Medical Journal of the Islamic Republic of Iran最新文献

{"title":"Gamified Educational Learning Path on HIV/AIDS Stigma and Discrimination (REDXIR): Design, Development and Pilot Study","authors":"F. Doroudi, Helia Ashourizadeh, Sara Moosapour, Ali Ganjizadeh, Alireza Ranjbar Shourabi, A. Parnia, Fereshteh Kazemipour, Minoo Mohraz, Zahra Bayat Jozani","doi":"10.47176/mjiri.37.136","DOIUrl":"https://doi.org/10.47176/mjiri.37.136","url":null,"abstract":"Background: HIV/AIDS-related stigma and discrimination are among the main barriers to controlling the HIV epidemic. Discriminatory behavior in healthcare settings deprives people of accessing high-quality health services. Methods: This study presents the design, development, and pilot study of a novel web-based application (“REDXIR”), which is designed based on behavioral and gamification principles and aims to eliminate HIV/AIDS-related discriminatory behavior among health professions students. REDXIR storyline is set in an imaginary world where the students' journey is like a 10-level game, in which each level consists of several missions with a certain amount of score. The participants have to accomplish the mission to reach the minimum amount of score to pass each level. Finally, each becomes an individual who has not only the knowledge but also the competency to educate and advocate appropriately in the field. Results: The pilot was done in six medical sciences universities in Tehran, Iran. The feasibility of the instructional design, specifically gamification strategies in the field of HIV education, and the executive functions to run the program on a bigger scale were evaluated. In total, 241 students were included and performed 1952 missions. The program evaluation showed a mean satisfaction score of 4.16 (from 1, the lowest, to 5, the highest) and participants considered their learning practical and gamification method appropriate for HIV education. Conclusion: A meaningful gamification design for an online medical education program could be a suitable, functional, and applicable learning model to reduce HIV/AIDS stigma and discrimination among health professions students.","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139316050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between Health Literacy and Proper Antibiotic Use Awareness in Tehran 2019-2020","authors":"Mardavij Hamedani, Soodabeh Hoveidamanesh, J. Koohpayehzadeh, Mohsen Arabi, Farshad Divsalar","doi":"10.47176/mjiri.37.133","DOIUrl":"https://doi.org/10.47176/mjiri.37.133","url":null,"abstract":"Antibiotic resistance","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139316319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Therapeutic versus Prophylactic Enoxaparin Therapy in Severe COVID-19 Patients: A Randomized Clinical Trial","authors":"Samira Kafan, Mohammad Reza Fattahi, Mahsa Akhbari Shojaie, Aida Hossein Nezhad, Mahshid Imankhan, Davoud Jahansouz, M. Montazeri, A. Hadadi, Sara Fattahi, Arad Iranmehr, M. Pazoki, Hormat Rahimzadeh","doi":"10.47176/mjiri.37.129","DOIUrl":"https://doi.org/10.47176/mjiri.37.129","url":null,"abstract":"Background: Coronavirus disease 2019 (COVID-19) has been associated with a hypercoagulopathy state; however, the efficacy of different anticoagulant regimens in preventing thrombotic events is not clear. We aimed to compare therapeutic versus prophylactic enoxaparin therapy in severe COVID-19 patients. Methods: In this single-center, open-label, randomized controlled trial, adult patients with severe COVID-19 presentations and an increased D-dimer level of more than 4 times the normal upper limit were randomly assigned to receive either prophylactic or therapeutic dose of enoxaparin. All patients were observed for at least 4 months regarding the overall survival as the primary outcome. Hospitalization duration, the need for intensive care unit (ICU) admission, the need for mechanical ventilation, and major adverse events (MAEs) were also analyzed as the secondary outcomes. Survival analysis was done via Kaplan-Meier curves and the Log-rank test. Cox regression was used, adjusting for baseline variables. Results: Overall, 237 patients (152 men and 85 women) were randomized to either arm (121 to prophylactic and 116 to therapeutic groups). The mortality rate was 27 (22.3%) and 52 (44.8%) in prophylactic and therapeutic arms, respectively. Prophylactic enoxaparin was associated with better survival in the log-rank test ( P < 0.001; HR, 0.42). Additionally, a significantly lower rate of ICU admission, a lower rate of MAEs, and shorter hospitalization were observed in the prophylactic arm ( P < 0.001, P = 0.009, and P = 0.028, respectively). Conclusion: The results of the current study were in favor of anticoagulant treatment with prophylactic doses of enoxaparin. Still, due to