Tehran University Of Medical Sciences Research Articles

Effect of specific training course for competency in professional oral hygiene care in the intensive care unit: a quasi-experimental study for developing a standardized learning curve

BackgroundThe development of evidence-based training standards can help improve the quality of educational programs for novice intensive care unit (ICU) nurses. This study was conducted to assess the application of a training course on competency development of nurses in relation to oral hygiene care in ICU patients and to develop a checklist for evaluating the competence performance. In addition, to achieve a certain level of oral hygiene competence, as well as to assess the relative importance of predicting factors and learning competency patterns in oral hygiene care, we used standard learning curve.MethodsThis quasi-experimental study with time series design was conducted on newly registered ICU nurses of a teaching hospital affiliated with Tehran University of Medical Sciences, Iran, between 2016 and 2018. In the first phase of this study, we designed a checklist to assess nurses' professional competence in oral hygiene care in three stages: before, during, and after care. Then, in the second phase, the level of competence of nurses in repeated times of oral hygiene care was determined based on checklist items and recorded in the learning curve.ResultsThe greatest increase of oral hygiene care competency due to repetition was observed in the first and fourth times of repetition in comparison to the subsequent and previous steps. In the linear regression model, demographic variables predicted 12–19% of changes related to skill scores in repetitions.ConclusionAccording to the learning curve, newly registered ICU nurses can reach an acceptable competency after 6 repetitions of oral hygiene care.

Use of Toenails as a Non-invasive Method of Determining Salt Intake in Epidemiologic Studies

ObjectivesThe currently recommended method for assessing salt intake is a 24-hour urine sodium excretion which is not feasible in large epidemiologic studies. This study aimed to investigate the validity of measuring sodium in toenails, as a novel feasible method, against 24-hour urine (24 HR) samples collected in the PERSIAN Cohort.MethodsWe recruited 176 individuals, aged 35–70, and obtained 24 HR urine samples every three months for a year and toenail samples at the end of the study. The concentrations of sodium were determined by flame photometry in urine samples and by instrumental neutron activation analysis in toenail samples. Toenails were washed with 10% nitric acid before measurement. The mean of the four 24 HR (m24 HR) urine samples was used for validation. A Spearman correlation test was conducted to assess agreement between the 24 HR urine samples and the toenail samples. A questionnaire asking about the frequency of bathing, swimming, or washing feet, and the time between the last wash/bath/swim and toenail clipping was filled out at the time of toenail collection.ResultsToenails and 24 HR urine samples were provided by 111 and 130 participants, respectively but in 43 participants the volumes of 24 HR urine samples were not reported. The median concentration of sodium in the toenail samples was 325.8 (235.4–479.3) μg/g and in the m24 HR samples was 1067.2 (1294.6–2305.2) mg/d. Twenty-one %, 1%, and 78% of participants reported daily bathing, swimming, and washing of their feet, respectively. The mass of nail samples and foot washing frequency were correlated with sodium concentrations in the toenails (r = 0.34 and −0.41 respectively). The correlation coefficient between sodium concentrations in toenails and m24 HRs was 0.12 (P = 0.3). However, by excluding the participants who reported more than one time per day washing their feet (n = 21), the coefficient became 0.22 (P = 0.13), and by excluding the participants who reported bathing or washing their feet every day (n = 32), the coefficient became 0.50 (P = 0.04).ConclusionsOur results show sodium may leak out during frequent foot washing and do not support the usage of toenails as a biomarker for sodium intake.Funding SourcesThe Intramural Program of the US National Cancer Institute (NIH) and Tehran University of Medical Sciences.

Evaluation of the Cause of Dental Treatment in Children under General Anesthesia from the Perspective of Pediatric Dentists and Postgraduate Students and Parents of Children under General Anesthesia at the Dentistry School of Tehran University of Medical Science.

Nowadays, dental treatment under general anesthesia is accepted as a treatment method in children in which other common methods do not allow to achieve acceptable results. The benefits of general anesthesia in pediatric dental treatment are that the treatment is completed in one session, the person is relieved of pain, and most importantly, the child does not need to cooperate. However, it is important to determine the exact dental reasons for children under general anesthesia. In this study, the cause of dental treatment under general anesthesia in children was examined from the perspective of specialists, assistants, and parents of children under general anesthesia. In this descriptive-analytical cross-sectional study, participants were selected from among the parents of children under general anesthesia for dental treatment and pediatric dentists and assistants in a purposeful manner. After the items were prepared by the professors, the prepared checklist was read to the people. After completing the checklist, the data were entered into SPSS software version 20 and analyzed using descriptive statistics such as frequency determination, mean, and statistical rests. According to the consensus of parents and experts, the main reasons for general anesthesia for children to perform their dental operations were: young age, lack of cooperation during previous dental treatment, a large number of dental treatments, systemic disease of the child, unwillingness of parents to perform behavioral control procedures, higher quality work under anesthesia, mental and physical behavioral problems, and reduced number of treatment sessions. Therefore, reasons such as young age, lack of cooperation, and a large number of dentist's work are among the most important factors that lead to the decision to perform general anesthesia in children. In light of this decision, the consequences and disadvantages/advantages of this method are important and therefore more research should be done on this issue.

