Mashhad University Of Medical Sciences Research Articles

Investigating the role of the built environment, socio-economic status, and lifestyle factors in the prevalence of chronic diseases in Mashhad: PLS-SEM model

BackgroundChronic diseases remain a significant contributor to both mortality and disability in our modern world. Physical inactivity and an unhealthy diet are recognized as significant behavioral risk factors for chronic diseases, which can be influenced by the built environment and socio-economic status (SES). This study aims to investigate the relationship between the built environment, SES, and lifestyle factors with chronic diseases.MethodsThe current study was conducted in Mashhad’s Persian cohort, which included employees from Mashhad University of Medical Sciences (MUMS). In the study, 5,357 participants from the cohort were included. To assess the state of the built environment in Mashhad, a Geographic Information System (GIS) map was created for the city and participants in the Persian Mashhad study. Food intake and physical exercise were used to assess lifestyle. A food frequency questionnaire (FFQ) was used to assess food intake. To assess food intake, the diet quality index was computed. To assess the link between variables, the structural model was created in accordance with the study’s objectives, and partial least square structural equation modeling (PLS-SEM) was utilized.ResultsThe chronic diseases were positively associated with male sex (p < 0.001), married (p < 0.001), and higher age (p < 0.001). The chronic diseases were negatively associated with larger family size (p < 0.05), higher SES (p < 0.001), and higher diet quality index (DQI) (p < 0.001). No significant relationship was found between chronic disease and physical activity.ConclusionFood intake and socioeconomic status have a direct impact on the prevalence of chronic diseases. It seems that in order to reduce the prevalence of chronic diseases, increasing economic access, reducing the class gap and increasing literacy and awareness should be emphasized, and in the next step, emphasis should be placed on the built environment.

EFFECTS OF PROLOTHERAPY WITH HYPERTONIC DEXTROSE IN PATIENTS WITH KNEE OSTEOARTHRITIS: A RANDOMIZED CLINICAL TRIAL

Background: The role of prolotherapy in the healing process of damaged tissues has been confirmed in patients with degenerative joint disease. Hypertonic dextrose has been introduced as the most common solution in prolotherapy for reducing pain and improving mobility in people with knee osteoarthritis (KOA). This study aimed to compare the KOA patients undergoing hypertonic dextrose prolotherapy (DPT) with the placebo in terms of pain intensity and functional level. Methods: This triple-blind study randomized clinical trial (RCT) was conducted on patients with mild to moderate KOA who were referred to the Rheumatic Diseases Research Center (RDRC), Mashhad University of Medical Sciences, Mashhad, Iran, in the year 2021. Patients were randomly assigned to two groups of the DPT ([Formula: see text] = 47) and normal saline placebo prolotherapy ([Formula: see text] = 50) intra- and peri-articular knee joints. Treatment was monthly for three months. Western Ontario and McMaster Universities’ Arthritis Index (WOMAC) and Anterior Knee Pain Scale (AKPS) were completed before and after intervention (weeks 0, 4, 8, 12, and 16). The variables were compared between the two study groups at a significance level of less than 0.05 ([Formula: see text] < 0.05). Results: The WOMAC score improved significantly compared to the baseline in both groups ([Formula: see text] < 0.005). An increase in WOMAC score (the last follow-up compared to baseline) was 97.4% and 85.7% in DPT and placebo groups, respectively ([Formula: see text] = 0.06). Before the intervention and also after the first injection, the AKPS score in the normal saline group was significantly better than the dextrose group ([Formula: see text] = 0.03). The AKPS score did not differ significantly between the two groups ([Formula: see text] > 0.05) in the next two visits and two-month follow-ups. Improvement of AKPS score in the last follow-up compared to baseline was reported in 66.7% and 68.4% of patients in the normal saline group and dextrose group, respectively, ([Formula: see text] = 0.86). Conclusion: Prolotherapy as intra- and peri-articular injections of hypertonic dextrose could be used to relieve pain and improve functional status in patients with mild to moderate KOA as much as a placebo does. Although no remarkable difference was observed between dextrose and placebo in the outcomes, the rate of improvement (last follow-up compared to the baseline) was relatively higher in the dextrose group than in the normal saline group.

