Medical Journal of the Islamic Republic of Iran最新文献

{"title":"Functional Outcomes of Different Bearing Surfaces for Total Hip Arthroplasty: A Systematic Review and Meta-Analysis.","authors":"Amirhosein Sabaghian, Amirhosein Shahbazi, Bahram Fadaei Dowlat, Iman Ghasemi, Seyyed Amir Yasin Ahmadi, Shayan Amiri","doi":"10.47176/mjiri.39.111","DOIUrl":"10.47176/mjiri.39.111","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty (THA) has changed significantly since its inception, with various bearing surfaces affecting clinical outcomes. This systematic review aimed to assess the functional results of various bearing surfaces in total hip arthroplasty using validated scoring systems.</p><p><strong>Methods: </strong>This systematic review was carried out in accordance with PRISMA guidelines, and the protocol was registered in PROSPERO under CRD42025634591. Studies were included based on predefined criteria for population, intervention type, and reported clinical outcomes. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Harris Hip Score (HHS), and SF-12 were analyzed closely.</p><p><strong>Results: </strong>18 clinical trials with a mean follow-up of 100.69 months were included. MoM implants showed superior HHS, WOMAC, and SF-12 scores compared to CoC, CoP, and MoP (<i>P</i><0.001), suggesting better quality of life and improved functional outcomes. CoM showed slightly better WOMAC scores over MoM, but the difference was not statistically significant. The most common reason for revision was dislocation (36 cases), while osteolysis was the most common complication (43 cases).</p><p><strong>Conclusion: </strong>MoM implants demonstrated better quality of life and functional outcomes, but their use has declined due to safety concerns. Other implants may reduce complications related to metal ion release. These findings help surgeons choose THA implants by weighing benefits against long-term risks. Further research is necessary to refine implant selection criteria and long-term performance.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"111"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292729","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":"Diagnostic Accuracy of Deep Learning for Predicting Lymph Node Metastasis Based on Computed Tomography in Gastric Cancer: A Systematic Review and Meta-analysis.","authors":"Armin Majd Gharamaleki, Arman Majd Gharamaleki, Alireza Amanollahi, Sarvin Tabibzadeh","doi":"10.47176/mjiri.39.110","DOIUrl":"10.47176/mjiri.39.110","url":null,"abstract":"<p><strong>Background: </strong>Early detection of lymphatic metastasis (LNM) in gastric cancer (GC) is essential to determine the treatment strategy. Conventional methods exhibit limited efficacy, highlighting the need for more reliable approaches. Deep learning (DL) models show promise for LNM detection in computed tomography (CT); their performance requires comprehensive evaluation. This systematic review and meta-analysis evaluate the diagnostic performance of CT-based DL models for detecting LNM in GC patients.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted according to PRISMA-DTA guidelines. PubMed, Embase, and Web of Science were searched up to May 5, 2025. The focus was on studies that used DL models to detect LNM in CT in GC. Using a bivariate random effect model, Pooled estimates were calculated, heterogeneity and publication bias were assessed, and clinical utility was evaluated via Fagan plots and likelihood ratio matrices. Validation type, input data types, CT phases, segmentation techniques, and DL architectures stratified subgroup analyses. The quality was assessed with QUADAS-2.</p><p><strong>Results: </strong>From the 14 included studies, 11 studies with 5296 patients were analyzed. In internal validation, DL feature-based models achieved a pooled area under the curve (AUC) of 0.91 (95% CI: 0.88-0.93), sensitivity of 0.86 (95% CI: 0.75-0.92), and specificity of 0.83 (95% CI: 0.67-0.92). Performance degraded in external validation, with specificity dropping to 0.59 (95% CI: 0.26-0.85). Models that integrated DL features with radiomics features showed similar overall performance but were noted to have a higher confirmatory power. In terms of clinical utility, although the models could significantly alter post-test probabilities, they ultimately lacked the certainty required to serve as standalone diagnostic tools.