Iranian Journal of Medical Sciences最新文献

{"title":"Synergistic Antimalarial Activity of Alpha-Mangostin Chitosan Alginate Nanoparticles with Chloroquine in Mice Infected with <i>Plasmodium berghei</i>: The Potential of a New Antimalarial Drug Combination.","authors":"Susy Tjahjani, Faizal Hermanto, Muchtaridi Muchtaridi, Diah Lia Aulifa, Fahmi Ahsanul Haq","doi":"10.30476/ijms.2025.108518.4347","DOIUrl":"10.30476/ijms.2025.108518.4347","url":null,"abstract":"<p><strong>Background: </strong>Malaria drug resistance is one of the leading causes of malaria-related morbidity and mortality worldwide. Alpha-mangostin exhibits antimalarial and antioxidant activity <i>in vitro</i>. The soluble alpha-mangostin chitosan alginate nanoparticles (ACAN) exhibit proper antimalarial activity <i>in vivo</i>. This study aimed to explore the antimalarial activity of the chloroquine-ACAN combination and the interaction between them in various ratios.</p><p><strong>Methods: </strong>A 4-day suppressive test, according to Peter's test, was conducted using <i>P. berghei</i>-inoculated Swiss Webster mice in Bandung, 2024. It was done for six different concentrations (in triplicate) of three kinds of the combinations respectively i.e.: ½ effective dose 50 (ED₅₀) ACAN: ½ ED₅₀ chloroquine (ratio-1, ACAN and chloroquine were used in a weight ratio of 189:1), ¼ ED₅₀ ACAN: ¾ ED₅₀ chloroquine (ratio-2, weight ratio of 63:1), ¾ ED₅₀ ACAN: ¼ ED₅₀ chloroquine (ratio-3, weight ratio of 567:1) to find out growth inhibitory percentage of each concentration. ED₅₀ of each combination was determined using probit analysis in IBM SPSS Statistics 27 software. The sum of fractional effective dose 50 (∑FED₅₀) was determined using a specific formula. ∑FED₅₀ indicates the kind of interaction: <1, >1, or =1 means synergistic, antagonistic, or additive.</p><p><strong>Results: </strong>ED₅₀ of ratio-1 (ACAN/Chloroquine weight ratio 189/1), ratio-2 (weight ratio 63/1), ratio-3 (weight ratio 567/1) is 9.196, 7.626, 82.13 mg/Kg BW (<100 mg/Kg BW). ∑FED₅₀ of ratio-1, ratio-2, and ratio-3 is 0.069, 0.113, and 0.414 (far below 1).</p><p><strong>Conclusion: </strong>ACAN-chloroquine exhibits good and marked synergistic antimalarial activity, especially in a ratio-1. It offers a glimmer of hope for future research to combat and ultimately eliminate malaria.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 5","pages":"350-358"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and Postnatal Umbilical Cord Blood Alpha-1-Acid Glycoprotein and Protein-Bound Hexose Levels as Inflammatory Biomarkers in Preeclampsia: A Case-Control Study.","authors":"Jian Hussein, Sardar Ahmed, Shahla Alalaf","doi":"10.30476/ijms.2025.108410.4331","DOIUrl":"10.30476/ijms.2025.108410.4331","url":null,"abstract":"<p><strong>Background: </strong>Preeclampsia (PE) is a multisystem disorder of unknown cause, leading to maternal and fetal morbidity and mortality. This study aimed to measure the inflammatory biomarkers alpha1-acid glycoprotein (α1-AGP) and protein-bound hexose (PBH) in the maternal circulation of women with PE and normotensive pregnant women, as well as in postnatal umbilical cord blood, to compare levels between groups and assess their association with PE.</p><p><strong>Methods: </strong>A hospital-based case-control study was conducted from June 2024 to July 2025 at the Maternity Teaching Hospital in Erbil, Kurdistan Region, Iraq, including 104 preeclamptic and 99 normotensive pregnant women. Maternal and postnatal umbilical cord α1-AGP levels were measured using a BiotecSunlong ELISA kit (cut-off: 71.3 and 50.64 ng/mL, respectively), while PBH was measured using the orcinol colorimetric method (cut-off: 111 and 67.36 mg/dL, respectively).</p><p><strong>Results: </strong>Maternal α1-AGP and PBH levels were significantly higher in preeclamptic women (P<0.001). In postnatal umbilical cord blood, α1-AGP was elevated in PE, while PBH showed no significant difference. Maternal and postnatal α1-AGP demonstrated a moderate positive correlation (ρ=0.522, P<0.001), whereas PBH showed a weak correlation (ρ=0.242, P=0.016). Receiver Operating Characteristic (ROC) analysis indicated excellent discrimination between groups, with an Area Under the Curve (AUC) of 1.00 for maternal α1-AGP and 0.964 for maternal PBH.</p><p><strong>Conclusion: </strong>Maternal α1-AGP and PBH are significantly elevated in preeclampsia, with α1-AGP also higher in postnatal umbilical cord blood. The high AUC supports their relevance as biomarkers of maternal and postnatal inflammation in PE.