Medical Sciences University Research Articles

The Association Between Mental Health Literacy of Parents and Referral of Children and Adolescents to Mental Health Service Centers

Background: Mental health literacy refers to an individual’s knowledge and beliefs about mental health, which can aid in the detection, management, and prevention of mental illnesses. Prompt diagnosis of mental disorders is crucial for timely intervention and treatment. This study aims to investigate the mental health literacy and help-seeking behaviors of parents with children and adolescents under the age of 18. Methods: In this descriptive-analytical study, a cross-sectional design was utilized, and a surveying method was employed. A total of 134 parents of children and adolescents under 18, who were referred to the mental health service centers at Iran University of Medical Sciences and private psychiatric clinics in 2019 and 2020, participated in the study through convenient sampling. Two psychiatrists evaluated the psychiatric disorders of the children, and the parents completed the General Health Questionnaire-28 (GHQ-28) and the Mental Health Literacy Questionnaire. The collected data were analyzed using SPSS version 24. Results: The results of the one-way analysis of variance indicated that the total score of mental health literacy significantly differed among groups with varying levels of maternal education (p=0.001). Conclusion: This study underscores the impact of maternal education on mental health literacy among parents. Notably, parents with higher levels of education exhibited greater mental health literacy. It is essential to consider these findings in developing targeted interventions to improve mental health literacy among parents from diverse educational backgrounds. Further research should explore effective strategies for increasing awareness and knowledge about mental health in communities with varying levels of education.

The Psychometric Properties of the Persian Version of the Relaxation, Meditation, and Mindfulness Experiences Questionnaire Utilized Among Patients with Cancer: A Cross-Sectional Study in Iran.

Mindfulness is increasingly recognized as an effective strategy for managing chronic illnesses and improving mental well-being in cancer patients. This study sought to adapt and validate a Persian version of Relaxation, Meditation, and Mindfulness Experiences Tracker Questionnaire trait month 3.1″ (P-RMMtm 3.1) for use with Iranian cancer patients. This cross-sectional study was conducted in several hospitals affiliated with Kerman University of Medical Sciences in southeastern Iran. Validity and reliability tests were administered between March and December 2023. Results showed strong psychometric properties, with a six-factor solution explaining 72.387% of the variance. The identified factors were mindful transcendence, mindful relaxation, mindful emotion, mindful focus/awareness, mindful quiet, and mindful action. Confirmatory factor analysis indices were generally satisfactory (χ2/d.f. = 2.253, RMSEA = 0.079, GFI = 0.833, CFI = 0.923, and IFI = 0.924). Cronbach's alpha values for the RMMtm 3.1 factors ranged from 0.802 to 0.89. In conclusion, the Persian version of RMMtm 3.1 is a reliable instrument for assessing relaxation, meditation, and mindfulness experiences in Iranian cancer patients. Its concise format makes it suitable for future research with this population.

Anthropometric indices growth references (length, Weight and Head Circumferences) of children aged 0–24 months in North-East of Iran by GAMLSS

BackgroundGrowth references play a crucial role in the screening, evaluation, and surveillance of children, aiding in the early identification of the requirement for diverse growth-promoting interventions. Variations in human growth across distinct ethnic cohorts arise from genetic disparities, lifestyle variances, nutritional diversity, and diverse social and environmental contexts. Consequently, the selection of growth references markedly influences the prevalence of developmental disorders and nutritional imbalances in children. The study aims to assess the growth percentile of children in the north-east of Iran and establish population-specific reference charts for length, weight, and head circumference spanning from birth to 24 months.MethodsThis cross-sectional population-based research conducted in the north-east of Iran, from 2016 to 2023. The Data extracted from the electronic health records of Mashhad University of Medical Sciences. All apparently healthy children aged from birth to 24 months who were measured at least once by health staff at the ages of birth,1,2,4,6,7,9,12,15,18,24 months were included. The target population of the study were 479,089 children (96.21%), encompassing 233,565 girls (48.75%) and 245,524 boys (51.25%). Gender-specific percentile curves for length, weight, and head circumference concerning age, as well as weight concerning length, were derived using the GAMLSS approach.ResultsFrom the anthropometric information of 479,089 children (245,524 boys and 233,565 girls), growth charts were constructed. In comparison to the standard WHO chart, Iranian neonates displayed lower weight across all percentiles during the first month after birth, exhibited decreased head circumference at the 3rd percentile, and boys showed reduced length across all percentiles. After this age, Iranian children demonstrated increased weight, length, and head circumference.ConclusionsThis research introduces the inaugural large-scale endeavor for indigenous reference charts. Through the noted distinctions from the international reference, the utilization of this novel resource offers the potential to enhance the surveillance of children’s growth within the area. Moreover, by accurately assessing growth anomalies such as underweight, stunting, and wasting, it expands the domain of impactful policies in this sphere. Simultaneously, it enables the exploration of the secular trend of children’s growth in the forthcoming years.

