Mashhad University Research Articles

P.384: The effect of different factors on the increase transplantation of organ donation from brain dead donors in Mashhad University of Medical Sciences between 2015 and 2023.

P.384: The effect of different factors on the increase transplantation of organ donation from brain dead donors in Mashhad University of Medical Sciences between 2015 and 2023.

Investigation of the Epidemiological Situation of Malta Fever in the Cities under Mashhad University of Medical Sciences during the years 2016 to 2022

Background Management of Malta fever disease requires policy-making and accurate epidemiological statistics and information. Aim The present study was conducted to determine the epidemiological status of Malta fever. Materials and Methods This study is of the secondary data analysis type, which was conducted using the recorded data of patients with brucellosis in the health center of Mashhad City from 2016 to 2022. Data related to 12,714 cases of brucellosis were analyzed using R software and Chi-2, Pearson, and independent t-statistical tests. Results The average age of the patients was 33.18 ± 18.81 years. About 87% of disease cases were related to rural areas and 13% to urban areas. The average annual incidence of the disease was 287 cases per 100,000 population at risk of the disease. The highest incidence rate was in 2020, and the lowest incidence rate was in 2016. The most cases of disease were related to the first three months of the year, and the least cases were related to the last three months of the year. Most cases of the disease were related to housewives, cattle breeders, and farmers. Conclusion The incidence of the disease increased from the beginning of the study to 2020 and decreased from 2020 to the end of the study. Health policymakers should integrate medicine, ecology, and education for the prevention and control of brucellosis. This holistic strategy recognizes the interconnectedness of human, animal, and environmental health, emphasizing the need for collaborative efforts across sectors to address the multifaceted nature of the disease.

The temporal-spatial association of respiratory manifestations and air pollution in children referred to the Emergency Department of Akbar Children’s Hospital, Mashhad, Iran

BackgroundAir pollution causes many respiratory disorders, especially in children and the elderly. These disorders include asthma exacerbations, bronchiolitis, and pneumonia. Research on the association between air pollution and respiratory disorders helps to reevaluate environmental policies in developing countries.MethodsThis descriptive cross-sectional study was conducted on 932 children with respiratory manifestations admitted from December 2017 to December 2019 at the Emergency Department of Akbar Children’s Hospital of Mashhad University of Medical Sciences, Mashhad, Iran. Air pollution indices such as concentration of sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and particulate matter (PM) smaller than 2.5 and 10 μm and other parameters, including the air quality index (AQI), air temperature, and humidity level from 2017 to 2019, were retrieved from Mashhad Environmental Pollution Monitoring Center. Demographic and clinical data of patients were collected from patients’ hospital documents. We used descriptive analytical methods such as central tendency, variability, and frequency distribution to report and analyze demographic and clinical data through tables and diagrams. The association between air pollution indices and respiratory manifestations was examined by the Spearman correlation test. The correlation between the AQI and total hospital admissions and asthma-related hospital admissions was also evaluated by the Spearman correlation test.ResultsHospital admissions due to respiratory manifestations were not associated with the AQI of each month (p-value = 0.794). The concentration of SO2 was correlated with respiratory-related hospital admissions (correlation coefficient = 0.487, p-value = 0.016) but not asthma attacks.ConclusionGenerally, our cross-sectional study showed no statistically considerable association between air pollution and hospital admissions due to respiratory manifestations and asthma attacks in children. Of the air pollution indices, only SO2 concentration was associated with respiratory-related hospital admissions but not asthma attacks.

Comparing the effects of warm footbath and foot reflexology on depression of patients undergoing radiotherapy: A randomized clinical trial

BackgroundCancer diagnosis not only impacts physical health but also mental well-being, often leading to significant stress, fear, and depression among patients.The utilization of CAM has shown a rising trend, influenced by the availability of different modalities offered by healthcare services, sometimes in an ad hoc fashion. This study seeks to examine and compare the respective impacts of warm foot baths and foot reflexology on depression in patients undergoing radiotherapy. MethodsA randomized clinical trial was conducted at Mashhad University of Medical Sciences in Iran in 2019, following CONSORT guidelines. Participants included non-metastatic cancer patients aged 18–60 undergoing a 28-day radiotherapy course. Patients were randomly assigned to receive either warm footbaths or foot reflexology as interventions, performed daily for 20 min over 21 days. The data were analyzed using appropriate statistical tests. ResultsStatistical analysis indicated no significant differences in demographic attributes between the two groups. Both interventions led to a significant reduction in depression scores post-treatment compared to pre-treatment assessments. Foot reflexology showed a greater reduction in depression scores compared to footbaths with warm water. ConclusionsBoth warm footbaths and foot reflexology are effective in alleviating depression in patients undergoing radiotherapy, with foot reflexology showing a greater impact on improving depression levels. The study recommends foot reflexology as a preferred intervention for managing depression in these patients if conditions and facilities permit.

