and Gynecology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran. Elham Shirali Department of Gynecologic Oncology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran. Firouzeh Akbari Asbagh Department of Obstetrics and Gynecology, School of Medicine, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran 2024 12 20 2024 12 28 Ovarian insufficiency is a significant cause of infertility in women, with limited effective treatment options. Platelet-Rich Plasma (PRP), rich in concentrated growth factors, has shown regenerative potential in various medical fields. However, its efficacy as an adjunct in infertility treatment, particularly in women with ovarian insufficiency, remains unclear. This study investigates whether PRP administration improves the success of IVF cycles in this specific population. This cohort study followed women with ovarian insufficiency undergoing IVF at a fertility center. Participants were divided into two groups: the intervention group, which received PRP alongside the standard IVF protocol, and the control group, which received only the standard protocol. Data collected included patient demographics, hormonal levels, number and quality of retrieved oocytes, fertilization rates, embryo quality, and pregnancy outcomes. The primary outcome was IVF success, defined by clinical pregnancy rates. Secondary outcomes included hormonal changes, oocyte quality, and embryo development. Statistical analysis utilized descriptive statistics, chi-square tests, and t-tests to compare outcomes between groups. PRP administration led to significant reductions in FSH levels (P<0.001) and marked increases in AMH levels and antral follicle count (AFC) (P=0.001 and P<0.001, respectively). The number of oocytes, mature MII oocytes, and Grade A embryos also improved significantly (P ranging from 0.004 to 0.017). Although the increase in Grade B embryos was not statistically significant, it was higher post-PRP. Chemical pregnancies occurred in 25% of participants, with 20.83% resulting in clinical pregnancies, including 2.1% spontaneous pregnancies. PRP significantly enhanced ovarian reserve markers (FSH, AMH, AFC), oocyte quality, and embryo development, translating into improved fertility outcomes. The findings suggest that with longer follow-up and larger sample sizes, PRP could be validated as a promising adjunctive therapy for women with ovarian insufficiency undergoing IVF. These results align with prior research and highlight PRP’s potential to advance reproductive outcomes in this challenging patient population.   https://acta.tums.ac.ir/index.php/acta/article/view/11420 https://acta.tums.ac.ir/index.php/acta/article/download/11420/5926

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 62 5 2025 01 27 273 276 Hossein Hemmati Department of Vascular & Trauma Surgery, School of Medicine, Road Trauma Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran. AND Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran. Behrang Motamed Department of Internal Medicine, School of Medicine, Inflammatory Lung Diseases Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran. Sedighe Masoudi Taramsari Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran. Mohammad Taghi Ashoobi Department of Vascular & Trauma Surgery, School of Medicine, Road Trauma Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran. AND Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran Mohaya Farzin Department of Physiology, Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran. Habib Eslami Kenarsari Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran. Rastin Hosseinzaeh Asli Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran. Zahra Abbasi Ranjbar Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran. Milad Sarafi Department of General Surgery, School of Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran. 2023 02 19 2025 01 07 Diabetic foot ulcer (DFU) is one of the most significant and destructive complications in diabetic patients. It is not only the main cause of patients' foot amputation but is also related to their mortality rate. The aim of this study was to evaluate the results of metatarsectomy in the recovery of diabetic-resistant foot neuropathic wounds to evaluate its clinical effectiveness. This quasi-experimental, before-and-after study was done on 16 diabetic patients with refractory neuropathic ulcers, who were referred to the vascular surgery ward undergoing metatarsectomy. Patients were followed up for two weeks, one month, and three months after surgery and were evaluated for complete recovery, partial recovery, and no response. Of 16 diabetic patients with 16 refractory diabetics plantar fasciitis, 12 (75%) were male and 4 (25%) were female. The mean age of patients was 56.63. There were 5 patients with type 1 diabetes and 11 patients with type 2 diabetes. 10 patients (62.5%) had the underlying non-diabetic disease. 50% of patients had had a history of amputation. The mean duration of diabetes in 16 patients was 18.06 years. All wounds healed completely with an average healing time of 4 months (100% epithelialization). The results of the present study demonstrate that metatarsectomy can be used as a primary technique for offloading in the treatment of diabetic-resistant neuropathic wounds in the soul instead of non-surgical methods. The results prove that this method with a high recovery rate and significant clinical effectiveness can be used as an effective method in the first line of treatment of diabetic-resistant neuropathic wounds of the sole.   https://acta.tums.ac.ir/index.php/acta/article/view/10567 https://acta.tums.ac.ir/index.php/acta/article/download/10567/5928