Knowledge and attitude in implant dentistry training courses amongst undergraduate dental students at Tehran University of Medical Sciences.

Due to the increase of implant treatments in daily practice, graduates should be well acquainted with appropriate diagnostic and therapeutic knowledge in implantology. This study sought to assess the knowledge and attitude of undergraduate students towards the benefits of their courses in the implant dentistry curriculum. This survey study was performed on all senior dental students at Pardis International Campus, School of Dentistry of Tehran University of Medical Sciences. Data collection was carried out through a questionnaire containing various items on knowledge and attitude. The validity and reliability of the questionnaire were already approved. Collected data were coded, entered in Microsoft Excel 2019, and analysed by t-test (α=.05). Forty questionnaires were filled out by 28 female and 12 male students. Only 7.5% and 12.5% of students reported that they had adequate knowledge to conduct the surgical and prosthetic steps of dental implant treatment, respectively. The majority of students had a positive attitude towards the quality of theoretical education. However, less than 50% of them perceived the same about their practical education. No significant difference existed between male and female students regarding their responses to the knowledge and attitude questions (p=.458 and p=.288, respectively). Ninety percent of the students felt the need for further education regarding dental implant treatment in the undergraduate curriculum. Despite the satisfaction of the theoretical knowledge, most senior students believed that they did not achieve adequate expertise to practice after graduation and were willing to receive further practical training in implantology.

Maternal mortality and its determining factors among hospitalised mothers in Tehran, Iran, 2013–2020

The maternal mortality ratio (MMR) is a significant indicator of the quality of a health care system. Despite considerable progress in reducing MMR in Iran in the past few years, we still face a long road ahead in eliminating preventable maternal deaths. In the present study, we evaluated all 80 cases of maternal deaths in 20 hospitals under the supervision of Tehran University of Medical Sciences between March 20 2013 and March 19 2020. During this time, these hospitals recorded 335,216 live births, with an MMR of 24 per 100,000 live births. The average age of deceased mothers was 31.9 ± 6.9 years. Direct causes accounted for 48.75% of maternal deaths, with haemorrhage being the most common direct cause of mortality (17.5%). Moreover, cancer (17.5%) and cardiovascular diseases (17.5%) were the most common indirect causes of maternal mortality. Even after accounting for the COVID-19 pandemic's effects, we have noticed an increase in maternal mortality. As a result, implementing a comprehensive approach for high-risk pregnancies is critical. Impact Statement What is already known on this subject? Although we have been able to reduce MMR in Iran to a reasonable level, previous measures would not be sufficient to accomplish future goals. Furthermore, we have a long way to go before reaching the ultimate goal of eradicating avoidable maternal deaths by 2030. What do the results of this study add? The causes, determinants and risk factors of maternal mortality were investigated in this study. With this level of detail, we can observe a steadily increase in MMR in recent years, regardless of the COVID-19 pandemic. The majority of pregnancy-related deaths can be avoided. What are the implications of these findings for clinical practice and/or further research? MMR reduction is a measurable goal that can be attained by improving financial resources, implementing safe delivery, team training, preparing multidisciplinary care with integration for high-risk pregnant women, establishing good provider relationships, and communicating with patients and providers for early warning signs and structural changes.

Intelligent Model of Nursing Shift in Tehran University of Medical Sciences, Tehran, Iran.

Nurses play a key role in increasing the efficiency of healthcare systems. Given the 24-hour performance of hospitals and the small number of nurses in the field of treatment, it is quintessential to re-shift them in the hospital. This study set out to achieve coherence in nursing shift planning and justice in the order of shifts in hospital. This applied and a developmental study was performed from 2019 to 2020. We used genetic algorithm to provide operational solutions and define flexible shifts and plan nurses' working hours in Yas Hospital, Tehran University of Medical Sciences Hospital, Tehran, Iran. Based on the selection of each nurse and determining the approved shifts of each ward, the possibility of appropriate planning was provided to determine the required shifts per month and to estimate the needs of each department. Using genetic algorithm and nursing shift in office automation console provides useful tools for managers at all organizational levels, according to which a good balance between the hospital's need for nurse and nurses' demands in different time periods.