Parents’ perception of challenges of caring of children with Epidermolysis bullosa: a qualitative study

ObjectiveThe present study was investigate parents’ experiences of children with Epidermolysis bullosa. So, this descriptive phenomenological qualitative study was conducted on 17 parents of children with EB from five hospitals affiliated with the University of Medical Sciences, west of Iran. Data was collected through semi-structured interviews. COLAIZZI’s method was also used to analyze the data.ResultsThree main themes were extracted in this study: invasion of psychological crisis, alive but no living, and comprehensive support, including 10 categories. The parents of these children are the target of psychological crises that severely reduce their quality of life. In this regard, they need extensive support to improve their living conditions. Therefore, it is suggested to provide cultural and institutional contexts in which all components of the children’s dignity are emphasized.

A Quality Gap Analysis of Educational Services among Iranian Medical Students Using the SERVQUAL Method

Introduction The quality gap in educational services among the students of Shahroud University of Medical Sciences in the year 2023 was evaluated using the SERVQUAL method. Methods In this cross-sectional study, 334 participants were selected through a multi-stage random sampling method, and 316 responded to the standard SERVQUAL questionnaire. Results The majority, 181 students [57.3%], had a strong interest in their field of study. The mean scores for the current status [perceptions] and the optimal status [expectations] of educational service quality were 3.27±0.66 and 4.41±0.63, respectively. There was a significant difference between the current and optimal status across all SERVQUAL dimensions. The largest gaps were in the dimensions of Responsiveness, Empathy, and Tangibles, followed by Assurance and Reliability. The comparison of mean scores for the educational service quality gap across variables, such as gender, academic semester, and interest in the field of study, indicated significant differences among these groups. Conclusion By assessing the status of educational services from the student's perspective, this study aims to provide valuable information to policymakers and university senior management to enhance the educational service system. Educational and incentive strategies, along with careful monitoring and planning according to different dimensions of service quality, can be effective in improving the system.

Enhancing academic performance: a shadow curriculum approach for medical and dental student preparation in basic sciences and pre-internship comprehensive exams

BackgroundThe shadow curriculum is an emerging concept in curriculum studies that has not yet garnered significant attention in medical education. It includes programs and activities outside formal education to improve students’ academic performance in the formal educational system.ObjectiveIn this study, we designed and developed an online course based on the shadow curriculum and evaluated its effect on students’ learning and academic performance.MethodsThis study represents a form of developmental research, with the study population comprising medical and dental students from universities of medical sciences in Iran. The course was conducted at the Smart University of Medical Sciences, following the ADDIE instructional design approach in three phases. The initial two phases involved designing and implementing the program according to the students’ needs and requirements. In the third phase, we evaluated the program using the Kirkpatrick model. In the first level evaluation, the reaction of 70 students in the course was investigated. To assess the impact of the course, pre and post-tests were administered to 30 students. Finally, the effect of the course on students’ success in the comprehensive exams for basic medical sciences, dentistry, and pre-internship was analyzed by examining the passing and failing statuses of 83 and 57 students who participated in the September 2023 and February 2024 exams.ResultsThe results indicated that the students responded positively to the program. The analysis of pre-test and post-test scores showed a significant improvement in the students’ academic performance across all the subjects presented in the course, including basic medical sciences, dentistry, and pre-internship (p < 0.01, p < 0.05). Overall, the descriptive analysis of the program’s influence on the students’ success in comprehensive exams in basic medical sciences, dentistry, and pre-internship showed that 70 out of 83 participating students passed the September 2023 comprehensive exams. Additionally, 51 out of 57 participants completed the comprehensive exams in February 2024.ConclusionsIn an era where the shadow curriculum is reshaping learning and the educational landscape, the findings presented in this study indicate that this type of curriculum should be given special attention in the theoretical, research, and practical dimensions of the field of medical education.