</p><p><strong>Conclusion: </strong>CT-based DL models show high diagnostic accuracy but limited generalizability across external datasets, indicating overfitting. A key finding of this meta-analysis is that pervasive and asymmetric heterogeneity, particularly in specificity, suggests that technical standardization alone is insufficient. Integrating clinical variables reduces heterogeneity; however, prospective, multicenter studies are needed to further enhance reproducibility.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"110"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292720","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":"Medication Adherence in Stroke Patients: The Role of Social Support, Social Health, Self-Esteem, and Leisure Time.","authors":"Younes Doostian, Aliakbar Godini, Seyedeh Fahimeh Shojaei","doi":"10.47176/mjiri.39.109","DOIUrl":"10.47176/mjiri.39.109","url":null,"abstract":"<p><strong>Background: </strong>Medication adherence in stroke patients remains a significant challenge, impacting treatment efficacy and patient outcomes. This study aimed to model the structural relationships predicting medication adherence based on social support and social health in stroke patients, focusing on the mediating roles of self-esteem and leisure time in Tehran.</p><p><strong>Methods: </strong>This correlational study used structural equation modeling. The statistical population included all stroke patients referred to the Neurology Clinic of Firoozgar Hospital in Tehran in 2021. A sample of 255 participants was selected through a convenience sampling method. Participants completed questionnaires on medication adherence (Lin & et al, 2018), social support (Wax and Reader, 1986), self-esteem(Rosenberg, 1965), social health (Keyes, C. L., & Shapiro, A. D, 2004), and leisure time (Wang, 2019 ). Data were analyzed using Pearson correlation and structural equation modeling methods.</p><p><strong>Results: </strong>The results indicate that SEM analysis demonstrated excellent model fit (χ²/df=2.91, CFI=0.97, RMSEA=0.062). Significant direct effects were found: social support → self-esteem (β=0.34, *<i>P</i>*<0.001), social health → medication adherence (β=0.45, *<i>P</i>*<0.001). Key indirect effects via mediators: social health → leisure time → adherence (β=0.15, *<i>P</i>*=0.001) and social support → self-esteem → adherence (β=0.15, *<i>P</i>*=0.001). All standardized coefficients (*<i>P</i>*<0.05) confirmed the hypothesized pathways.</p><p><strong>Conclusion: </strong>The findings demonstrate that psychological factors significantly influence medication adherence and, ultimately, patient recovery. Strengthening social support, self-esteem, social health, and leisure time can enhance treatment outcomes and facilitate better management of stroke patients.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"109"},"PeriodicalIF":0.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292728","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":"Consistency of Blood Pressure Measurement Methods in Atrial Fibrillation.","authors":"Shadi Mostafavi, Majid Haji Karimi, Ali Pazoki, Abbas Allami, Kimia Rahimi Ardali, Shahin Aliakbari, Amir Behnam Kharazmy","doi":"10.47176/mjiri.39.108","DOIUrl":"10.47176/mjiri.39.108","url":null,"abstract":"<p><strong>Background: </strong>Ensuring precise measurement of blood pressure (BP) is crucial for effectively diagnosing and treating hypertension in atrial fibrillation patients. However, the reliability and agreement between the two commonly utilized techniques, oscillometric and auscultatory methods, remain unclear in these individuals. This study seeks to bridge this gap by examining the consistency of BP measurements using these methods in atrial fibrillation patients.</p><p><strong>Methods: </strong>This cross-sectional study included 100 patients with atrial fibrillation and sinus rhythm. BP was measured using both methods (three times with each method): 1) the auscultatory method based on Korotkoff sounds and 2) the oscillometric method. The SPSS version 25 software was used for data analysis. In all steps, <i>P</i>-values < 0.05 are considered significant.