the limitations of this paper, we suggest that these findings be treated cautiously.","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139315876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Analysis of Spontaneous Electroencephalogram (EEG) in Chronic Low Back Pain Patients Compared with Healthy Subjects","authors":"Sanaz Bemani, J. Sarrafzadeh, Shohreh Noorizadeh, Saeed Talebian, Reza Salehi, Jamileh Zarei","doi":"10.47176/mjiri.37.128","DOIUrl":"https://doi.org/10.47176/mjiri.37.128","url":null,"abstract":"Background: Quantitative electroencephalography (EEG) power spectra analysis was applied to assess brain activation during chronic pain. Although many studies have shown that there are some common characteristics among individuals suffering from various pain syndromes, the data remains inconclusive. The present study aimed to assess chronic low back pain (CLBP) based on functional brain changes with EEG in CLBP patients compared with healthy controls. Methods: Multichannel electroencephalogram data were recorded from 30 subjects with CLBP and 30 healthy controls under eye-open resting state conditions and active lumbar forward flexion, and their cortical oscillations were compared using electrode-level analysis. Data were analyzed using a pair t-test. Results: A total of 30 patients (19 men and 11 women in the case group (mean [SD] age, 35.23 [5.93] years) with 30 age and sex-match healthy controls participated in the study. A paired t-test was applied to identify whether there was any difference in the absolute and relative power of frequency spectra between CLBP patients and healthy controls. The results showed a significant increase in alpha relative power in CLBP patients compared with healthy controls in an open-eye resting state ( P < 0.050) and active lumbar forward flexion ( P < 0.050). Conclusion: The enhanced alpha relative power in CLBP patients could be relevant to attenuating sensory information gating and excessive integration of pain-related information. Increased power at the EEG seems to be one of the clinical characteristics of individuals with CLBP. EEG can be a simple and objective tool for studying the mechanisms involved in chronic pain and identifying specific characteristics of CLBP patients.","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139315883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor Regarding “The Non-Significant Benefit of BCG Vaccination for the Treatment of Iranian Patients with Type 1 Diabetes up to 48 Weeks: A Controversial Result”","authors":"Denise L Faustman, Willem Kuhtreiber","doi":"10.47176/mjiri.37.132","DOIUrl":"https://doi.org/10.47176/mjiri.37.132","url":null,"abstract":"","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139315910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introducing Matrix Metalloproteinases as Crucial Targets for Intra-articular Laser Therapy in Patients with Synovial Fluid of Knee Osteoarthritis","authors":"Reza M Robati, Z. Razzaghi, B. Arjmand, M. Rezaei Tavirani, Fatemeh Sheibani","doi":"10.47176/mjiri.37.130","DOIUrl":"https://doi.org/10.47176/mjiri.37.130","url":null,"abstract":"Background: Many elder people have knee osteoarthritis (OA). The patients are faced with pain and disability in movement. Given the challenging lifestyle of the patients, finding an efficient therapy approach is necessary. Since low-level laser therapy applies to the treatment of many diseases, it seems it can be a suitable option for the treatment of knee OA. The present study aimed to evaluate the molecular mechanism of laser therapy on knee OA via a protein expression change study. Methods: The present study examines the gene expression profile of patients with OA in the knee using bioinformatics. The protein expression change profile of synovial fluid of knee OA patients is extracted from the literature and is analyzed based on the rate of expression and interactions between the differentially expressed proteins (DEPs). The results are compared with the DEPs of similar tissue of the treated knee OA patients (from published documents) after laser therapy. Results: Apolipoprotein B (APOB) and matrix metallopeptidase 2 (MMP2) were determined as the hub bottlenecks of the protein-protein interaction (PPI) network of synovial fluid of knee OA patients. MMP2, complement 5, transthyretin, and apolipoprotein A-1 from laser-treated patients were related to the PPI network of knee OA patients. The reduction of Interleukin-6 activity was highlighted as a critical event as a function of laser on the human body. Conclusion: In conclusion, it was noted that the main phenomenon associated with laser therapy-induced improvement in the condition of knee OA patients is the downregulation of MMP2.","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139316115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Importance