A dynamic management model for sustainable drug supply chain in hospital pharmacies in Iran.

Sustainable supply chain management encompasses the strategic coordination and control of material, information, and financial flows, as well as the collaborative efforts among the entities engaged in the medicinal supply chain. This research proposes a dynamic and sustainable supply chain management model tailored explicitly for the inpatient pharmacies of Medical Centers and Hospitals affiliated with Iran University of Medical Sciences. This is a quantitative study in terms of research objective and a qualitative study based on the stages in the conceptual development of the model. Therefore, the current study can be considered a mixed-methods approach. After identifying the key factors influencing the sustainability of the medicine supply chain, we conducted a dynamic analysis of the problem using system dynamics methodology. In order to simulate the system's behavior over 24 months, we utilized a combination of existing documentary information and expert opinions. The developed model was implemented using Vensim PLE software, allowing us to simulate and analyze the impact of various policies on the system. Medicine disposal exhibited an upward trend, particularly during the second 12-month period. Conversely, the trend of medicine expirations remained relatively stable in the initial months but showed an upward trajectory after that. The cost associated with disposed medicine experienced a consistent increase, with a higher rate observed during the second 12-month period. In contrast, sales of low-consumable medicine experienced a significant initial surge followed by a slower growth rate. Finally, the pharmacy's profit demonstrated an overall increasing trend, although the rate of increase was higher during the first 12 months. Among the various scenarios considered, namely "increasing the adequacy of human resources," "increasing the speed of response," and "utilizing pharmacists in the drug prescribing team," it was found that these interventions had a substantial effect on both enhancing the pharmacy's profit and reducing medication waste. Therefore, these scenarios were identified as having the most significant impact. The proposed model can serve as a valuable tool for forecasting and informing policy-making, providing insights into addressing the challenges associated with the sustainable drug supply chain in hospital pharmacies.

The impact of perfectionism on suicidal ideation among medical residents in Iran: the mediating role of psychological distress.

Among medical residents, suicide is the second most prevalent cause of mortality. In Iran, the suicide of medical residents has become one of the most important challenges. This study aimed to investigate the mediating role of psychological distress in the relationship between perfectionism and suicidal ideation among medical residents in Iran. This research was a descriptive-correlational study based on structural equation modeling. The statistical population of the present research included all the residents in Shahid Beheshti University of Medical Sciences (SBMU) in 2023, of whom 277 people were selected as a sample using the available sampling method. The Beck Scale for Suicidal Ideation (BSSI-1997), the Tehran Multidimensional Perfectionism Scale (TMPS-2007) and the Depression, Anxiety and Stress Scale (DASS-21-1995) were used to collect the data. Data was analyzed using structural equation modeling with SPSS and Amos software version 22. Out of 277 participants, 30% (N = 83) were male and 70% (N = 194) were female. The findings showed that the research model had goodness of fit. There was a significant relationship between perfectionism and psychological distress (β = 0.76, P < 0/001) and between psychological distress and suicidal thoughts (β = 0.66, P < 0/001). However, there was no direct relationship between perfectionism and suicidal ideation (P > 0.01), but perfectionism played a role in residents' suicidal ideation through psychological distress (β = 0.50, P < 0/001). In other words, perfectionism led to suicidal ideation by increasing the psychological distress of the residents. In addition, perfectionism and psychological distress were able to explain 42% of the variances of suicidal ideation (R2 = 0/42). The results highlighted the crucial role of psychological distress in suicidal ideation of medical residents. Accordingly, substantial support from health-sector managers and policymakers is essential to meet the requirements of medical residents.

Investigating the Status of Mothers and Newborns' Access to Safe and Quality Care from the Perspective of Midwifery Personnel Working in Government Hospitals: A Cross-Sectional Study

Aim The present study was conducted to determine the status of mothers’ and newborns' access to safe and quality care from the perspective of midwifery personnel. Background Safe and quality care is recognized as a principle in providing healthcare to mothers and newborns. Methods This was a cross-sectional study conducted through random sampling on 270 midwifery personnel working in government hospitals of Mashhad University of Medical Sciences in 2023. The data were collected using a questionnaire created by a researcher and analyzed using descriptive and inferential statistical tests in SPSS-22 statistical software at a significance level of less than 0.05. Results The average age of the participants was 34.41 ± 7.93 years. The results showed the status of mothers' and newborns' access to safe and quality care to be in the average range of 38.30 ± 6.67. The midwifery personnel have demonstrated adherence to scientific and specialized protocols regarding the way for childbirth and how to care for mothers and newborns to be the most frequent (51.5%), while the provision of emotional and psychological support to women who have given birth with newborn problems to be the least frequent (8.5%). Conclusion Midwifery personnel believe that the safe and quality care provided to mothers and newborns is adequate. Midwifery personnel are committed to following evidence-based practices, but need additional training and resources to support women in need emotionally and psychologically. This is particularly concerning given the potential impact of maternal mental health on both the mother and the newborn.