</p><p><strong>Results: </strong>The mean systolic blood pressure (SBP) measured by the oscillometric method was 116.38±16.73 mmHg in the sinus group and 127.29±21.51 mmHg in the atrial fibrillation (AF) group. In contrast, the mean by the auscultatory method was 116.18 ±15.46 mmHg in the Sinus rhythm group and 131.07±23.72 mmHg in the AF group (respectively <i>P</i>=0.006, <i>P</i><0.001). This study shows a significant difference in the SBP measured using the two methods in patients with AF (<i>P</i>=0.003). We also found that the significant difference between the two methods only applies to heart rates of 80 beats per minute and higher (<i>P</i>=0.017).</p><p><strong>Conclusion: </strong>The findings of this study indicated that although there is a significant correlation between oscillometric and auscultatory methods for assessing blood pressure in patients with atrial fibrillation, a significant difference was observed in the measurement of systolic blood pressure.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"108"},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292747","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":"Comparative Effect of Intravenous Ketamine and Tramadol on Hemodynamic Parameters, Pain, Sedation, and Postoperative Nausea and Vomiting in Patients Undergoing Urological Surgery Under Spinal Anesthesia: A Triple-Blind Randomized Clinical Trial.","authors":"Siavash Sangi, Mehrdad Mesbah Kiaei, Shahnam Sedigh Maroufi, Maryam Aligholizadeh, Rezvan Rajabzadeh, Seyed Mohammad Reza Amouzegar Zavareh, Mahmoud Reza Mohaghegh Dolatabadi, Parisa Moradimajd","doi":"10.47176/mjiri.39.107","DOIUrl":"10.47176/mjiri.39.107","url":null,"abstract":"<p><strong>Background: </strong>Spinal anesthesia is widely used in urological surgeries but is often associated with hemodynamic instability, insufficient sedation, and postoperative nausea and vomiting (PONV). While ketamine and tramadol have been employed as adjuncts, their comparative effects on perioperative parameters remain underexplored. This study aimed to compare the efficacy of intravenous ketamine and tramadol in modulating hemodynamic stability, sedation, pain, and PONV in patients undergoing urological surgery under spinal anesthesia.</p><p><strong>Methods: </strong>In this triple-blind randomized clinical trial, 90 patients undergoing transurethral or ureteroscopic urological surgeries under spinal anesthesia were randomly allocated into 3 equal groups: ketamine (0.5 mg/kg IV), tramadol (0.5 mg/kg IV), or saline. Hemodynamic parameters, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and oxygen saturation (SpO₂), were recorded at multiple intraoperative and postoperative time points. Secondary outcomes included pain scores, sedation levels, and incidence of PONV. The data were entered into SPSS software, Version 21, and analyzed using the chi-square test, independent sample t-test, and repeated-measures analysis of variance with post-hoc Bonferroni tests.</p><p><strong>Results: </strong>The study population exhibited demographic consistency. Ketamine demonstrated significantly superior hemodynamic stability compared to tramadol and saline, with less reduction in SBP, DBP, and MAP over time (MAP: <i>P</i> < 0.001, η² = 0.33). The heart rate was also more stable in the ketamine group (<i>P</i> < 0.001, η² = 0.11). The ketamine group showed the highest sedation scores (mean increase: -0.91, <i>P</i> ≤ 0.001) and the lowest incidence of PONV (3.3%) compared to tramadol (16.7%) and saline (10%) (<i>P</i> = 0.017, φ = 0.34). Pain scores showed no significant differences among groups. No serious adverse effects, including hallucinations or hypersensitivity reactions, were reported.</p><p><strong>Conclusion: </strong>Intravenous ketamine significantly enhances hemodynamic stability, increases sedation, and reduces PONV when used as an adjunct to spinal anesthesia in urological surgeries. These findings support the clinical use of ketamine to optimize perioperative outcomes and patient safety. These findings possess external validity and may be extrapolated to broader populations undergoing urological procedures under spinal anesthesia.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"107"},"PeriodicalIF":0.