A survey on occupational injuries and related factors among emergency patients of Mashhad teaching hospitals over a year.

Occupational injuries (OI) are a - significant source of social and economic costs. They can cause prolonged absences from work, loss of limb, and worker disability, among other negative consequences. In light of this, the present study aimed to evaluate the factors associated with OI in trauma centers affiliated with Mashhad University of Medical Sciences. This cross-sectional study was carried out among patients admitted to the trauma ward of four teaching hospitals in Mashhad during 2019-2020. Patients' data was collected in a checklist and trauma severity was assessed based on injury severity score. The Epworth questionnaire was completed for patients. Data was analyzed by SPSS 20.0. Out of a total of 13660 patients who were referred to the emergency department of four hospitals of Mashhad University of Medical Sciences, 683 (5.15%) individuals suffered occupational trauma and entered the study. The mean (±SD) age and work experience of the participants were 34 (±10) and 10 (±9) respectively. Most of the participants were in the age group of 20-40 years. the most common mechanism of trauma was falling (p=0.00) and the most injury frequency was among manual working (p=0.01). There was not a significant association between trauma severity and demographic characteristics. Those who had falling or electric accidents had more severe trauma compared to other injured patients. (p=0.00) CONCLUSIONS: In general, the most burden of occupational accidents and in fact, the most serious injuries were related to men and manual workers. Also, most of the injuries happened through falls and cuts. The results of this study showed the need for serious policies to reduce occupational injuries.

Intra-Abdominal Cysts Not Originating from Liver, Spleen, or Kidney in Children: Assessment of the Diagnostic Value of Ultrasound Features

Background: Cystic abdominal masses are relatively prevalent in the pediatric population. Ultrasound (US) often serves as the initial imaging modality for evaluating these lesions, assisting in diagnosis, and guiding clinical decisions. Objectives: This study aimed to delineate the characteristic US features of intra-abdominal cystic lesions not arising from the liver, spleen, or kidney in children and to assess their diagnostic value for providing definitive diagnoses. Methods: Conducted in the radiology department of pediatric hospitals affiliated with Mashhad University of Medical Sciences from 2019 to 2022, this cross-sectional study examined 104 children with cystic abdominal lesions. Patient demographic data and US characteristics were documented. Definitive diagnoses were established through histopathological reports, surgical outcomes, or clinical follow-up. The accuracy of US findings was evaluated against these definitive diagnoses, with the sensitivity and specificity of US features for various intra-abdominal cystic lesions being calculated. Results: The most frequent cystic lesions identified were perinatal ovarian torsion (22.1%) and duplication cysts (18.2%). Ultrasound achieved a sensitivity and specificity of 82.61% (95% CI = 0.6 - 0.94) and 100% (95% CI = 0.94 - 1), respectively, in diagnosing perinatal ovarian torsion and 89.47% (95% CI = 0.65 - 0.98) and 94.11% (95% CI = 0.86 - 0.97) in diagnosing duplication cysts. In 80.8% of the cases, the initial US diagnosis corresponded with the final diagnosis. Conclusions: Ultrasound exhibits commendable sensitivity and specificity in identifying intra-abdominal cysts not originating from the liver, spleen, or kidneys in children, demonstrating its effectiveness in the diagnostic evaluation of these lesions.

Evaluation of the Status of Patients with Autoimmune Bullous Diseases (Pemphigus and Bullous Pemphigoids) in Dermatology Clinics of Mashhad University of Medical Sciences During the COVID-19 Pandemic Using Telemedicine.

Background: The COVID-19 pandemic impacted the growth of telemedicine. The challenge was in the way of dermatologists, who needed a comprehensive examination of the lesions. Here, we tried a tele-management of patients with autoimmune bullous diseases. Methods: This cross-sectional study was conducted on confirmed bullous disorder cases. Demographic data and the status of COVID-19 infection were assessed in the patients. Some of the cases were provided online, and some with office visits. Drug and treatment plan changes were compared between these two groups. All statistical analysis was conducted using SPSS version 20. Result: Totally, 100 patients, including 46 males (46.0%) and 54 females (54.0%), 48.15 ± 11.11 years old, were studied. Among them, 73 were pemphigus vulgaris (73.0%), 11 were bullous pemphigoid (11.0%), 10 were pemphigus foliaceus (10.0%), and the other 6 (6.0%) were categorized as other autoimmune bullous diseases. During the pandemic, 38 cases (38.0%) had COVID-19 infection. 72 patients had office and 28 had online visits. Treatment plans after visits during the pandemic (p = 0.588) and drug dose change (p = 0.297) showed no significant difference between office and online visits. Conclusion: Our patients tended to plan office visits more than online; however, we found no differences regarding the plan or treatment changes. Online visit has good efficacy, but further investigation in case of provision of a suitable platform and getting the attention of the patients is needed.