The Etiology of Non-traumatic Loss of Consciousness in Patients Admitted to the Emergency Department

Background: Loss of consciousness (LOC) is one of the most common complaints in the emergency department (ED). This disorder can result from a wide range of clinical conditions, such as structural brain damage, infection, shock, respiratory failure, or psychiatric disorders. Objectives: This study was conducted with the aim of investigating the cause and prognosis of patients with non-traumatic LOC referred to two referral hospitals of Mashhad University. Methods: This prospective cohort study was conducted on 1000 patients presenting with complaints of LOC at Ghaem and Imam Reza hospitals in Mashhad in 2020. All patients with a decreased level of consciousness and a Glasgow Coma Scale (GCS) score of less than 14 were included in the investigation. Results: A total of 1037 patients participated in this study, while 37 patients were excluded. Of the participants, 524 (52.4%) were men and 476 (47.6%) were women. The average age was 59.85 ± 16.06 years, ranging from 18 to 95 years. The relatively common causes of LOC included sepsis (38.3%), stroke (9.2%), heart failure (8%), myocardial infarction (7.3%), meningitis (7.2%), hepatic encephalopathy (6.5%), and toxic alcohol ingestion (5.8%). Deceased patients were older, had higher respiratory rates and temperatures, and had lower blood sugar and blood pressure upon admission. A previous history of stroke, hyperlipidemia, hypertension, and diabetes were associated with death. The relationships between different study outcomes were assessed using multivariate binary logistic regression; a two-sided P < 0.05 was considered significant. Conclusions: Patients presenting to the ED with LOC are more likely to die, making LOC a potential prognostic factor for in-hospital death.

A Comparative Study of Trauma Management Education Using Traditional and Combined Methods with Instructional Videos on the Knowledge and Skills of Medical Students

Background: Improving the knowledge and skills of medical students using new educational methods to deal with trauma can help reduce the mortality and morbidity of injured patients. Objectives: This study aimed to compare the effect of traditional training with combined trauma management training using educational videos on the knowledge and skills of medical interns at Mashhad University in 2021. Methods: This educational intervention study involved two groups during the academic year 2019 - 2020. Eighty-seven medical interns participated over a six-month period and were randomly assigned to either the intervention or control group. Data collection tools included a demographic questionnaire, a clinical skills checklist covering seven skills, and a pretest-posttest MCQ test. Statistical tests used included the independent univariate test and multiple linear regression, analyzed with Stata Ver 17 software. The significance level was set at 0.05. Results: The average knowledge score of the intervention and control groups before the intervention was 12.09 ± 3.06 and 13.00 ± 3.01, respectively. After the intervention, the average knowledge score was 14.84 ± 3.30 in the intervention group and 15 ± 2.98 in the control group. The average skill score of the students before the intervention in the intervention and control groups was 7.00 ± 2.67 and 7.56 ± 2.42, respectively. After the intervention, the skill score was 10.67 ± 3.70 in the intervention group and 8.72 ± 3.46 in the control group. Conclusions: Although the advanced trauma life support course in Iran is relatively new, its positive impact on increasing the skills of medical students suggests a need to review traditional teaching methods. Incorporating new combined methods could enhance the quality of education and improve the skill levels of young doctors.