New experience of implementing patient e-referral in the Iranian health system: a qualitative study.

Implementing an electronic system of service categorization and a referral system in healthcare is a strategic approach to improving overall health outcomes and optimizing resource use. This study aimed to investigate challenges experienced with the electronic patient referral system in Mashhad University of Medical Sciences (MUMS). In this qualitative research, data were collected using semi-structured interviews. Participants included physicians, experts, and stakeholders working in the Family Physician Program and the referral system, selected through purposive sampling. The data were analyzed using a thematic analysis framework, in which a thematic framework was developed, and key themes were identified. Data analysis was performed using Atlas.ti8 software. According to the interviewees, the challenges of digitizing the referral system can be categorized into three main themes: structure, process, and outcomes. These themes include ten sub-themes, such as challenges related to Internet Infrastructure and the Sina System, Patients' Choice of Desired Specialists, Receiving Payment for Services, Appointment Scheduling, Interdepartmental Coordination, Recording Definitive Diagnosis Codes Before Referral, False Referrals, Dissatisfaction, Feedbacks, and Health Indicators. To improve the e-referral in Iran's health system, several strategies can be implemented. These include sustainable resource allocation, designing consequence mechanisms within the referral system to motivate collaboration and improving appointment scheduling systems. Furthermore, addressing these challenges requires a collaborative approach involving healthcare providers, IT professionals, and patient representatives to ensure that the system is efficient, user-friendly, and effectively meets the needs of all parties involved. Not paying enough attention to these issues cause reform failure while solving them requires multi-dimensional, systematic and coordinated interventions with a deep understanding of the obstacles and challenges. Disregarding these factors may result in apathy over time, ultimately impacting both the quantity and, more importantly, the quality of services.

Relationship Between Job Satisfaction and Various Factors of the Job Demand-Control-Support Model Among Iranian Nurses: Structural Equation Modeling Modeling Study

Background: Stress at work is a significant occupational risk that diminishes performance and job satisfaction. Objectives: This study aimed to assess the relationship between job satisfaction and various factors of the job demand-control-support (JDCS) model among 840 nurses working in public hospitals affiliated with Mazandaran University of Medical Sciences, Iran. Methods: The Job Content Questionnaire and the Minnesota Satisfaction Questionnaire were utilized to assess various aspects of the JDCS model and job satisfaction, respectively. The structural equation model (SEM) was employed to explore the relationships between variables. A significance level of P &lt; 0.05 was considered. Results: The findings revealed that the highest average scores were for skill discretion (30.92 ± 10.34) and decision authority (30.82 ± 6.91), while the lowest mean scores were related to social support (21.37 ± 7.60) and job insecurity (7.78 ± 1.49), indicating high levels of job stress among participants. The study identified direct and positive relationships between demand and control (r = 0.58, P = 0.021), control and support (r = 0.51, P = 0.032), and demand and support (r = 0.87, P = 0.009). Social support had a positive influence on job satisfaction (standardized = 0.75, P = 0.008) and a negative effect on job insecurity (standardized = -0.56, P = 0.009). Control negatively impacted job insecurity (standardized = -0.1, P = 0.02) and positively affected job satisfaction (standardized = 0.012, P = 0.012). Additionally, "job insecurity" moderated the effect of "control" on "job satisfaction" (standardized = 0.02, P = 0.005). Conclusions: Higher job demands and control contribute to increased dissatisfaction and insecurity among nurses. Conversely, nurses who receive more social support feel more secure and satisfied. To enhance job satisfaction and reduce insecurity, efforts should focus on increasing support and managing control and demand, as these factors significantly influence job performance and satisfaction.

Blood Donation awareness and implementation among Undergraduate Medical Students of Sindh, Pakistan.