Buprenorphine induced opioid withdrawal syndrome relieved by adjunctive Magnesium: A clinical trial

IntroductionPrecipitated opioid withdrawal syndrome (OWS) is a severe and intolerable situation that may occur by a pharmaceutical agent. Reactivation of inhibited N-methyl-d-aspartate (NMDA) receptor in person with prolonged opioid use can led to severe OWS. We conducted a double-blind, randomized clinical trial to assess the effect of magnesium sulfate (MGSO4) as an NMDA receptor antagonist on OWS. Materials and methodsThe study randomly divided forty patients with precipitated OWS due to partial agonist (buprenorphine) use referred to the emergency unit of Toxicology Department of Mashhad University of Medical Sciences, Iran; into two groups. The control group received conventional therapies, including clonidine 0.1 mg tablet each hour, intravenous infusion of 10 mg diazepam every 30 min, and IV paracetamol (Acetaminophen) 1 g, while the intervention group received 3 g of MGSO4 in 20 min and then 10 mg/kg/h up to 2 h, in addition to the conventional treatment. The clinical opiate withdrawal scale (COWS) evaluated OWS at the start of the treatment, 30 min, and 2 h later. ResultsBoth groups had similar demographic, opiate types, and COWS severity at the start of the intervention. COWS was lower in the intervention than the control group at 30 min (11.20 ± 2.86 and 14.65 ± 2.36, respectively, P = 0.002) and at 2 h (3.2 ± 1.61 and 11.25 ± 3.27, respectively, P < 0.001) after treatment. The intervention group received lesser doses of clonidine (0.12 ± 0.51 and 0.17 ± 0.45 mg, P = 0.003) and Diazepam (13.50 ± 5.87, 24.0 ± 6.80 mg, P = 0.001) than the control group. Serum magnesium levels raised from 1.71 ± 0.13 mmol/L to 2.73 ± 0.13 mmol/L in the intervention group. ConclusionMagnesium can significantly reduce the severity of OWS. Additional studies are required to confirm these results.

Knowledge and Use of International Classification of Function, Disability and Health Among Rehabilitation Specialists of Mashhad University of Medical Sciences: A Cross-sectional Study

Introduction: The lack of integrated registration of information causes additional burden, inefficiency in health and treatment systems, and finally increases cost and decreases effectiveness. Correct coding requires knowledge and use of the latest editions of the International classification of functioning, disability and health (ICF). This study aimed to investigate the level of knowledge and use of ICF among professors and rehabilitation and optometry specialists at Mashhad university of medical sciences.Material and Methods: This cross-sectional study was conducted from September 2022 to March 2023. First, the pre-designed questionnaire consists of ten multiple-choice questions that were distributed among professors and rehabilitation and optometry specialists at Mashhad university of medical sciences. Second, the data were analyzed. For this purpose, descriptive data was calculated. SPSS version 21 statistical software was used to analyze the data.Results: The majority of the participants 16 (59.3%) stated that they knew ICF. However, only 13 (48.1%) of them identified the name or abbreviation of ICF correctly, and only 3 of them (11.1%) recognized the ICF components correctly. Fifteen of the participants (55.6%) stated that they did not use the ICF, followed by 3 (11.1%) who stated that they used the ICF in the clinic and 3 (11.1%) in training. The relationship between participants' graduation degree and their familiarity with ICF was significant (p=0.02).Conclusion: The results of this study show that most of the participants did not have enough information about the ICF and its components. A lack of knowledge about the ICF prevents professionals from following the recommendations of the world health organization. As the medical industry is driven to use evidence in patient care, universities, and educational centers must also provide the necessary grounds and infrastructure for teaching and using international classification tools such as ICF, which will be used by healthcare professionals in the future.