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292572","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":"Fractionated Gamma Knife Surgery: Long-Term Results and Patient Outcomes for Intracranial Lesions.","authors":"Farid Kazemi Gazik, Taghi Aghajanlou, Narges Mirzania, Ali Ariyaei Motahar, Amin Jahanbakhsi","doi":"10.47176/mjiri.39.106","DOIUrl":"10.47176/mjiri.39.106","url":null,"abstract":"<p><strong>Background: </strong>Fractionated gamma knife surgery (f-GKS) is an effective and safe procedure for treating various intracranial lesions, including pituitary adenomas and meningiomas. It offers noninvasive treatment with short hospitalization periods. This study aims to assess the long-term outcomes of f-GKS in patients at the Iran Gamma Knife Center (IGKC).</p><p><strong>Methods: </strong>This cross-sectional study examined patients who underwent at least 2 GKS sessions between 2011 and 2018. Lesion sizes in 2-dimensional slices were compared before and after the procedure. Data were analyzed using descriptive statistics in SPSS software Version 22.</p><p><strong>Results: </strong>The study included 106 patients (32 male, 74 female), with a mean age of 49.95 ± 16.6 years. The follow-up period was 24.98 ± 19.01 months. The most common pathology was meningioma, with f-GKS typically performed 3 times at 1-day intervals. The median change in lesion area was 185.67 mm². Out of 36 patients at the last visit, 26 (72.2%) showed improved prognosis. The maximum radiation dose used was 13.05 ± 5.21 Gy. The pathology coverage was 98.69% ± 2.15%, with a mean and mode of 99%.</p><p><strong>Conclusion: </strong>In this study, we examined various factors, including lesion levels from brain Magnetic Resonance Imaging findings, patient prognosis, and changes after f-GKS. Our results confirm those of previous studies, highlighting the significant role of noninvasive GKS in improving patient prognosis and reducing tumor size.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"106"},"PeriodicalIF":0.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292764","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":"Prevalence of Acne Vulgaris Among Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis.","authors":"Bita Pourahmad, Mostafa Majidnia, Nadia Saniee, Maryam Afraie, Sevda Riyahifar, Zeinab Darbandi","doi":"10.47176/mjiri.39.105","DOIUrl":"10.47176/mjiri.39.105","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Acne vulgaris is one of the most common dermatological conditions worldwide, particularly affecting women of reproductive age. It is often linked to underlying hormonal imbalances, including those seen in polycystic ovary syndrome (PCOS). PCOS is a prevalent endocrine disorder characterized by hyperandrogenism and insulin resistance, both of which contribute to acne vulgaris development. This systematic review and meta-analysis aimed to estimate the global prevalence of acne vulgaris among women with PCOS and identify contributing factors, thereby highlighting the burden of this skin condition in the context of a common endocrine disorder.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines, a systematic review of cross-sectional studies was conducted to assess the prevalence of acne vulgaris among women with PCOS. The literature search included studies published up to January 2025 and was performed in 5 major databases: PubMed, EMBASE, Scopus, Web of Science, and Google Scholar. Study selection was guided by the POLIS framework, focusing on women diagnosed with PCOS based on established criteria (Rotterdam, National Institute of Health [NIH], or Androgen Excess Society [AES]). Only cross-sectional studies reporting the prevalence of acne vulgaris in this population were included. A random-effects (REM) meta-analysis was performed using data from 95 eligible studies. Subgroup analyses were conducted based on geographical region, age, body mass index (BMI), PCOS diagnostic criteria, and acne vulgaris severity to explore sources of heterogeneity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;As per the findings, acne vulgaris, the pooled prevalence of which was 49% (95% CI: 47%-52%), determined 95 studies, with high heterogeneity (I² = 98.86%, &lt;i&gt;P&lt;/i&gt; = 0.04) and evidence of publication bias (&lt;i&gt;P&lt;/i&gt; &lt; 0.001), remained the most frequent comorbidity in women with PCOS. However, after trim and fill adjustment, the prevalence fell to 