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 5","pages":"340-349"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revolutionizing Stem Cell Sorting with Machine Learning: A Review of Trends, Tools, and Future Directions.","authors":"Marziyeh Mousazadeh, Atieh Jahangiri-Manesh, Hossein Soltaninejad, Farzaneh Yazdi, Karim Rahimian, Kathleen M Curran, Patricia Khashayar","doi":"10.30476/ijms.2025.107395.4197","DOIUrl":"10.30476/ijms.2025.107395.4197","url":null,"abstract":"<p><p>Stem cells are critical tools in regenerative medicine, large-scale cell production, drug discovery, and cell-based therapies, making their precise identification and sorting essential for advancing both research and clinical applications. Accurate stem cell sorting enables improved therapeutic outcomes, efficient production pipelines, and more reliable biological studies. Traditional sorting methods, while effective, face challenges related to speed, scalability, cost, and human error. Recent advances in machine learning (ML) techniques based on image and video processing have revolutionized stem cell sorting by enabling rapid, automated, and highly accurate classification. In addition to visual data approaches, non-visual processing methods using ML have also emerged as powerful tools for stem cell analysis and separation. In this review, various ML-driven strategies for stem cell sorting, with a particular focus on visual and non-visual data processing methodologies and their applications in different stem cell types, have been comprehensively explored and categorized based on the input data types, ML techniques, stem cell types, study objectives, and performance metrics. Furthermore, an overview of the historical development of stem cell sorting technologies and ML applications was introduced, and emerging automated systems, software solutions, start-ups, and future directions for this type of stem cell sorters were discussed.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 5","pages":"285-304"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ursodeoxycholic Acid in the Management of Prolonged Neonatal Hyperbilirubinemia: A Randomized Controlled Clinical Trial.","authors":"Manijeh Tabrizi, Sadroddin Mahdipour, Seyyedeh Azade Hoseini Nouri, Vahid Aminzadeh, Zahra Ghadiri, Maryam Shahrokhi","doi":"10.30476/ijms.2025.107785.4238","DOIUrl":"10.30476/ijms.2025.107785.4238","url":null,"abstract":"<p><strong>Background: </strong>Prolonged indirect hyperbilirubinemia (PIH) is defined as bilirubin levels >10 mg/dL for more than 14 days in term infants and 21 days in preterm infants. Although the role of ursodeoxycholic acid (UDCA) as an adjunct to phototherapy has been evaluated, evidence in PIH remains limited. Therefore, this study aimed to investigate the effects of UDCA on PIH.</p><p><strong>Methods: </strong>This randomized controlled trial was conducted on infants with PIH in Rasht, Iran, (July 2023-July 2024). Participants were enrolled through consecutive sampling and randomly assigned to intervention or control groups. The intervention group received 10 mg/Kg/day UDCA for 5 days. The control group received no intervention and was observed. Bilirubin, ABO, and Rh blood group status were measured on day 1 and day 5. Data were analyzed using an independent samples <i>t</i> test with SPSS software (version 26). P<0.05 was considered statistically significant.</p><p><strong>Results: </strong>Fifty-eight patients were included, with 29 in each group. Both groups showed a significant reduction in bilirubin levels over 5 days (control: 12.26±1.65 to 10.09±2.74 mg/dL; intervention: 11.96±1.48 to 9.07±3.45 mg/dL; P<0.001). The mean bilirubin reduction was 2.17±2.50 mg/dL in the control group and 2.89±3.00 mg/dL in the intervention group, with no statistically significant difference between groups (P=0.323). On day 5, bilirubin levels were 10.09±2.74 mg/dL in the control group and 9.07±3.45 mg/dL in the intervention group (P=0.216). ABO incompatibility was associated with lower bilirubin levels on day 5 in the intervention group (7.26±2.33 vs. 9.76±3.61 mg/dL; P=0.041). Rh incompatibility was correlated with greater bilirubin reduction over 5 days (4.98±1.54 vs. 2.45±3.07 mg/dL; P=0.025).</p><p><strong>Conclusion: </strong>Five-day UDCA therapy did not significantly reduce bilirubin levels in infants with PIH.<b>Trial Registration Number:</b> IRCT 2018.228.38895N2.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 4","pages":"266-276"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and Diagnostic Utility of Clinical and Radiological Features of Spontaneous Intracranial Hypotension in Postpartum Patients with Neurological Symptoms: A Cross-Sectional Study.","authors":"Farrokh Seilanian Toosi, Armin Doostparast, Maryam Emadzadeh, Nafiseh Akbari","doi":"10.30476/ijms.2025.108257.4312","DOIUrl":"10.30476/ijms.2025.108257.4312","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous intracranial hypotension (SIH) is an often underrecognized neurological condition resulting from spontaneous cerebrospinal fluid (CSF) leaks. Postpartum women represent a vulnerable population due to unique physiological and procedural factors, yet SIH remains poorly characterized in this group. This study aimed to determine the diagnostic value of clinical and radiological features in identifying SIH among postpartum patients with neurological symptoms.