Satisfaction With Tele-Psychotherapy Among Students of Mashhad University of Medical Sciences During the COVID-19 Pandemic

Introduction: Previous experiences have shown that mental health is one of the areas that is quickly affected during an epidemic. Students, in particular, require guidance and consultation with psychologists in various aspects of their lives. This study aimed to investigate the satisfaction and effectiveness of tele-psychotherapy among students at Mashhad university of medical sciences during the COVID-19 pandemic.Material and Methods: This cross-sectional study was conducted from September 2022 to March 2023. A standard questionnaire developed by Ghalibaf et al. was used. Three experts in related fields confirmed the content validity of the questionnaire, and its internal consistency was assessed using Cronbach's alpha coefficient. Questionnaires were distributed to all students from affiliated faculties at Mashhad university of medical sciences who had utilized tele-psychotherapy during the COVID-19 pandemic. Descriptive statistics were used to summarize and analyze the data, while analytical statistics provided a basis for inference and interpretation.Results: The majority of students reported engaging in informal counseling through virtual communication methods such as chat and voice (47.7%), while video communication methods like video conferences were less commonly used (0.05%). Overall, most students (50%) expressed moderate overall satisfaction with tele-psychotherapy. However, only a small percentage (16.7%) agreed or strongly agreed that they would continue with this style of counseling in the future. Gender was found to have a significant relationship with satisfaction in tele-psychotherapy (p&lt;0.001), with female students reporting higher levels of satisfaction. Additionally, confidence in the confidentiality of conversations on the Internet also had a significant relationship with satisfaction in tele-psychotherapy (p&lt;0.001).Conclusion: The COVID-19 pandemic necessitated a sudden shift from face-to-face psychotherapy consultations to tele-psychotherapy for students, presenting them with unique challenges. The results of our study demonstrate that tele-psychotherapy can be a satisfactory option for ensuring continuity during crises. Furthermore, tele-psychotherapy offers flexibility in terms of time and location, allowing for quicker appointments if more frequent sessions are required or during emergencies.

Prevalence of mental disorders among middle-aged population of primary healthcare centers in Northeastern Iran

BackgroundPrimary healthcare centers (PHCs) serve as the cornerstone of accessible medical services in society, playing a crucial role in screening, detecting, and treating various health issues. This study aimed to investigate the prevalence of psychiatric disorders in middle-aged individuals who refer to PHCs and the potential of PHCs in diagnosing mental disorders.MethodsThis cross-sectional study was implemented at PHCs under the supervision of Mashhad University of Medical Sciences (MUMS) in northeast Iran in 2018. The enrolled subjects were middle-aged adults who had electronic medical records in SINA, an integrated health management system, and the electronic medical records of MUMS. The prevalence of psychiatric disorders by type and their relationship with demographic information was evaluated by a Chi-square test using SPSS 22.ResultsThis study involved 218,341 middle-aged participants. Prevalence of psychiatric disorders was 8.59%, and depression (53.72%) and anxiety (42.02%) were the most common psychiatric disorders in both males and females. The prevalence of mental disorders was significantly higher in females than in males (88.18% vs. 18.81%; P < 0.0001). Indeed, a significant higher prevalence of depression, anxiety, somatoform, childhood psychiatric disorder, and bipolar disorders was observed in females compared to males (P < 0.05). In addition, individuals between the age of 45–60 years, and those from rural areas showed more prevalence of mental disorders than others, but these differences were not significant.ConclusionsConsidering the previous studies in Iran, the prevalence of mental disorders among patients presenting to PHCs was noticeably lower than expected rates. It seems probable that this huge difference is due to poor screening and detection of mental illness in PHCs of MUMS. It is recommended that health policymakers pursue specific measures to make PHCs more helpful for people with mental health problems in the community.

Is There a Correlation Between Internet Use and Sleep and Cognitive Function Among Medical Students?