of Uncertainty in Health Scenarios: A Scoping Review on COVID-19 Scenarios","authors":"Mostafa Hosseini Golkar, Mohammad Mahdi Mowlaei, Anahita Behzadi, Mohsen Keshavarz-turk, Atefeh Zolfagharnasab, Morteza Hosseini Golkar","doi":"10.47176/mjiri.37.137","DOIUrl":"https://doi.org/10.47176/mjiri.37.137","url":null,"abstract":"Background: Scenarios are the most efficient methods to explore our uncertainty about the future. Even with increasing utilization, the majority of scenarios still fall short of meeting the future “uncertainties” in health. This article examines one of the most sensitive encounters of the health system with uncertainties—COVID-19 pandemic—and the type of uncertainty analysis in health scenarios to discuss the importance and determine the existing gaps while providing a better mechanism for scenario planning in the health system. Methods: To examine the extent, range, and nature of scenario research, a preliminary mapping of the existing literature, summarizing research findings, and identifying research gaps, we have taken help from the Arksey and O'Malley (2005) model and to improve the quality of the results, we have also used the PRISMA framework. To identify the studies relevant to the issue, the PubMed and Embase databases were searched for peer-reviewed published articles. All peer reviewed articles from January 01, 2020, to December 31, 2020, were included in this review. The search strategy was mainly the systematic use of English keywords such as “coronavirus,” “covid-19,” “SARS-CoV-2,” “2019-ncov,” and scenario. To improve the search sensitivity, subject searching based on MeSh and Emtree keywords was used. Results: It is crucial to identify the health domains where the scenarios can be used. The major ideas that were covered and their variations would also be identified using these different scenarios. Based on the selected articles, we can answer some critical questions. First, in which health fields is the scenario method used? Second, what are the key concepts in these studies, and third, what is the difference between them? Policy, epidemiology, and economics use futures studies scenarios more than other social science disciplines in health. Furthermore, we have looked at the fact that selecting the appropriate kind, utilizing new methodologies, and emphasizing uncertainty analysis are the core difficulties associated with health case scenarios. Conclusion: Based on examining the existing indicators in the health scenarios, establishing the “uncertainty analysis” as the basis can improve scenario planning in this field. Also, if scenario planning is done as a process based on uncertainty analysis, it is more accurate and helps make better decisions in the field of health.","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139316138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Importance of International Normalized Ratio Monitoring in Patients With Mechanical Pulmonary Valve Prosthesis","authors":"Mahta Arbabi, Zahra Ghaffarinejad, Hossein Dehghani Mohammad Abadi, Sajad Erami, Anahita Esmaeili, Yeganeh Dehghani Mohammad Abadi, Maryam Shojaeifard","doi":"10.47176/mjiri.37.131","DOIUrl":"https://doi.org/10.47176/mjiri.37.131","url":null,"abstract":"Background: The most challenging risk of mechanical valves is thromboembolic events; therefore, life-long anticoagulation therapy is necessary. Anticoagulation therapy should be adjusted for each patient with serial international normalized ratio (INR) monitoring. Due to the small number of patients with a mechanical valve in the pulmonary position, we are facing a lack of information about the therapeutic range of the INR in these patients. We aimed to evaluate patients with a history of pulmonary valve replacement (PVR) who faced malfunction and compare their INR and echocardiographic data at the time of malfunction and 3 months prior. Methods: In this cross-sectional study, 71 patients who had previously undergone PVR and presented to Shaheed Rajaie Cardiovascular Medical and Research Center with a diagnosis of pulmonary valve malfunction between 2014 and 2021 were included. Patients' INR and echocardiographic data at the time of the malfunction and 3 months before the malfunction diagnosis were gathered from the hospital's registry. IBM SPSS 20.0 was used for data analysis. Results: In this cross-sectional study, 71 patients with mechanical pulmonary valve malfunction were included. 