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, Un scale provides a total score and three subscale scores: General Health, Social Support, and Physical Health. Scores are standardized on a scale from -100 to 100, where any positive score indicates improvement in the physical and emotional well-being of patients who have undergone tonsillectomy, whereas negative scores suggest deterioration. Analysis of the findings showed significant differences among the subscale scores, with the Social Support subscale having the lowest score, followed by the General Health subscale, while the Physical Health subscale had the lowest final rank. After tonsillectomy, improvements were observed in the overall GBI score as well as in the General Health, Social Support, and Physical Health subscales. These findings indicate that tonsillectomy has clinical benefits and may help address some claims made against the procedure. This study supports the appropriate use of healthcare budgets and highlights the importance of tonsillectomy in the management of chronic tonsillitis, particularly for otolaryngologists. https://acta.tums.ac.ir/index.php/acta/article/view/12004 https://acta.tums.ac.ir/index.php/acta/article/download/12004/6074

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 64 7 2026 07 12 443 446 Shahin Talebi Musculoskeletal Injuries Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Salman Ghaffari Department of Orthopedic Surgery, Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran. Mohammad Tehrani Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Akbar Ehsani Musculoskeletal Injuries Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Reza Zandi Musculoskeletal Injuries Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2023 10 19 2025 04 03  Ipsilateral femur and tibia fractures (floating knee injury) is a complex injury with severe associated injuries. The aim of this study was to assess the characteristics and treatment outcomes in patients with floating knee in a single trauma center. A retrospective study was conducted among patients with floating knee treated between January 2012 and January 2019 in a single trauma center. Patients with knee osteoarthritis, inflammatory arthritis, pathologic fracture, and with a history of previous fracture in ipsilateral leg were excluded. Data demographics, associated injuries, complications, and treatment outcome were collected. Karlstrom’s criteria were used to assess the results. We identified 48 patients aged 18 to 50 years old. All patients sustained a road traffic accident. Fraser type 1 was the most frequent type (62.5%). Open fracture reported in 25 cases (52.1%) at least in one bone. According to Karlstrom’s criteria, 8 cases (16.67%) with excellent results, 19 cases (39.58%) with good results, 14 cases with (29.17%) fair results, and 7 cases (14.58%) poor results were reported. Floating knee injury occurs in a high energy trauma context. Complication rate remains high, and surgeons should focus on reducing these complications. https://acta.tums.ac.ir/index.php/acta/article/view/10844 https://acta.tums.ac.ir/index.php/acta/article/download/10844/6075

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 64 7 2026 07 06 447 452 Ali Ibrahim Rahim Al-Dulaimi Department of Anatomy, Faculty of Medicine, University of Kufa, Najaf, Iraq. AND College of Medicine, University of Al-Ameed, Karbala, Iraq . AND Al-Kafeel IVF Center, Al-Kafeel Super-Speciality Hospital, Karbala, Iraq. Amina A. Al-Tameemi College of Medical Techniques, Al-Farahidi University, Baghdad, Iraq. Layla Kadhum Radeef College of Medical Technologies, Al-Kafeel University, Najaf, Iraq Muhjah Falah Hassan Department of Anatomy, Faculty of Medicine, University of Kerbala, Karbala, Iraq 2026 01 24 2026 02 24 Semen analysis and the evaluation of male reproductive hormones remain integral to the assessment of infertile men. Recent studies have demonstrated that serum 17-hydroxyprogesterone (17-OHP) levels serve as a reliable marker of the intratesticular testosterone environment. This study aims to determine the correlation between serum 17-OHP levels, seminal fluid analysis (SFA), and the hormonal profiles in infertile men. In this cross-sectional study, one hundred serum and seminal fluid samples were collected from infertile men attending the Al-Kafeel IVF center, Karbala, from October 2024 to May 2025. Participants were divided into four groups according to their SFA results. All included men underwent seminal fluid analysis according to WHO 2021 guidelines, and serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (TT), prolactin, estradiol (E2), and 17-OHP were measured using the ELISA technique. The current study showed no significant correlation between 17-OHP and any of the measured hormones in the normozoospermia group, and a strong, statistically significant negative correlation between serum 17-OHP and FSH across all groups (r= -0.375, P=0.000). There was also a negative correlation between sperm concentration and serum 17-OHP across all groups (r= -0.234, P=0.019). In the asthenozoospermia group, serum 17-OHP exhibited a highly significant negative correlation with sperm concentration and semen viscosity (r= -0.670, P=0.001) and (r= -0.590, P=0.005), respectively. A significant positive correlation was found between serum 17-OHP and sperm motility in the asthenozoospermia group (r=0.538, P=0.012), and a positive correlation with round cells in the oligoasthenoteratozoospermia (OAT) group (r=0.438, P=0.025). The study emphasizes the complex relationship between 17-OHP levels and sperm parameters. Although 17-OHP showed a strong negative association with FSH, statistically significant correlations may still have limited or unclear clinical implications, necessitating further studies. Semen analysis and the evaluation of male reproductive hormones remain integral to the assessment of infertile men. Recent studies have demonstrated that serum 17-hydroxyprogesterone (17-OHP) levels serve as a reliable marker of the intratesticular testosterone environment. This study aims to determine the correlation between serum 17-OHP levels, seminal fluid analysis (SFA), and the hormonal profiles in infertile men. In this cross-sectional study, one hundred serum and seminal fluid samples were collected from infertile men attending the Al-Kafeel IVF center, Karbala, from October 2024 to May 2025. Participants were divided into four groups according to their SFA results. All included men underwent seminal fluid analysis according to WHO 2021 guidelines, and serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (TT), prolactin, estradiol (E2), and 17-OHP were measured using the ELISA technique. The current study showed no significant correlation between 17-OHP and any of the measured hormones in the normozoospermia group, and a strong, statistically significant negative correlation between serum 17-OHP and FSH across all groups (r= -0.375, P=0.000). There was also a negative correlation between sperm concentration and serum 17-OHP across all groups (r= -0.234, P=0.019). In the asthenozoospermia group, serum 17-OHP exhibited a highly significant negative correlation with sperm concentration and semen viscosity (r= -0.670, P=0.001) and (r= -0.590, P=0.005), respectively. A significant positive correlation was found between serum 17-OHP and sperm motility in the asthenozoospermia group (r=0.538, P=0.012), and a positive correlation with round cells in the oligoasthenoteratozoospermia (OAT) group (r=0.438, P=0.025). The study emphasizes the complex relationship between 17-OHP levels and sperm parameters. Although 17-OHP showed a strong negative association with FSH, statistically significant correlations may still have limited or unclear clinical implications, necessitating further studies. https://acta.tums.ac.ir/index.php/acta/article/view/11981 https://acta.tums.ac.ir/index.php/acta/article/download/11981/6077

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