The effect of using the hip exoskeleton assistive (HEXA) robot compared to conventional physiotherapy on clinical functional outcomes in stroke patients with hemiplegia: a pilot randomized controlled trial

Trial designThis study is a pilot randomized clinical trial aimed to investigate the effect of using Hip Exoskeleton Assistive (HEXA) robot compared to conventional physiotherapy on the quality of walking, disability, and quality of life of stroke patients with hemiplegia.MethodsIn this study, 24 patients were randomly assigned to the intervention group (robotic physiotherapy with HEXA robot), or control group (conventional physiotherapy). In each session, both groups received 30 min of conventional physiotherapy including electrotherapy and conventional exercises, and then the intervention group did gait training for 30 min with the HEXA robot and the control group for 30 min without the HEXA robot. The treatment program was 12 sessions, 3 times a week. Before the 1st and after the 12th sessions, both groups were evaluated for walking quality, disability, and quality of life.ResultsThe results showed that the main effect of time was significant (P < 0.05) in all outcomes and patients in both groups achieved significant improvement in all outcomes after the intervention. The main effect of the group was also significant in the outcomes of 6MWT (P < 0.05) and TUG (P < 0.05), and the intervention group patients experienced more distance and speed in these two tests. This study was approved by the ethics committee of Mashhad University of Medical Sciences (IR.MUMS.FHMPM.REC.1400.079 dated 28th Jan 2022). The trial was registered with the clinical trials site of www.IRCT.ir (IRCT20210730052024N1) on January 28th 2022.ConclusionIt seems that the HEXA robot can effectively improve walking capacity and speed.

Comparison of GAP, R-GAP, and new trauma score (NTS) systems in predicting mortality of traffic accidents that injure hospitals at Mashhad University of medical sciences

BackgroundThere are several trauma scoring systems with varying levels of accuracy and reliability that have been developed to predict and classify mortality in trauma patients in the hospital admission. Considering the importance of the country's emergency organization and the World Health Organization in the category of traffic accidents, we used this information in the study. The objective of this study is to evaluate and compare the predictive power of three scoring systems (R-GAP, GAP, and NTS) on traffic accident injuries. MethodsIn an analytical cross-sectional study, all the data related to the mission of traffic accidents at the pre-hospital emergency management of Mashhad University of Medical Sciences in 2022 were extracted from the automation system, and the outcome of the patients in the hospital was recorded from the integrated hospital system. Then, GAP, R-GAP, and New Trauma Scores (NTS) were calculated, and their results were compared using ROC curve and logistic regression. ResultsIn this study, 47,971 injuries from traffic accidents were evaluated. Their average age was 30.16 ± 10.93 years. R-GAP showed negligible difference than GAP and NTS scores (the area under the curve equals 0.904, 0.935, and 0.884, respectively), and the average scores of R-GAP, GAP, and NTS are equal to 22.45/45 ± 1/9, 22.25 ± 1.5, and 22.49 ± 1.3, respectively. Injury severity based on R-GAP, GAP, and NTS scores was mild in most patients. The effect of these models on the patient outcome based on OR values, R-GAP, GAP, and NTS models showed high values. All analysis was performed in SPSS 26. ConclusionAccording to the study results, it seems that R-GAP, GAP, and NTS, have the highest power to predict death in traffic accident injuries. It is recommended to include these points in the electronic file of the pre-hospital emergency for the injured. Also, the severity and outcome of the patient can be predicted by these scores, which play an important role in the triage of the injured and determining the appropriate treatment center.

The prevalence of SMN gene deletion/duplication in spinal muscular atrophy families referred to neuro-genetic centers of Mashhad, Iran

BackgroundSpinal muscular atrophy (SMA) is a group of motor neuron diseases. In 95% of SMA patients, the telomeric copy of the SMN gene (SMN1) is homozygously deleted. Due to the autosomal recessive pattern of SMA inheritance, individuals with a family history of SMA are at risk of being carriers. A total of 622 individuals from SMA families, including parents, siblings, and first, second, and third-degree relatives, were recruited to the neuro-genetic clinic of Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. SMA cases and suspected carriers were referred to the genetic laboratory. Pregnant women underwent amniocentesis and chorionic villi sampling at 12–14 gestational weeks. RFLP-PCR and real-time PCR were performed for symptomatic and asymptomatic individuals (possible carriers), respectively. RFLP and real-time PCR were performed for amniotic fluid and chorionic villi samples.ResultsThe study enrolled 622 subjects from SMA-affected families, including 159 fetuses and 463 non-fetuses. Two samples were missing. A total of 268 individuals (43.2%) were healthy (wild type), 187 individuals (30.1%) were heterozygous for exon deletion of SMN1, and 143 individuals (23%) were homozygous for exon deletion of SMN1. Four individuals (0.6%) showed three copies of the SMN1 gene.ConclusionThe frequency of carriers with two SMN1 copies on a single chromosome (cis) was estimated at 2.9% (18/622), and the total rate of carriers was approximately 21.8%. Considering the high rate of SMA carriers in this study, genetic counseling and definitive prenatal diagnosis are of utmost importance for reducing the psychosocial burden of the SMA disease among Iranian families.