49.3% (n = 35) were men, 50.7% (n=36) were women, and their mean age was 33.23 (±8.279). The mean INR of all patients 3 months before malfunction and at the time of malfunction was 2.29 (±0.753) and 2.20 (±0.704), respectively. Conclusion: In this study, most of our patients had an INR below the therapeutic range, both at the time of malfunction and 3 months prior. It emphasizes the importance of patient follow-up and keeping the INR in the therapeutic range.","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139316354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Affecting Respondents’ Strategies in Answering Queries Related to the Field of Health on Social Question Answering (SQA) Websites","authors":"Maedeh Kheirabadi, Afshin Mousavi Chelak, S. Ziaei, Mohsen Haji Zeinolabedini","doi":"10.47176/mjiri.37.134","DOIUrl":"https://doi.org/10.47176/mjiri.37.134","url":null,"abstract":"Background: The study of various aspects of information behavior has attracted the attention of many researchers. This study used the structural equation modeling method to identify factors affecting respondents’ strategies in answering health-related questions on social question answering (SQA) websites. Methods: The study population in this quantitative-applied survey included all respondents answering health-related questions on national and international SQA websites, among whom 431 individuals were selected as the sample using SPSS SAMPLE POWER software and convenience sampling. The data were collected using the Respondents’ Motivations and Strategies Questionnaire and the Social Support Questionnaire. The items of these questionnaires are scored on a 5-point Likert scale. The conceptual research model was evaluated using the structural equation modeling method, and the collected data were analyzed in SPSS 26.0 and AMOS 24.0. Results: The authors identified and analyzed the factors influencing respondents' strategies and the relationships between these factors. Motivations, social support, sex, age, income, level of education, amount of activity per week, and response time are effective on response strategies with factor loadings of 0.61, 0.56, 0.50, 0.53, 0.31, 0.66, 0.53, and 0.65, respectively. The variable determination coefficient of response strategies in the structural equation model is reported to be 0.55 and significant. Finally, response strategies can be predicted based on the independent variables. Conclusion: In order to enhance response strategies, it is important to promote effective response behaviors, as determined by the components that influence response strategies. The quality of related online services, such as expert question-answering and digital reference services, can be improved with the help of the present findings.","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139316460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of COVID-19 on Education: A Cross-Sectional Study of Distance Learning among Medical Students.","authors":"Farida Iskakova, Zhazira Utepbergenova, Saltanat Mamyrbekova, Anar Daniyarova, Zhanar Zhagiparova, Zinat Abdrakhmanova, Elmira Auyezova","doi":"10.47176/mjiri.37.112","DOIUrl":"https://doi.org/10.47176/mjiri.37.112","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic affected educational institutions and caused the transfer to distance learning. The study aimed to assess medical students' satisfaction with synchronous distance learning (SDL) during the pandemic and predict their choice of it in the future.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among undergraduate medical students at the Al-Farabi Kazakh National University in July 2021. An online questionnaire was used to collect data on demographic and educational characteristics, satisfaction, and perspective on the future choice of SDL. IBM SPSS Statistics, version 26, was used to analyze the qualitative data on descriptive and inferential statistics.</p><p><strong>Results: </strong>Students' satisfaction and future choice of SDL were 43.2% and 20.2%, respectively. Regression analysis revealed the significance of SDL predictors with a direct relationship in the case of gender and academic performance and predictors with an inverse relationship in the case of residency, student life satisfaction, and SDL with student satisfaction. In the predictive model, student satisfaction and probability of future choice of SDL over traditional learning were 59.5% and 43.5%, respectively; over hybrid learning, it was 20.2% of students.</p><p><strong>Conclusion: </strong>The research findings suggested that slightly less than half of the respondent medical students were satisfied by distance learning during the COVID-19 pandemic when their satisfaction probability was significantly higher in the predictive model. The predictive model of perspective of choice of distance learning did not show statistically significant results compared with traditional and hybrid learning.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10744191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032440","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}