37% (95% CI: 35%-39%). The subgroup analyses also revealed the prevalence of the highest in Oceania (76%, 95% CI: 69%-83%), whereas the prevalence of adolescents &lt;18 years was 66%, 95% CI: 49%-81%, and less in Europe (32%, 95% CI: 28%-36%) and women &gt;30 years (42%, 95% CI: 38%-46%), respectively. The rate was somewhat higher among women with a BMI ≤25 kg/m&lt;sup&gt;2&lt;/sup&gt; (53%) in comparison with those with a BMI of &gt;25 kg/m&lt;sup&gt;2&lt;/sup&gt; (48%). Mild acne vulgaris scored the most (40%, 95% CI: 27%-53%) among the research participants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The prevalence of acne vulgaris among women with PCOS varies widely across studies, with subgroup analyses revealing a range influenced by factors such as region, age group, and diagnostic criteria. These findings highlight the need for standardized diagnostic tools for PCOS and comprehens","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"105"},"PeriodicalIF":0.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292753","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":"Short Foot Exercises as a Preventive Strategy for ACL Injury in Women with Dynamic Knee Valgus.","authors":"Yousef Moghadas Tabrizi, Hooman Minoonejad, Aysan Jamshidi, Arash Khaledi","doi":"10.47176/mjiri.39.104","DOIUrl":"10.47176/mjiri.39.104","url":null,"abstract":"<p><strong>Background: </strong>Dynamic knee valgus (DKV) is a well-established contributor to knee injuries, with women at higher risk. Traditional rehabilitation often emphasizes proximal muscle strengthening, but growing research suggests that foot and ankle dysfunction may play a critical role in DKV development. This study aimed to investigate the effects of a 6-week short foot exercise (SFE) program on the DKV angle, navicular drop, ankle dorsiflexion range of motion (DFROM), and proprioceptive acuity at the knee and ankle in women with DKV.</p><p><strong>Methods: </strong>This quasi-experimental study involved 28 female university students (aged 20-30 years) with DKV and excessive navicular drop, assigned to either an SFE group or a control group. The intervention group performed supervised SFE sessions 3 times per week for 6 weeks. Measurements taken before and after the intervention included DKV angle, navicular drop, ankle DFROM, and proprioceptive acuity at the knee and ankle. Appropriate parametric and nonparametric statistical tests (t-tests, analysis of covariance, Mann-Whitney U, and Wilcoxon test) were used based on data distribution.</p><p><strong>Results: </strong>After the intervention, the SFE group demonstrated significant improvements compared to the control group in DKV angle (adjusted mean difference = -4.0°, 95% CI: -6.0° to -2.1°, p = 0.001, d = 2.04), navicular drop (-4.2 mm, 95% CI: -5.4 to -2.9 mm, <i>P</i><0.001, d=2.08), and ankle DFROM (+6.9°, 95% CI: 5.2° to 8.7°, <i>P</i><0.001, d=2.89). Knee joint proprioception error decreased by -1.2° (95% CI: -1.8° to -0.7°, <i>P</i><0.001, d=1.47), and ankle proprioception error (dorsiflexion) improved by -1.4° (95% CI: -2.5° to -0.6°, <i>P</i>=0.002, r=0.60). The control group showed no significant changes in any outcome (all <i>P</i>>0.05).</p><p><strong>Conclusion: </strong>A structured 6-week SFE program effectively enhances foot posture, ankle mobility, and proprioceptive control, leading to reduced knee valgus in young women. These findings support the inclusion of distal kinetic chain exercises in rehabilitation programs aimed at correcting lower limb dysfunction and preventing knee injuries.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"104"},"PeriodicalIF":0.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292533","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":"Mapping and Estimating the Size of Key Affected Populations in Iran: Methodological Issues.","authors":"Mahmoud Khodadost, Hamid Sharifi, Ahmad Hajebi, Seyed Abbas Motevalian","doi":"10.47176/mjiri.39.103","DOIUrl":"10.47176/mjiri.39.103","url":null,"abstract":"<p><strong>Background: </strong>Reliable estimates of key affected populations (KAPs), including people who inject drugs (PWID) and people who use drugs (PWUD), are essential for effective human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and harm reduction programming. This study compares how 3 methodological adjustments collectively modify PWID/PWUD size estimates across 4 Iranian cities.