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 62 5 2025 01 27 277 289 Mpho Ndou Department of Biochemistry, Faculty of Science, UnstName>Abbas Hajian Department of General Surgery, Kashan University of Medical Sciences, Kashan, Iran Shadman Nemati Otorhinolaryngology Research Center, Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. 2021 01 12 2021 01 25 In this study, we aimed to find the frequency of agger nasi cells (ANC) and their correlation with other anatomical anomalies in dacryocystorhinostomy (DCR) candidates, compared with a control group. The study was conducted on 42 patients with nasolacrimal duct obstruction who underwent DCR surgery. Also, 80 C.T. of healthy sex- and age-matched subjects were selected as the control group. Paranasal sinuses computed tomography scanning was performed preoperatively, and abnormalities including ANC, concha bullosa, osteomeatal complex disease (OMC), nasal septum deviation, and polyposis were investigated and registered. Radiologic findings showed ANC presence in 83.3% of cases, and frequency of concha bullosa was 23.8%, and OMC disease, septal deviation, and nasal polyposis recorded as 11.9%, 85.7%, and 14.3%, respectively. In the control group, ANC was found in 52 subjects (65%), and the difference was statistically significant (P=0.036). There was no significant correlation between the presence of ANC and the coexistence of other mentioned anatomical changes as attributing factors for NLD obstruction. The frequency of ANC was much higher in patients with NLD obstruction compared with the control group, but its association with other anomalies was non-significant. https://acta.tums.ac.ir/index.php/acta/article/view/9087

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 4 2021 05 18 228 231 Hamidreza Hasani Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Amin Zand Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran 2020 12 09 2021 04 05 Lipid keratopathy refers to corneal lipid infiltrations. We report a 54-year-old female without any systemic disorder presented with a slowly progressive yellow-white infiltrate in the inferotemporal part of the left cornea for six years. Due to a visual axis involvement leading to decreased visual acuity, the patient underwent penetrating keratoplasty on the left eye. The excised corneal button specimen was sent for pathological evaluation. Anterior segment optical coherence tomography (AS-OCT) and confocal scanning microscopy showed an intra-stromal hyper-reflective material consistent with lipid crystalline keratopathy diagnosis. Histopathology revealed an excessive amount of fat droplets in corneal stroma presented as clear areas in hematoxylin and eosin (H & E) staining in keeping with Oil Red O staining. Idiopathic lipid crystalline keratopathy is a diagnosis of exclusion. For such a diagnosis, the serum lipid profile should be checked to rule out fat metabolic disorders and ocular diseases causing chronic inflammation leading to secondary corneal lipid depositions. https://acta.tums.ac.ir/index.php/acta/article/view/9006

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 4 2021 05 18 232 235 Adeleh Hashemi Fard 1 Surgical Oncology Research Center, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. AND Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Hormoz Hoseinpour Deyrestani 1 Surgical Oncology Research Center, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran ANDof Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Hamed Golmohamadi 1 Surgical Oncology Research Center, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. AND Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Alireza Rezapanah Surgical Oncology Research Center, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. AND Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 2020 07 09 2020 10 23 Hydatid disease is mainly because of the Echinococcus granulosus at the larval stage. The liver and lung are its most consequences. The pancreatic hydatid cyst (PHC) incidence is very low (0.14%-2%). A 55-year-old female patient presented with epigastric pain for the last one year that the pain did not continue but during one months ago suffered continually. In physical examination, there was not any abdominal bulb, tenderness and rebound tenderness. A 54×59 mm cystic structure was observed by ultrasonography (USG) and Contrast-enhanced Computed Tomography (CT) in the pancreatic body with stone in the gallbladder. Amylase, lipase, and LFT levels were normal. The Anti-hydatid antibody was positive. During laparoscopic exploration, a hydatid cyst was found. Partial cystectomy with external drainage and cholecystectomy was performed once irrigation with scolicidal agent and evacuation of cystic contents was conducted. Histopathological biopsy reported Hydatid cyst. A pancreatic, hepatic cyst is a rare event. Hematogenous is the most common spread way. Cysts in the pancreatic head could be found with obstructive jaundice. Usually, cysts in the body and tail are known to be asymptomatic. USG, CT, and Hydatid serology are useful with the clinical diagnosis as well as monitoring the recurrence. An exploration via surgery is an option that includes pericystectomy, partial cystectomy with/without external drainage or omentopexy, marsupialization, or cysto-enterostomy, which is done. What makes this case unique is the laparoscopic method that we used instead of open surgery, which is a treatment of choice. The recommendation is pre-operative and postoperative antihelminthic (Albendazole). PHC could be present as pseudocyst or cystic neoplasm of the pancreas. For patients with endemic regions and laparoscopic surgery, differential diagnosis of the cystic pancreatic lesion should be noticed. Common surgery approach could be considered for such patients. https://acta.tums.ac.ir/index.php/acta/article/view/8615

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 4 2021 05 18 236 238 EN Natalia Dayane Moura Carvalho 1 State University of Amazonas, School of Health Sciences, Cytogenetics Laboratory, Manaus, Amazonas, Brazil Ronaldo Castillo Camargo Francisca Mendes University Hospital, Federal University of Amazonas, Manaus, Amazonas, Brazil Heliana Maria Costa Garcia Francisca Mendes University Hospital, Federal University of Amazonas, Manaus, Amazonas, Brazil Suely Regina da Silva Teles Francisca Mendes University Hospital, Federal University of Amazonas, Manaus, Amazonas, Brazil CLEITON FANTIN UNIVERSIDADE DO ESTADO DO AMAZONAS 2020 12 06 2021 02 18 22q11.2 deletion syndrome is caused by a deletion in chromosome 22q11.2 and has more than 180 distinct phenotypes, however, no finding is pathognomonic or even mandatory. This syndrome can be diagnosed by fluorescence in situ hybridization. Thus, we report herein a patient from Manaus,