Objective: To determine the knowledge and practice of blood donation among undergraduate students.Methodology: This descriptive study was conducted at the Liaquat University of Medical and Health Sciences, Jamshoro Pakistan from September 2021 to December 2021. A convenient sampling technique was applied for collection of sample comprised of undergraduate medical students of all disciplines and batches. All the participants were interviewed by using a validated questionnaire. The analysis was carried out with SPSS 22.0.Results: Out of 374 respondents, 324 (86.6%) complied with the inclusion criteria. All 324 (86.6%) were non-blood donors; although majority is familiar with necessity of blood donation for the community. Among total population115 (35.5%) had no specific reason as their primary barrier towards blood donation, followed by 96 (29.6%) health-related issues. However, the most common motivation for 156 (48.1%) was approved certifications.Conclusion: Medical students were revealed to have an excellent primary understanding of blood donation. It is necessary to organize blood donation camps on university campuses and increase help calls. Keywords: Blood donation; KAP Study; Knowledge; Practice; Undergraduate students.

Comparative Study of Nursing Informatics Competencies in Educators, Students, and Clinical Nurses

Background: Nursing informatics refers to a specialty in nursing that influences the learning environment, interprofessional collaboration, patient care, strategic planning, and patient satisfaction. Nursing informatics competency has been identified as a critical factor influencing the quality-of-care services. Nurses must integrate informatics into clinical decision-making processes. Objectives: This study aims to conduct a comparative analysis of nursing informatics competency among nursing educators, students, and clinical nurses. Methods: This descriptive-analytical study was conducted in 2023 at the nursing faculty of Abadan University of Medical Sciences. The study sample included 670 participants: Nursing educators, students, and clinical nurses. Nursing educators and students were selected through a census method, while clinical nurses were chosen via random sampling. Data were collected using the Nursing Informatics Competency Assessment Tool (NICAT) and demographic questionnaires. The NICAT assesses informatics competency across 30 components, categorized into three dimensions: Computer literacy, informatics literacy, and information management skills. Data were analyzed using SPSS version 26 software. Results: The average nursing informatics competency score among the participants was 105.58, falling within the competent range. Nursing educators achieved the highest competency score (110.21), followed by clinical nurses (106.24) and students (103.78). The highest score was observed in informatics literacy (45.84), while the lowest score was seen in information management skills (24.59). Information management skills, computer literacy, and informatics literacy were significantly correlated with the overall nursing informatics competency score (P &lt; 0.001). Conclusions: Nursing educators, students, and clinical nurses were found to be competent in nursing informatics. However, due to technological advancements and the growing use of electronic health services, there is a need to enhance nurses' competencies in all dimensions, particularly in information management skills. It is recommended to revise the curriculum and provide the necessary infrastructure and equipment to integrate informatics into nursing education and empower nurses.

Investigating the Challenges of Infertility Treatment Development in Centers of Iran University of Medical Sciences and Health Services

Investigating the Challenges of Infertility Treatment Development in Centers of Iran University of Medical Sciences and Health Services

Evaluating the accuracy of International Classification of Disease Perinatal Mortality (ICD-PM) codes assigned on death certificates before and after expert panel review: a mixed methods observational study

IntroductionThe present study was conducted with the aim of evaluating the accuracy of International Classification of Disease Perinatal Mortality (ICD-PM) codes assigned on death certificates before and after an expert panel review.MethodThe present study was a mixed methods observational study conducted at Umm al-Benin Hospital, the sole specialized obstetrics and gynecology center affiliated with Mashhad University of Medical Sciences. The study comprised three distinct stages: (1) Collecting primary ICD-PM codes assigned to perinatal death certificates, along with other relevant information, from October 2021 to March 2022; (2) Examining the circumstances of each perinatal death case and re-identifying the causes of death through a consensus process involving a panel of experts comprising pediatricians, obstetrics and gynecology specialists, and nursing and midwifery experts; presenting the new ICD-PM code; (3) Comparing the ICD-PM codes assigned to perinatal death certificates before and after the expert panel’s evaluation.ResultDuring the study period, a total of seven specialized panels were conducted to examine perinatal deaths. Out of the 71 cases, 41 were carefully reviewed by experts. These cases included 32 stillbirths and nine neonatal deaths. The examination process followed specific inclusion and exclusion criteria. The findings revealed that there were no significant changes in the causes of neonatal deaths. However, it was notable that 80% of the previously unknown causes of stillbirths were successfully identified. Notably, the occurrence of stillbirths increased by 78% due to maternal causes and conditions.ConclusionConvening panels of experts to discuss the causes of perinatal deaths can effectively reduce the percentage of unknown causes, as classified by ICD-PM. This approach also guarantees the availability of essential data for implementing effective interventions to decrease preventable perinatal deaths.