Trends, Issues and Future Directions of Urban Health Impact Assessment Research: A Systematic Review and Bibliometric Analysis.

Health impact assessment (HIA) has been regarded as an important means and tool for urban planning to promote public health and further promote the integration of health concept. This paper aimed to help scientifically to understand the current situation of urban HIA research, analyze its discipline co-occurrence, publication characteristics, partnership, influence, keyword co-occurrence, co-citation, and structural variation. Based on the ISI Web database, this paper used a bibliometric method to analyze 2215 articles related to urban HIA published from 2012 to 2021. We found that the main research directions in the field were Environmental Sciences and Public Environmental Occupational Health; China contributed most articles, the Tehran University of Medical Sciences was the most influential institution, Science of the Total Environment was the most influential journal, Yousefi M was the most influential author. The main hotspots include health risk assessment, source appointment, contamination, exposure, particulate matter, heavy metals and urban soils in 2012–2021; road dust, source apposition, polycyclic aromatic hydrocarbons, air pollution, urban topsoil and the north China plain were always hot research topics in 2012–2021, drinking water and water quality became research topics of great concern in 2017–2021. There were 25 articles with strong transformation potential during 2020–2021, but most papers carried out research on the health risk assessment of toxic elements in soil and dust. Finally, we also discussed the limitations of this paper and the direction of bibliometric analysis of urban HIA in the future.

Validation of the Persian Version of Occupational Coping Self-efficacy for Nurses Scale

Background: Assessing the self-efficacy beliefs of Iranian nurses in coping with occupational stressors requires to have a reliable tool. This study aims to assess the validity and reliability of the short form of Occupational Coping Self-Efficacy for Nurses (OCSE-N) Scale for Iranian nurses. Methods: This is a methodological study. Participants were 151 nurses who were randomly selected from among those working in oncology wards of hospitals affiliated to Tehran University of Medical Sciences in 2021. The nurses completed the short form of OCSE-N and the Coping Inventory for Stressful Situations- Short Form (CISS-SF). This study employed exploratory factor analysis and Confirmatory Factor Analysis (CFA) to examine the factor structure of the Persian OCSE-N. The reliability was assessed by calculating Cronbach’s alpha coefficients. The data were analyzed in AMOS and SPSS software v. 26. Results: The results of Principal Component Analysis by the Promax rotation and CFA showed that the Persian OCSE-N had two factors: 1) Coping self-efficacy to cope with the relational burden and 2) coping self-efficacy to cope with occupational burden. The correlation between subscales of OCSE-N and CISS-SF confirmed the convergent validity of the Persian OCSE-N. Cronbach’s alpha coefficients for factors 1 and 2 were reported 0.75 and 0.77, respectively. Conclusion: The Persian OCSE-N is a valid and reliable tool to measure the perceived self-efficacy in coping with stressful situations among Iranian nurses.

Clinical outcomes of transepithelial photorefractive keratectomy with epithelial ablation targeting actual epithelial thickness vs default laser platform values.

To investigate the clinical outcomes of transepithelial photorefractive keratectomy (tPRK) with actual epithelial thickness vs default software values. Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Prospective controlled study. Patients with refractive spherical error of -1.50 to -7.00 diopters (D) and refractive astigmatism up to 4.00 D were consecutively enrolled and divided into 2 groups: group 1 undergone tPRK with actual central and peripheral epithelial thickness input in right eyes, group 2 undergone tPRK with actual central and 10 mm higher peripheral epithelial thickness in right eyes. Left eyes in both groups underwent tPRK with default protocol. Outcome measures were induced refractive error, achieved optical zone (OZ), and wasted stromal tissue. 83 patients were included in this study. Mean ± SD of induced spherical equivalent was +0.15 ± 0.39 D and +0.01 ± 0.35 D in right and left eyes of group 1 (P = .01) and +0.04 ± 0.22 D and +0.03 ± 0.23 D in right and left eyes of group 2 (P = .75), respectively. There was no statistically significant difference between wasted tissue between right and left eyes in group 1 and group 2 (P = .77 and P = .49, respectively). OZ contraction was significantly higher in right compared with left eyes in group 1 (P = .05), but not in group 2 (P = .95). In tPRK, refractive outcomes, wasted tissue, and OZ contraction depend little on preexisting corneal epithelial thickness in corneas with normal range epithelial thickness. However, OZ contraction may be a concern in lower amount of ablations.