</p><p><strong>Methods: </strong>Using data from mapping exercises in 4 Iranian cities (Ahvaz, Sari, Yazd, and Tehran), we applied 3 methodological adjustments: (1) frequency adjustment (correcting for infrequent hotspot attendance); (2) duplication adjustment (accounting for multihotspot visitors); and (3) hidden population adjustment (incorporating KAPs avoiding mappable sites). Input parameters were derived from field surveys and national studies, including the Iranian Mental Health Survey.</p><p><strong>Results: </strong>Frequency adjustment increased initial PWID estimates (eg, Ahvaz: from 843 to 2104), while duplication adjustment reduced them by 29% to 37%. Hidden population adjustment (assuming 76% of PWID avoid hotspots) yielded final estimates of 1966 (Ahvaz), 854 (Sari), 663 (Yazd), and 28 (Tehran). PWUD estimates followed similar trends, although hidden population adjustments were limited by data gaps.</p><p><strong>Conclusion: </strong>Standard hotspot mapping significantly underestimates KAP sizes if methodological biases are unaddressed. Our 3-step adjustment framework enhances accuracy but highlights limitations, including reliance on mobility assumptions and accuracy of the available national survey data. These findings advocate for integrating correction factors into KAP surveillance systems to optimize resource allocation for harm reduction.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"103"},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292743","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":"Complications of CT-Guided Percutaneous Lung Biopsy: A 1-Year Single-Center Experience in Iran.","authors":"Mohammad Reza Sasani, Majid Paknahad","doi":"10.47176/mjiri.39.102","DOIUrl":"10.47176/mjiri.39.102","url":null,"abstract":"<p><strong>Background: </strong>Despite observing all precautions, complications are not uncommon during transthoracic needle biopsy (TTNB). We aimed to evaluate the complications associated with TTNB in patients with lung masses from 1 center in southern Iran.</p><p><strong>Methods: </strong>In this retrospective cohort study, data on complication rates, types, and potential risk factors from 87 biopsies were collected. Complications were assessed through immediate post-biopsy computed tomography (CT) scans and follow-up chest X-rays, and their correlations were evaluated with patient demographics, lesion characteristics, and procedural factors. Chi-square and Wilcoxon rank-sum tests were used for univariable analysis, and multivariable binary logistic regression analyses were conducted to control for potential confounders.</p><p><strong>Results: </strong>The overall complication rate was 37.9% (95% CI, 27.6%-48.3%), with pneumothorax being the most common, occurring in 26.4% (95% CI, 17.3%-35.6%) of cases, followed by perilesional hemorrhage (17.2%) (95% CI, 10.3%-25.3%), hemoptysis (3.3%), and pleural effusion (1.1%). All pneumothorax cases were identified via immediate post-biopsy CT, and only 1 patient required chest tube insertion. No significant correlations were found between age, sex, presence of emphysema, lesion size, location, and depth, or needle path and the incidence of pneumothorax. However, a significantly higher perilesional hemorrhage incidence was observed for smaller lesion size (26 mm [interquartile range, IQR], 13,40 vs 43 mm [IQR, 24,73]; <i>P</i> = 0.019), deeper lesion (10 mm [IQR, 0.17] vs 0 mm [IQR, 0.10]; <i>P</i> = 0.041), and longer needle path (17 mm [IQR, 9.29] vs 0 mm [IQR, 0.7]; <i>P</i> < 0.001). Furthermore, 47.8% of pneumothorax cases identified on postbiopsy CT showed no signs on follow-up chest X-ray 3 hours later.</p><p><strong>Conclusion: </strong>TTNB is generally safe, with a manageable complication profile. Early detection and appropriate follow-up are crucial, particularly for pneumothorax, which often resolves spontaneously. The findings underscore the importance of considering lesion characteristics to minimize complications during biopsy procedures.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"39 ","pages":"102"},"PeriodicalIF":0.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292782","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}