Pregnancy outcomes in women with Celiac disease in Northeast Iran: a regional retrospective cohort study

PurposeTo investigate the odds and associations of pregnancy outcomes with exposure to biopsy-confirmed celiac disease (CD) in Northeast Iran.MethodsIn this regional retrospective cohort study, pregnancy records of all women with celiac disease who visited Celiac Disease Clinic of Imam-Reza Hospital from 2017 to 2023 (exposed group) and a sample of women without CD (unexposed group) were extracted using the Electronic Health Record of Mashhad University of Medical Sciences called “Sina”. The unexposed group was randomly selected of the database and matched to exposed group on age, location of residence, socioeconomic factors. Our exclusion criteria included age ≥ 45, presence of concomitant disorders, history of non-obstetric uterine surgery, induction of pregnancy through assisted reproductive technology, and any concurrently ongoing pregnancy at the time of study. Pregnancy outcomes evaluated in this study included normal delivery, miscarriage, preterm labor, preeclampsia, and stillbirth. Adjusted odds ratios were calculated using logistic regression adjusted for confounders.ResultsNinety pregnancy records of women with CD and 270 pregnancies of women without CD were included in this study. Low neonatal birthweight (i.e. under 2500 g) had no significant association with CD (aOR = 0.99, 95% CI = 0.92–1.06), as well as postpartum hemorrhage (aOR = 1.12, 95%CI = 0.91–1.38), fetal anomaly (aOR = 0.89, 95%CI = 0.69–1.15), miscarriage (aOR = 1.00, 95%CI = 0.91–1.10), ectopic pregnancy (aOR = 0.94, 95%CI = 0.73–1.20), preterm labor (aOR = 1.00, 95%CI = 0.92–1.10), gestational diabetes mellitus (aOR = 1.07, 95%CI = 0.98–1.16), gestational hypertension (aOR = 0.99, 95%CI = 0.89–1.11), and gestation hypothyroidism (aOR = 0.95, 95%CI = 0.82–1.11). However, we found significantly lower odds of preeclampsia in pregnancies affected by CD (aOR = 0.83, 95%CI = 0.69–0.99).ConclusionCeliac disease was not associated with increased odds of low neonatal birthweight, postpartum hemorrhage, fetal anomaly, miscarriage, ectopic pregnancy, preterm labor, gestational diabetes mellitus, gestational hypertension and gestational hypothyroidism. Preeclampsia had significantly lower odds in pregnancies affected with CD.

Changes in root and nutrient uptake of chickpea affected by organic fertilizers and inoculation with arbuscular mycorrhizal fungi and Rhizobium

AbstractAlthough humans have studied biological nitrogen (N) fixation for nearly two centuries, our understanding of how legumes–microbiome interactions impact agroecosystem function is still evolving. To understand the effects of organic fertilizers and dual inoculation with Rhizobium and arbuscular mycorrhizal fungi (AMF) on root activity, N fixation and nutrient uptake of chickpea (Cicer arietinum), a two‐year greenhouse study was conducted in 2020–2021 at the research station of Ferdowsi University of Mashhad, Iran. The experiment design was a randomized complete blocks in the factorial arrangement with three replications. The first factor consisted of two seedbeds including S1 (field soil) and S2 (soil + humic acid + 40 ton ha−1 cattle manure). The second factor included inoculation with Rhizobium alone, mycorrhiza alone, both Rhizobium and mycorrhiza and non‐inoculated treatment. The results showed that the application of organic fertilizers increased the number of nodules, nodule weight, AMF colonization, leaf N content, leaf P content, root volume, root biomass and N uptake of chickpea, significantly. Also, the effect of seed inoculation was significant on all studied parameters where the highest root biomass (2 g), root volume (3.6 cm3) and leaf phosphorus (0.54%) were obtained in co‐inoculated treatments. There was no significant difference between the effect of single inoculation of Rhizobium and dual inoculation of mycorrhiza and Rhizobium on nodule number, nodule weight, leaf N and N uptake of chickpea. Generally, rhizobia and AMF can benefit nutrient uptake and root activity of chickpea, potentially leading to higher crop production.