Background: Currently, the Internet is widely used by students for academic purposes; however, excessive Internet use might have negative consequences on students’ academic performance, sleep quality, and cognitive abilities. Objectives: This study aimed to investigate the relationship between Internet usage, sleep quality, and cognitive function among medical students. Methods: This analytical cross-sectional study was conducted on 525 pre-internship medical students, including 304 first- and second-year students, 113 third-year students, and 108 externs, within 2019 and 2021 at Mashhad University of Medical Sciences, Mashhad, Iran. The participants were selected using a stratified sampling method. All participants completed the Cognitive Ability Questionnaire (CAQ), Internet Addiction Questionnaire (IAQ), and Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using SPSS software (version 22). Results: According to the IAQ, 430 participants (81.9%) were categorized as average Internet users, 94 participants (17.9%) had occasional or frequent problems, and 1 participant had significant problems with Internet use. Mean PSQI and CAQ scores were significantly higher among participants with occasional or frequent problems/significant problems than the average Internet users (P &lt; 0.001 each). The total IAQ score showed a positive correlation with total CAQ (r = 0.439, P &lt; 0.001) and total PSQI (r = 0.264, P &lt; 0.001) scores. Among the PSQI subscales, sleep latency (P = 0.032), daytime dysfunction due to sleepiness (P &lt; 0.001), sleep efficiency (P = 0.001), and overall sleep quality (P &lt; 0.001) were worse in participants with occasional or frequent problems/significant problems than in average Internet users. Conclusions: Excessive Internet use negatively affects the sleep quality and cognitive performance of medical students.

Comparison Static and Dynamic Ultrasound Techniques of DDH: The Role of the Patient's Position.

The ultrasound examination of the hip joint is performed in the static (Graf) technique in the lateral recumbent position and in the dynamic technique in the supine position. This study compares the two static and dynamic techniques and assesses the role of the patient's position in the examination of DDH. This cross-sectional study was conducted in 2020-2021 at Akbar Hospital, Mashhad University of Medical Sciences, Iran. 126 patients suspected of having DDH (199 hip) infants were enrolled in the study. All ultrasound examinations were performed with two static and dynamic techniques by a pediatric radiologist. In the static and dynamic ultrasound examinations, the average alpha angle was 51.57 ± 6.41 degrees, and 53.41 ± 6.94 degrees, respectively. These changes were not statistically significant (P = 0.312). The relationship and agreement between instability with dynamic technique and instability with static technique (IIC unstable, D, III, and IV) were investigated. Significant agreement (Kappa=0.77 (95% CI: 0.66-0.87) with excellent clinical significance was obtained between the two ultrasound examination method. Also, in terms of DDH types in the static method with instability types in the dynamic method, a substantial agreement was found between the two examination methods (Kappa =0.67; (95% CI: 0.59-0.75) with good clinical significance. In the ultrasound examination of DDH with static and dynamic techniques, the change in the alpha angle was not statistically significant. Therefore, the hand of the radiologist is open in measuring alpha angles and there is no need to emphasize a specific position. The type of DDH in the static technique completely corresponded to the type of stability or instability in the dynamic technique.

Burnout syndrome and related factors among health team employees.

Burnout is not only related to mental health but also to efficiency. Thus, recognizing effective coping strategies has a significant role in improving mental health, the efficiency and productivity of human resources, and making better the level of quality of service. To determine burnout syndrome and examine related factors among the employees of Mashhad University of Medical Sciences. This cross-sectional study was conducted among 600 employees at Mashhad University of Medical Sciences. They were selected by a stratified sampling method. The data collection tool was the demographic information and the Burnout Self-Test Maslach Burnout Inventory (MBI) questionnaire. Data were analyzed through SPSS software version 20, using descriptive statistics and independent samples t-tests, one-way ANOVA, and Pearson and Spearman regression. The findings showed that emotional exhaustion (EE) and depersonalization (DP) in the majority of employees were high and personal accomplishment (PA) was low at 88.33% of cases. All participants presented burnout. However, participants aged 35-40 years, those with professional and Ph.D. degrees, and research staff reported higher burnout levels. Job burnout and its subscale levels among the employees were high. Job burnout is associated with socioeconomic status that can be affected by individual, organizational, management, and environmental factors. Therefore, this study suggests that employees need to get out of EE and DP conditions for higher job performance. Additionally, further research is required to examine the long-term effects of workplace burnout.