Serum melatonin levels and in a sample of Iranian patients with migraine

Migraine, a complex disorder, is characterized by recurrent headache episodes. The production of melatonin in the pineal gland, which is crucial for controlling circadian rhythms and sleep–wake cycles, is altered in various conditions, including neurological disorders such as migraine. Recent studies underscore the significance of serum melatonin levels in patients with chronic and episodic migraine, the focus of this study. This case‒control study, conducted from September 2017 to June 2020 in Tehran, Iran, selected potential participants aged 18–65 years from a headache clinic at Sina Hospital (affiliated with Tehran University of Medical Sciences). Both episodic migraine and chronic migraine were diagnosed following the diagnostic criteria in the International Classification of Headache Disorders’ third edition. Melatonin levels were measured according to the instructions of the ELISA kits. There were significant differences in the frequency of headache days and the duration of abortive medication usage between the two groups (P value < 0.001). Besides, analysis revealed significantly lower serum melatonin levels in patients with episodic ((80.45–45.06) 72.83) and chronic migraine ((154.34–63.34) 70.38, P value < 0.001) than in healthy controls (281.25–160.86) 280). Although no considerable differences were found between episodic and chronic migraine patients, the current study demonstrated that serum melatonin levels were substantially greater in healthy controls than in patients with migraine.

Ethical Considerations of Establishing Social Restrictions in the Prevention and Control of the Corona Epidemic from the Point of View of Medical Students of Kermanshah University of Medical Sciences

Background: Covid-19 (coronavirus), with its different dimensions, has created a serious international crisis in the world and has presented mankind with a new challenge. Among these, it can be claimed that the most difficult challenge in the Corona crisis is the moral challenge. Objectives: Considering the significance of ethical considerations and the crucial role students play in conveying these concepts to society, we decided to examine their perspectives. Methods: The present study was a cross-sectional descriptive study, and the statistical population was medical students in the basic sciences of Kermanshah Medical School. The sample size was 205 people based on Cochran's formula (d = 0.05), and the sampling method was random sampling. To collect data, a researcher-made questionnaire was designed based on current issues and approved by several professors (25 questions with a 5-point Likert scale from "very much" to "very little"). The reliability coefficient (0.83 Cronbach's Alpha) was satisfactory for the questionnaire. After completion and collection, the data was entered into SPSS-21 software. Then, it was subjected to statistical analysis with descriptive statistics (prevalence, mean, and standard deviation) and inferential statistics (due to the non-normality of the data distribution, non-parametric tests were used to analyze and compare the answers). Results: The average age was 20.58 ± 2.41 years, 115 people (56.1%) were male, and 198 people (96.6%) were single. Natives accounted for 63.2%. The effective factors in interventions were, in order: Use of different media for information, appropriate, accurate, and timely information, appropriate and sufficient training, preparation and provision of conditions before the above interventions, presentation of decisions and programs in simple and practical language, and fair distribution of protective equipment. Conclusions: According to our results, it was found that the role of using different media for informing, training, preparing, and providing conditions before interventions is very important. Therefore, policymakers and health planners should have the necessary preparation in these matters to control future epidemics.

Investigating the effect of adding silymarin to the standard treatment of naloxone in methadone intoxication; a double-blind clinical trial