Expression of Concern: Garlic (Allium sativum) and mushroom (Agaricus bisporus) powder: Investigation of performance, immune organs and humoural and cellular immune response in broilers.

H. Noruzi and F. Aziz-Aliabadi, "Garlic (Allium Sativum) and Mushroom (Agaricus Bisporus) Powder: Investigation of Performance, Immune Organs and Humoural and Cellular Immune Response in Broilers," Veterinary Medicine and Science 10, no. 2 (2024): e31367, https://doi.org/10.1002/vms3.1367. This Expression of Concern is for the above article, published online on 15 February 2024 in Wiley Online Library (wileyonlinelibrary.com), and has been published by agreement between the journal Editor-in-Chief, Gayle Hallowell and John Wiley & Sons Ltd. The Expression of Concern has been agreed due to concerns raised by a third party regarding the availability of an ethical approval. The authors have received Higher Degree by Research (HDR) committee approval and a bioethical course certificate. The authors and their institute confirmed that this was equivalent to an ethical approval from the Ferdowsi University of Mashhad at the time when the research was conducted but could not provide the HDR committee approval documentation. Since this does not fully comply with the ethics policy of the journal, as noted on the journal's author guidelines page, the journal has decided to issue an Expression of Concern to inform and alert the readers.

Prevalence, characteristics, and risk factors of non-alcoholic fatty liver disease in North East of Iran: a population-based study

BackgroundNonalcoholic fatty liver disease (NAFLD) is a common dietary disorder caused by fatty changes in the liver parenchyma and hepatocytes without alcohol consumption. The present study aimed to investigate the prevalence, characteristics, and risk factors of NAFLD in the Mashhad Persian Cohort Study population.MethodThe present population-based cross-sectional study included all PERSIAN Organizational Cohort study in Mashhad University of Medical Sciences (POCM), Mashhad, Iran by census sampling method. Eligible participants were divided into two groups due to their NAFLD condition (NAFLD positive or NAFLD negative). All enrolled participants were evaluated based on their clinical aspects, anthropometric measures, laboratory tests, and ultrasound features. Statistical analysis was conducted using SPSS software version 16 (SPSS Inc., Chicago, USA –version 16). A P-value less than 0.05 was considered as the significance level.ResultsA total of 1198 individuals were included in the study, of which 638 (53.3%) were male and the rest were female. The mean age of the participants was 46.89 ± 8.98 years. A total of 246 patients (20.53%) were NAFLD positive, of which 122 (49.59%) were in grade 1, 112 (45.52%) were in grade 2, and 12 (4.87%) were in grade 3. The prevalence of fatty liver was significantly higher in males than in females (p < 0.001). There were significant differences between NAFLD positive and NAFLD negative participants in terms of having a history of hypertension (P = 0.044), body mass index (P < 0.001), body fat percentage (P = 0.001), waist circumference (P < 0.001), liver craniocaudal length (P = 0.012), fasting blood sugar (FBS) (P = 0.047), aspartate aminotransferase (AST) (P = 0.007), and alanine aminotransferase (ALT) (P = 0.001). Further analysis revealed a strong significant association between BMI, previous history of hypertension, higher levels of serum ALT, and NAFLD (P < 0.05).ConclusionIt can be concluded that ultrasound findings accompanied by laboratory AST and ALT level enzymes could be a cost-benefit approach for NAFLD early diagnosis. The craniocaudal size of the liver could be a beneficent marker for estimating the severity of the disease; however, more studies are recommended to evaluate this variable for future practice against the issue.