The Strabismus Prevalence in a Random Sample of Iran's Northeastern Population

Purpose: To investigate prevalence of strabismus and related factors in Mashhad, Iran. Study Design: Cross sectional study. Place and Duration of Study: Khatam-al-Anbia Hospital, affiliated with Mashhad University of Medical Sciences. Methods: Using multistage cluster sampling, participants were selected. All participants underwent detailed ocular examinations. A unilateral cover test was performed with the prism bar to achieve binocular alignment. Deviation magnitude was determined by considering the best refractive correction. Fixation targets were chosen as single letters one line above the best-corrected visual acuity on the distance and near chart. Results: This study included 5054 participants with a mean age of 35.35 ± 19.4 years. Strabismus was detected in 110 participants (2.17%) including 26 (0.51%) with esodeviation, 74 (1.46%) with exodeviation, and 10 (0.19%) with vertical deviation. The prevalence rates for strabismus, exotropia and esotropia were 2.38%, 1.64%, and 0.56% in females and 2.00%, 1.31%, and 0.51% in males respectively. The results did not indicate a significant gender difference in terms of strabismus prevalence (p&gt;0.05). Among the deviated eyes, there were 25.5% with hyperopia, 39.1% with myopia, and 35.5% with emmetropia. Anisometropia and amblyopia rates were 2.79% and 2.55%, respectively. The results did not reveal a significant correlation between strabismus prevalence, exotropia, and esotropia and age (p=0.56). The familial strabismus prevalence was 5.45%. Conclusion: Exotropia was more prevalent form of strabismus. Myopia was the dominant refractive error associated with deviated eyes. Tropia showed no age-related association.

Predictive factors of breast cancer mammography screening among Iranian women.

Understanding the factors that influence women's cancer screening behavior is crucial in reducing cancer mortality through early detection. Therefore, the objective of this study was to examine the status of mammography and related factors among women who presented to the health centers of Khorasan Razavi province, Iran. For this study, a sample of 251,011 women who visited healthcare centers affiliated with Mashhad University of Medical Sciences was selected. The study examined several variables, including sociodemographic information, current smoking, nutrition status, and physical exercise. All analyses were performed using Python programming language and SPSS software. Furthermore, to handle imbalanced data, we used SMOTE balancing method that is an oversampling method and produce synthetic samples from the minority class. The factors of age, education, being employed, having children, family history of cancer, physical activity, smoking status, and diet were all predictors of mammography screening. Moreover, findings showed that age and family history of breast cancer were most important variables to predict mammography status, respectively. By examining various variables such as dietary habits, exercise, smoking, and demographic properties, it sheds light on the relationships between these factors and mammography screening. This provides valuable insights into the associations between breast cancer screening behavior and preventive lifestyle behaviors. By targeting both preventive lifestyle choices and breast cancer screening behaviors, interventions can effectively promote positive changes in behavior and ultimately reduce the incidence and impact of breast cancer.

Exploring Factors Affecting Student-Professors Communication at Mashhad University of Medical Sciences

Introduction: Establishing effective communication between professors and students is very important in the university environment and it can have a significant impact on the academic and professional success of students. This study aimed to to identify the factors affecting the relationship between students and professors at Mashhad University of Medical Sciences.&#x0D; Methods: This descriptive cross-sectional study was conducted in 2022 on medical basic sciences students an data were gathered through a standard questionnaire containing demographic information and 35 questions about the factors affecting the relationship between students and professors. The data were analyzed using SPSS software and an independent t-test.&#x0D; Results: In this study, 69% of the students were male and 73% were single. According to the students' opinions, the speaking skills (77%), physical appearance (33%), rank (31.5%), maintaining the dignity and respect of students (25%), empathy and mutual understanding (19%) had the most significant impact on establishing a relationship between them and professors. However, the professor's age proximity to the student (15%), good listening skills and appropriate response to questions (15%), receptivity to criticism (13%), use of communication techniques (10%), and adherence to ethical principles (9%) had the least impact. Among all demographic variables, only sex had a signifant relationship with personal abilities dimension.&#x0D; Conclusion: Based on the results, it seems that most communication factors are important. Improving these relationships and focusing on effective factors can help improve students' academic status and organizationally lead to better efficiency and performance of the university.