</p><p><strong>Methods: </strong>In a retrospective observational study conducted at Qaem Hospital (Mashhad, Iran), 183 postpartum patients presenting with central nervous system (CNS) symptoms who underwent brain magnetic resonance imaging (MRI) between 2010 and 2023 were evaluated. Demographic, clinical, and gynecologic data were collected. Brain MRI findings were independently reviewed for features indicative of SIH. Comparative analyses were conducted between patients with and without SIH using Fisher's exact test.</p><p><strong>Results: </strong>SIH was identified in 30 patients (16.4%), making it the third most common diagnosis after normal MRI (46.5%) and posterior reversible encephalopathy syndrome (30.4%). Orthostatic headache (63.3%) and seizure (43.3%) were the most common symptoms among SIH patients. However, no clinical symptom significantly differentiated SIH from non-SIH cases (P>0.05). Specific MRI findings-particularly pachymeningeal enhancement (P<0.001), dural venous sinus distension (P<0.001), pituitary enlargement (P=0.01), and brain sagging (P=0.004)-were significantly more frequent in SIH patients.</p><p><strong>Conclusion: </strong>SIH is a noteworthy cause of postpartum neurological symptoms. Given the limited specificity of clinical features, contrast-enhanced brain MRI plays a crucial role in diagnosis. Clinicians should maintain a high index of suspicion for SIH in postpartum patients presenting with CNS symptoms.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 4","pages":"248-255"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cosmetic Surgery in the Gulf Cooperation Council: Societal Shifts, Psychological Implications, and Policy Challenges: A Narrative Review.","authors":"Mohamed Anas Patni, Rasha Aa Salama, Sakina Mustafa Vakhariya, Rida Ahmad, Areebah Akhter, Gousiya Fathima, Zaina Falak, Ketaki Devendra, Syeda Nishaat Fatima, Emir Altinoz, Dania Hassan","doi":"10.30476/ijms.2025.105988.4009","DOIUrl":"10.30476/ijms.2025.105988.4009","url":null,"abstract":"<p><p>The impact of globalization, along with the change in societal values and economic growth, has contributed to the growing popularity of cosmetic procedures across the Gulf Cooperation Council (GCC) countries, including Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. This study explores the prevalence of cosmetic procedures and their correlation with body image perception in this region. Utilizing a comprehensive literature review of research published preferably between 2011 and 2024, this study explores the trends of surgical and non-surgical procedures, the demographics of the users, as well as the determinants of the decision to undergo the procedure in the region. Key determinants include social media popularity, an increased level of awareness towards aesthetic options, and cultural shifts. There is a growing trend of increasing acceptance of rhinoplasty, liposuction, and Botox procedures among women and men aged 20-40. The motivations behind these choices include societal trends, professional image, and self-esteem. However, disparities in access, cultural sensitivities, and ethical concerns persist, especially when balancing traditional values with modern beauty standards. The implications of cosmetic surgery go beyond aesthetics, encompassing physical health risks, psychological outcomes, and ethical dilemmas. Much attention has focused on strengthening robust regulatory frameworks, ethical practices, and patient education to ensure patients are safe and well-informed before making a decision. Moreover, the literature remains sparse on several fronts, including male underrepresentation, long-term psychosocial outcomes, and the influence of cultural and religious norms. Further investigation into these issues will broaden understanding and inform policy formulation in the rapidly evolving field of cosmetic surgery in GCC countries.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 4","pages":"224-235"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resilience in Security Crises: Supportive and Resistance Approaches for Employees and Students.","authors":"Vahid Gharibi","doi":"10.30476/ijms.2025.107628.4214","DOIUrl":"10.30476/ijms.2025.107628.4214","url":null,"abstract":"","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 4","pages":"282-284"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Serum Cotinine with Hyperuricemia in American Adolescents: A Cross-Sectional Study.","authors":"Han Wu, Zhiling Wang, Fang Gu","doi":"10.30476/ijms.2025.107138.4148","DOIUrl":"10.30476/ijms.2025.107138.4148","url":null,"abstract":"<p><strong>Background: </strong>Cotinine is a known harmful toxicant, while its relationship with hyperuricemia in adolescents remains unclear. This study aimed to analyze the relationship between serum cotinine concentration and hyperuricemia among US adolescents aged 12-19 years.