The Impact of Mindfulness-Based Stress Reduction on Workplace Well-Being and Empathy Levels Among Nurses Working in Psychiatric Wards in Iran: A Controlled Trial

Workplace stressors can negatively impact the well-being and nurse-patient empathy among nurses working in psychiatric wards. This controlled trial investigated the impact of mindfulness-based stress reduction (MBSR) on workplace well-being and empathy levels among these nurses. In this study, 80 clinical nurses from the psychiatric wards of Ibn-e-Sina psychiatric hospital, affiliated with Mashhad University of Medical Sciences, Mashhad, Iran, completed a demographics form, the Eudaimonic Workplace Well-being Scale, and the Clinical Interpersonal Reactivity Index. Subsequently, participants were allocated to either the MBSR group (n = 40) or the control group (n = 40). The MBSR group received an eight-week program consisting of weekly two-hour sessions based on the MBSR principles developed by Kabat-Zinn. The participants in both the MBSR and control groups completed the data collection tools immediately after the intervention and one month later. The mean scores of workplace well-being and its intrapersonal dimension increased significantly more in the MBSR group than in the control group over time. Similarly, empathy and its perspective-taking subscale improved significantly more in the MBSR group than in the control group over time. The MBSR intervention can be a beneficial tool to improve workplace well-being and nurse-patient empathy levels among nurses working in psychiatric wards.

Effect of Induced Myopia on the Vestibulo-ocular Reflex Evaluated by Ocular Vestibular Evoked Myogenic Potential.

The possible effects of refractive errors on vestibulo-ocular reflex (VOR) has been a conflicting issue. The aim of this study was to evaluate the effects of induced myopia on VOR using the ocular Vestibular Evoked Myogenic Potential (oVEMP). In this cross-sectional quasi-experimental study, 35 emmetropic and normal subjects with the mean age of 23.89 3.93 (range, 20-40 years) without any ocular, nervous system, and vestibular disorders, underwent the oVEMP test in the comprehensive rehabilitation center of Mashhad University of Medical Sciences. The oVEMP was performed under five different conditions of testing binocularly, monocularly, and when myopia was induced with the use of spherical lenses of +1.00, +3.00, and +5.00 diopters, respectively. There were 2 to 5 min of rest with closed eyes after each condition to avoid adaptation, fatigue, and any other sources of bias. Mean latencies of oVEMP waves (N1 and P1) and amplitudes of N1-P1 complex were measured. There was no significant difference between the right and left sides (P 0.05). The induced myopia significantly increased the N1 and P1 latencies using lenses of +1.00, +3.00, and +5.00 diopters but the amplitudes of N1-P1 complex were not influenced by the different amounts of induced myopia. There was no significant difference among the different conditions of induced myopia either (P 0.05). Induced myopia could affect the VOR due to prolonging the latencies of oVEMP waves. However, the amplitudes were not affected and the effects of multiple degrees of induced myopia were not significantly different.

Fuzzy Interpretive Structural Modeling regarding Factors Affecting Employees’ Experience Management in Mashhad University of Medical Sciences

Background: Employees are considered internal customers of the organization, and today, employee’s experience has become a prominent topic in the field of human resources. This study aims to model the factors affecting employees’ experience management in Mashhad University of Medical Sciences using fuzzy interpretive structural modeling. Methods: This applied study was descriptive-analytical conducted in 2023. 10 faculty members, managers, and staff of Mashhad University of Medical Sciences were selected using a purposive sampling method. Interpretive Structural Modeling (ISM) questionnaire consisting of a 7x7 matrix was then given to them, and they were asked to find the contextual relationship between the variables based on the pairwise comparison scale. In the analysis section, fuzzy interpretive structural modeling and MICMAC analysis were used to structure and analyze the status of the factors. Results: 7 organized themes (organizational, physical environment, technological, job, managerial, cultural, and individual factors) were identified for employees’ experience in Mashhad University of Medical Sciences. Findings showed that cultural and managerial factors are at the lowest level of the structure and have more influence and less dependence. In other words, these are the most influential factors on employees’ experience. Job, technology, and organizational factors were placed at the second level. In contrast, individual and physical factors were at the highest level of the structure and had less influence and more dependence on other factors. Conclusion: The findings indicate that Mashhad University of Medical Sciences should focus on strengthening and improving cultural and managerial factors to improve employees’ experience. Additionally, attention to job, technology, and organizational factors, along with addressing individual employee’s needs and providing a favorable physical environment, are essential for employees’ effective experience management at the university. This study, by providing a comprehensive model of factors influencing employees’ experience, assists universities and other organizations in gaining a deeper understanding of this concept and developing effective strategies for its enhancement.