Internet gaming disorder in medical students: Is it a risk factor for poor educational outcomes?

Background: Today, computer games have taken a prominent place in the lives of children and teenagers, and statistics indicate that online gaming constitutes the majority of computer usage. Numerous studies have explored the detrimental effects of internet gaming on individuals. However, to date, no comprehensive research has been conducted specifically investigating the effect of online gaming on academic performance within a medical education context. To address this gap, we have conducted this study, focusing on the impact of online gaming on the academic performance of Iranian medical students. Methods: In a cross-sectional study, 185 medical students from four disciplines ((basic sciences, Physiopathology, extern, intern) were selected through a multi-stage sampling method at Mashhad University of Medical Sciences. Internet gaming disorder (IGD) test as well as the grade point average (GPA) of the last academic semester, the average study hours on normal days and near the exam, the efficiency of study hours, the number of failed semesters, and academic satisfaction were assessed. Results: In this study, a total of 185 medical students participated, of which 62.2% (115 students) were females. The prevalence of IGD was found to be 3.8%. Interestingly, the prevalence of IGD was approximately four times higher in males than in females (7.1% vs. 1.7%, P=0.106). Furthermore, both the overall daily study time (P&lt;0.001) and the daily study time on days near exams (P=0.031) were found to be significantly higher in students without IGD compared to those with IGD. However, factors such as age, gender, being native to Mashhad, discipline level, last GPA, number of failed semesters, and satisfaction with education showed no correlation with IGD. Conclusion: These findings may serve as a cautionary signal for educational authorities within the Iranian medical education system. However, to obtain more robust results, further investigations are recommended, particularly in other academic majors.

Knowledge Mapping of Global Status and Trends for Thromboangiitis Obliterans: A Bibliometrics and Visual Analysis.

Thromboangiitis obliterans (TAO) is a segmental nonatherosclerotic inflammatory vascular disease characterized by recurrent progressive inflammatory reactions and thrombosis in the small and medium-sized arteries and veins of the extremities. However, there are few bibliometric studies on TAO. Therefore, this study was employed to generalize the research status, hotspots and development trends of TAO-related research. The data from 1999 to 2022 were collected from the Web of Science core collection database, and analyzed through bibliometrics software. VOSviewer was utilized to carry out academic collaboration between different countries/regions, institutions, and authors, visualization map of co-cited authors, journals, reference, and co-occurring keywords. CiteSpace was used to analyze the dual-map of journals, keyword bursts, and timeline of keywords. Bar and pie charts in this study were statistically analyzed and graphed through Microsoft Excel 2021. Scimago Graphica was applied to map the academic collaboration between different countries/regions. A total of 553 literatures were involved in this study. Japan at the leading global position not only in the number of publications, but also total citations, average citations and H-index. Institution with the major contribution to TAO research is Mashhad University of Medical Sciences, and Nagoya University. Annals of Vascular Surgery, Angiology, Journal of Vascular Surgery are the main publication channel for articles related to TAO. Fazeli, B., Iwai, T., and Kihara, Y. are major contributors in this field. The studies on TAO keywords could be grouped into four clusters: Etiology, Mechanism, Cell therapy and Clinical therapy. Although the number of TAO publications has fluctuated over the past 20 years, it has generally shown a steady upward trend. Etiology and treatment research on TAO and some keywords such as trail, therapy, outcome, management, stem cells, angioplasty, and activation will become a hot spot in the future.

Potential Role of Zinc Finger 365 rs10822013 and rs10995190 in Mammographic Density, Sporadic Breast Cancer Risk, and Prognosis.