Introduction: In cases of methadone intoxication, the drug is mainly processed by the liver, however, its elimination through the kidneys is also crucial. On the other hand, naloxone therapy is a gold standard treatment for opioid intoxication, the addition of other drugs can improve its benefits and reduce side effects. Objectives: This study aimed to assess the effectiveness of adding silymarin to the standard treatment of naloxone in patients with methadone intoxication, to improve patient outcomes and reduce the risk of complications associated with alone naloxone therapy. Patients and Methods: This clinical trial study aimed to investigate the efficacy of silymarin in combination with standard treatment for methadone intoxication patients. The study employed a control group, which received standard treatment with naloxone, and an intervention group, which received both naloxone and silymarin. Liver functional tests (LFTs), kidney functional tests, malondialdehyde (MDA), and ferric-reducing ability of plasma (FRAP) were measured at admission and post-intervention times to compare the outcomes between the two groups. Statistical analyses, including chi-square, independent and paired t tests, Wilcoxon, and Mann-Whitney tests were conducted to identify significant differences between the groups. Results: Results indicated that 32 and 33 patients were included in the naloxone and naloxone + silymarin groups, respectively. The results showed that the changes in kidney functional tests such as blood urea nitrogen (BUN) and creatinine (Cr), MDA, and FRAP were not statistically significant between the two groups. However, the changes in LFTs, including, aspartate transaminase (AST), alanine transaminase (ALT), and alkaline phosphatase (ALP), were statistically significant. Notably, the LFT changes were more pronounced in the group receiving both naloxone and silymarin, indicating a greater reduction in liver enzymes in this combined treatment group. Conclusion: The addition of silymarin to standard naloxone treatment for methadone intoxication patients could improve liver function, as the combined therapy showed a more pronounced reduction in liver enzyme levels compared to standard treatment alone; however, this combination treatment could not change the kidney function and oxidative stress markers. Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT20210216050377N1; ethical code from Shahrekord University of Medical Sciences; IR.SKUMS.REC.1400.048). This study was also registered in Research Registry website with Unique Identifying Number (UIN) of researchregistry10395.

Implementation and evaluation of the impact of virtual workshops of voluntary educational assistance among occupational health and safety students: Case study, Ardabil, Iran

BACKGROUND: The advancements and growth in information and communication technology have created new paths in the process of teaching and learning, leading to a shift in focus towards the use of electronic resources and digital teaching platforms. This study aimed to examine the impact of virtual workshops as a tool for improving learning among industrial health and safety students. MATERIALS AND METHODS: This study was a descriptive-analytical study and was conducted on 104 students of occupational health and safety at the University of Medical Sciences in Ardebil during the course of a year. In this study, five specialized courses were chosen, including the following: “OSCO”, “ESCC”, and “Erg”. “SSM” and “EMS”. In this study, the participants were divided into two groups: participating and non-participating students. The results of their grades in the workshop were compared. The study consisted of two parts, the preparation stage and the evaluation stage, which included the preparation of the workshop, data collection and analysis, and the final stage of evaluation. Then, a list of workshops related to the courses was prepared, and the obtained results were analyzed by SPSS software (Ver. 22). RESULTS: The results showed that the correlation between the student’s scores in the cognitive, emotional and psychomotor areas before and after attending the virtual workshops was significant. Variance analysis test showed a significant difference between the scores of the cognitive, emotional, and psychomotor areas, both before and after (P &gt; 0.001) participation in workshops. CONCLUSION: This study suggests that additional workshops, in parallel with classroom training, are an effective tool in raising student academic performance, as the students who participated gained better grades than those who did not participate in the courses. Therefore, it is possible to enhance student academic levels by increasing the number of workshops in addition to course unit.

Exploring internet addiction during Covid-19 pandemic: a comparative study considering psychological, social, familial and individual aspects in University students.

Internet addiction causes a variety of social, interpersonal, psychological, and physical issues. We are confronting a worldwide crisis about internet addiction and its effects. Utilizing five questionnaires to survey university students during the COVID-19 epidemic, the current study sought to evaluate internet addiction and associated risk variables. At the University of Medical Sciences in North Iran, a cross-sectional analytical investigation was carried out. The sample was done among 318 students, selected through the random cluster sampling method. Data collection was done during August and September 2021. Based on our findings, the prevalence of internet addiction was 28.9% (92/318). Our results revealed that women are at twice the twice the risk of internet addiction as men (p = 0.028). Students in the medicinal field (p = 0.043; students with a positive history of mental illness in the family) p = 0.001 (and students with a fear of COVID-19) p = 0.002 (recognized in the risk of Internet addiction, thus depression) p < 0.001 (anxiety) p < 0.001 (somatization) p = 0.001 (and psychological distress) p < 0.001 are risk factors for internet addiction. Age, marital status, place of living, total social support, and use of Alcohol/cigarettes are not risk factors for internet addiction. The findings suggest that university students with a fear of COVID-19, depression, anxiety, somatization, psychological distress and a positive history of mental illness in the family, particularly medicinal field students, are at significant risk for Internet addiction.