Advancing Healthcare Infrastructure: The Features of Iran’s Sina Electronic Health Record System

Background and aims: The Sina Electronic Health Record (SinaEHR) system was developed to support primary care delivery across Iran by enabling chronic disease monitoring, infectious disease surveillance, health policy decision-making, and quality improvement initiatives. Methods: The SinaEHR system was implemented by Mashhad University of Medical Sciences which contains health records of over 5 million people across various regions of Iran. It utilizes the International Classification of Diseases (ICD) version 10, integrating laboratory results through a laboratory information system to facilitate real-time clinical decision-making. Results: Widespread implementation of the SinaEHR system has established an invaluable healthcare infrastructure resource for the improvement of primary care services across Iran. Strict security and confidentiality measures are enforced to protect sensitive patient information. Conclusion: The SinaEHR system significantly advances Iran’s healthcare infrastructure by providing a comprehensive electronic health record platform to improve healthcare delivery and promote evidence-based decision-making.

Comparison of the effects of burn assessment mission game with feedback lecture on nursing students’ knowledge and skills in the burn patients’ assessment: a randomized clinical trial

BackgroundLearning of burn patient assessment is very important, but heart-breaking for nursing students. This study aimed to compare the effects of feedback lecture method with a serious game (BAM Game) on nursing students’ knowledge and skills in the assessment of burn patients.MethodIn this randomized controlled clinical trial, 42 nursing students in their 5th semester at Mashhad University of Medical Sciences School of Nursing and Midwifery, were randomly assigned to intervention (BAM game, available for two weeks) and control (feedback lecture method presented in two 90-minute sessions) groups. Two weeks after the intervention, all students were evaluated for their knowledge (using knowledge assessment test) and skills (using an Objective Structured Clinical Examination). Statistical analysis involved independent t-test, Fisher’s exact test, analysis of covariance (ANCOVA), and univariable and multivariable ordinal logistic regression models.ResultsFollowing the intervention, the skill scores were 16.4 (SD 2.2) for the intervention group and 11.8 (SD 3.8) for the control group. Similarly, the knowledge scores were 17.4 (SD 2.2) for the intervention group and 14.7 (SD 2.6) for the control group. Both differences were statistically significant (P < .001). These differences remained significant even after adjusting for various factors such as age, gender, marital status, residence, university entrance exam rank, and annual GPA (P < .05). Furthermore, the BAM game group showed significantly higher skills rank than the feedback lecture group across most stations (eight of ten) (P < .05) in the univariable analysis. Multivariable analysis also revealed a significantly higher skills score across most stations even after adjusting for the mentioned factors (P < .05). These results suggest that the BAM game group had higher skills scores over a range of 1.5 to 3.9 compared to the feedback lecture group.ConclusionsThis study demonstrated that nursing students who participated in the BAM game group exhibited superior performance in knowledge acquisition and skill development, compared to those in the control group. These results underscore a significant enhancement in educational outcomes for students involved with the BAM game, confirming its utility as a potent and effective pedagogical instrument within the realm of nursing education.Trial registrationIranian Registry of Clinical Trials: IRCT20220410054483N1, Registration date: 18/04/2022.

Machine learning techniques to identify risk factors of breast cancer among women in Mashhad, Iran.

Low survival rates of breast cancer in developing countries are mainly due to the lack of early detection plans and adequate diagnosis and treatment facilities. This study aimed to apply machine learning techniques to recognize the most important breast cancer risk factors. This case-control study included women aged 17-75 years who were referred to medical centers affiliated with Mashhad University of Medical Science between March 21, 2015, and March 19, 2016. The study had two datasets: one with 516 samples (258 cases and 258 controls) and another with 606 samples (303 cases and 303 controls). Written informed consent has been observed. Decision Tree (DT), Random Forest (RF), Logistic Regression (LR), and Principal Component Analysis (PCA) were applied using R studio software. Regarding the DT and RF, the most important features that impact breast cancer were family cancer, individual history of breast cancer, biopsy sampling, rarely consumption of a dairy, fruit, and vegetable meal, while in PCA and LR these features including family cancer, pregnancy number, pregnancy tendency, abortion, first menstruation, the age of first childbirth and childbirth number. Machine learning algorithms can be used to extract the most important factors in the diagnosis of breast cancer in developing countries such as Iran.

Prevalence and determinants of suspected developmental delays among 12-month-old children in northeast of Iran: a large-scale population-based study

BackgroundEarly identification of suspected developmental delays (SDDs) is crucial for planning early interventions. This study aimed to determine the prevalence of SDDs and the associated determinants in children aged 12...