Despite suggesting many genetic risk markers as the outcome of Genome-wide association studies (GWAS) for breast cancer, replicating the results in different populations has remained the main issue. In this regard, this study assessed the association of two variations in Zinc Finger 365 (ZNF365) in an Iranian population. In a case-control study conducted at Mashhad University of Medical Sciences, Mashhad, Iran, between 2017 and 2020, ZNF365-rs10822013 and rs10995190 were genotyped using Allele-Specific PCR (AS-PCR). Breast density was assessed using mammography images. PHASE software module version 2 and SPSS version 16.0 were used for haplotype and statistical analyses. Quantitative and qualitative variables were compared between groups using independent t tests and Chi square tests, respectively. Binary logistic regression analysis was performed to calculate odds ratios. Multivariate analysis was then undertaken for the baseline variables, with a P<0.05 in the univariate analysis. The survival analysis was performed using the Kaplan-Meier method and the log-rank test. In this survey, 732 females, including 342 breast cancer patients and 390 healthy subjects, were enrolled. rs10822013-T allele (P=0.014), rs10995190-G allele (P=0.003), and TG haplotype (P=0.002) were significantly associated with the increased risk of breast cancer. Moreover, rs10995190-GG genotype (P=0.042) and C-G haplotype (P=0.019) revealed a significant association with better overall survival. However, considered polymorphisms and their haplotypes indicated no association with breast density and clinical features of breast cancer. ZNF365 variants might be a potential risk marker of breast cancer in the Iranian population. The interaction between alleles in haplotypes may modulate the amount of the risk conferred by these variants. Further studies on different ethnic groups can validate these results.

Clinical Risk Factors of Systemic Antimony Treatment Failure in Patients with Acute Cutaneous leishmaniasis referred to the Dermatology Clinics of Mashhad University of Medical Sciences, Iran

Background: Systemic or topical forms of pentavalent antimony compounds such as meglumine antimoniate (MA) are used as standard treatment for cutaneous leishmaniasis (CL). However, an increasing number of studies demonstrate evidence of treatment failure with these drugs. The objective of this study was to determine the factors associated with systemic MA treatment failure in patients with acute CL. Methods: In this case-control study, patients with urban cutaneous referred to leishmaniasis clinics in Mashhad from 2017 to 2018 were followed up 12 months after the start of treatment and were evaluated for improvement or failure according to the national leishmaniasis protocol. Results: A total of 112 cases of CL (59 men and 53 women) with a mean age of 23.3±21.11 years were studied. The number of patients with clinical improvement was significantly higher in women (P=0.005). Age, body mass index (BMI), occupation and education, the possible infection and living location, past medical, drug and leishmaniasis recurrence history, lesion’s characteristics and ulceration were also significantly different between the two groups of improved and unhealed patients. Conclusion: The results of this study showed that the male sex, age less than 18 years, receiving pentostam, previous treatment history, lymphadenopathy, urban leishmaniasis, duration of illness more than 4 months, having a single lesion especially on the face, BMI less than 18 kg/m2 and a lesion size of more than 3 cm is more common in patients with treatment failure.

Opening the Black Box of Virtual Education: Medical Students’ Learning and Study Strategies

Background: This study explains learning and study strategies in virtual education among medical students during the coronavirus disease 2019 (COVID-19) pandemic and analyzes its relationship with their academic performance. Methods: This cross-sectional study included 298 medical students in preclinical disciplines in the medical curriculum at Mashhad University of Medical Sciences (MUMS), Mashhad, Iran. The data were collected from students who completed the Learning and Study Strategies Inventory (LASSI) within 2 weeks, from the 10th of June 2021 to the 24th of June 2021. This questionnaire measures three variables related to skill, self-regulation, and will. The data were analyzed using independent t-test, correlation, analysis of variance (ANOVA), and Tukey post hoc tests by SPSS software (version 23). Results: The highest and lowest mean scores of the LASSI questionnaire were related to information processing (28.54 ± 4.10) and study aids (22.41 ± 4.07), respectively. Each scale’s possible score range was from 8 to 40 points. The results indicated significant statistical differences between different genders of students in anxiety, attitude, motivation, time management, and self-testing (P &lt; 0.05). In all areas of the LASSI, except self-testing and study aids, the students’ mean scores with a grade point average (GPA) - range of 0 to 20 - higher than 17.5 were significantly higher than those with GPAs lower than 14.85 and those with GPAs between 14.86 to 17.50 (P &lt; 0.05). Conclusions: Since learning and studying strategies contribute to student’s academic success and facilitate the learning process, they can be improved using educational involvement. Embedding learning and study strategies interventions in curriculum design and learning content could help promote academic performance.