</p><p><strong>Methods: </strong>This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. Eligible participants were adolescents (12-19 years) with complete data for serum cotinine and uric acid. Out of 61,125 total participants during the study period, 6,831 participants were included in the analysis. The independent variable was serum cotinine, and the outcome was hyperuricemia. Multiple logistic regression analyses were performed to assess the relationship between serum cotinine and hyperuricemia, and sensitivity analyses were performed from multiple perspectives.</p><p><strong>Results: </strong>The study population comprised 6,831 individuals. The mean age of the participants was 15.5±2.3 years, 52.3% were men, and 28.6% were non-Hispanic white. Participants with hyperuricemia were more likely to be older (15.9±2.3 years vs. 15.1±2.2 years), male (56.9% vs. 43.1%), and non-Hispanic white (32.8%). The adjusted odds ratio of hyperuricemia associated with a unit increase in serum cotinine was 1.07 (95% CI: 1.01-1.13). This association remained consistent across subgroups and sensitivity analyses.</p><p><strong>Conclusion: </strong>This study suggested an association between serum cotinine concentration and hyperuricemia in American adolescents. This modifiable risk factor warrants further investigation as a potential target for mitigating hyperuricemia in this population.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 4","pages":"256-265"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpreting Neurocognitive Signals in Child Sexual Abuse Perpetrators: The Strengths and Limitations of a Multi-Modal Approach.","authors":"Haewon Byeon","doi":"10.30476/ijms.2025.107310.4171","DOIUrl":"10.30476/ijms.2025.107310.4171","url":null,"abstract":"","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 4","pages":"277-281"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to Medication, Mediterranean Diet, and Physical Activity and Their Predictors in Heart Failure Patients.","authors":"Maryam Afshari, Mohammad Hossein Sharifi, Hossein Molavi Vardanjani, Amirreza Nikmanesh","doi":"10.30476/ijms.2025.106829.4113","DOIUrl":"10.30476/ijms.2025.106829.4113","url":null,"abstract":"<p><strong>Background: </strong>Adherence to prescribed medications, a healthy diet, and regular physical activity is essential for the optimal management of heart failure (HF). Therefore, the present study aimed to determine the level of adherence to medications, the Mediterranean diet (MD), and physical activity, and to identify their correlations.</p><p><strong>Methods: </strong>In this cross-sectional study, HF patients who were hospitalized from March to November 2022 were enrolled. Medication adherence, the MD, and physical activity were assessed using the 8-item Morisky medication adherence scale, the 14-item MD adherence Screener (MEDAS), and the International Physical Activity Questionnaire (IPAQ), respectively. Univariate analyses were conducted using the Chi square and Kruskal-Wallis tests. Ordinal logistic regression was applied to examine factors associated with adherence levels. Data were analyzed using Stata software (version 17), and P<0.05 was considered statistically significant.</p><p><strong>Results: </strong>Data from 320 patients were analyzed. Suboptimal adherence was observed in 97 (30.3%), 88 (27.5%), and 224 (70%) of participants for medication, MD, and physical activity, respectively, and was linked to lower left ventricular ejection fraction. Multivariable analysis revealed that lower medication adherence was associated with older age, tobacco use, and a higher number of comorbidities. Reduced MD adherence was related to a higher body mass index (BMI), the presence of comorbidities, and a history of cerebrovascular accident or myocardial infarction. Lower physical activity levels were associated with older age, a higher BMI, a greater number of comorbidities, and a lower socioeconomic status.</p><p><strong>Conclusion: </strong>In HF patients, nonadherence to medication, the MD, and physical activity were common and associated with poorer cardiac function and a greater comorbid burden. These findings underscore the importance of a multidisciplinary approach to enhance adherence and improve overall patient outcomes.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 4","pages":"236-247"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}