Association between Poor Sleep Quality with Anxiety and Depression Scores among Patients with Urological Cancers

Background and Objective: It has been postulated that patients with cancer experience various degrees of poor sleep quality at different points of disease courses. On the other hand, a high proportion of patients with cancer present symptoms of anxiety and depression. The purpose of the study was to assess the association of sleep quality with anxiety and depression in patients with urological cancers.
 Materials and Methods: The present study was a cross-sectional study performed in the Cancer Registry Center at Tehran University of Medical Sciences, Tehran, Iran, in 2019-2020. For eligible patients, demographic data were collected from their records, and Pittsburgh Sleep Quality Index (PSQI) questionnaire, Hamilton Anxiety Rating Scale (HAM-A), and Hamilton Rating Scale for Depression (HAM-D) were completed for each patient.
 Results: The mean + SD age of participants was 64.1 ± 14.5 years, and the most of patients were male (90.1%). In total, 142 patients were enrolled in the study, and 92 patients (64.8%) were categorized as patients with poor sleep quality. The mean global score was 7.85 ± 3.94, and the mean of anxiety and depression was 10.85 ± 6.80 and 15.30 ± 4.90, respectively. The regression analysis showed that for one-unit increase in sleep quality score, the anxiety score significantly increased by 0.98 unit [95% confidence interval (CI): 0.74-1.22, P < 0.001], and for depression significantly increased by 0.69 unit (95% CI: 0.52-0.87, P < 0.001).
 Conclusion: More than half of our patients suffer from poor sleep quality, associated with anxiety and depression symptoms.

Psychiatric training program during the COVID-19 pandemic: An experience in Iran.

ObjectiveThis study aims to report a redesigned psychiatric training program in the internship and the externship courses at Tehran University of medical sciences, in Iran during the COVID-19 pandemic.MethodsIt is a retrospective cohort study which 531 externs and 381 interns enrolled. The students’ satisfaction and their exam scores were assessed before and during the COVID-19 pandemic.ResultsBlended learning was used for clinical education which theoretical, case-based discussions; and assessments were provided online. Externs’ clinical scores and satisfaction were significantly higher while interns’ scores got worse.ConclusionE-learning can be effective, applicable and acceptable in clinical education.

Changes in the Prevalence of Micronutrient Deficiencies Among Under-2- and 6-Year-Old Children in Two National Surveys in Iran

Background: Micronutrients, such as vitamin A, vitamin D, iron, and zinc have several useful functions in the body and are necessary for normal growth and development, especially among children. Unfortunately, recent research has showed different levels of deficiency of these two vitamins among children. Objectives: This study aimed to compare the prevalence of micronutrient deficiencies, including vitamin A, vitamin D, iron, and zinc, among under-2- and 6-year-old children in Iran in two National Integrated Micronutrient Surveys (NIMS-I, NIMS-II). Methods: In NIMS studies, sampling was done using a single-stage cluster sampling method. The country was divided into 11 study zones. Using simple random sampling, more than 4,400 individuals (about 400 samples in each zone) were included in each study (NIMS-I, NIMS-II). At least 4-mL venous blood samples were taken from all children and transferred to the central laboratory of Tehran University of Medical Sciences (TUMS) with special identification code for further analysis. Then, the levels of vitamin A, vitamin D, iron, and zinc were measured. Results: In NIMS-I, the prevalence of vitamin A deficiency among under-2-year-old children was 0.5%, which significantly increased to 18.3% in NIMS-II. Regarding vitamin D deficiency, the rate of deficiency was 3.7% in NIMS-I and 23.3% in NIMS-II, which was statistically significant. In none of the NIMS studies (I and II), vitamin A was measured in under-6-year-old children. Also, in the NIMS-I study, vitamin D was not measured among under-6-year-old children, and in NIMS-II study, the prevalence of vitamin D deficiency was 61.8%. Zinc deficiency among under-2-year-old children in both studies was nearly the same (19.1% vs. 19.4%); but in NIMS-II study, zinc deficiency among under-6-year-old children was 13.6%, which significantly decreased compared to the NIMS-I (31%). Iron deficiency status among under-2-year-old children significantly decreased from 37.8% in NIMS-I to 17.1% in NIMS-II. A significant reduction in iron deficiency status was also observed in the NIMS-II study compared to the NIMS-I in under-6-year-old children (9.9% in NIMS-II compared 18.2% in NIMS-I). Conclusions: The increase in both vitamin A and vitamin D deficiency rates in NIMS study is alarming. Due to the special roles of these two vitamins in health, special considerations and effective actions are needed in this respect. Data from two national studies indicated a decrease in the prevalence of iron deficiency in both age groups, which could be due to the successful implementation of nutritional intervention programs in Iran, such as iron supplementation and iron fortification.

Evaluation of Serum Levels of Interlukine-17A (IL-17A), Fibrinogen, and Red Distribution Width (RDW) in Patients with Coronary Artery Ectasia, Candidate for Coronary Angiography: A Cross-Sectional Study

Background: Coronary stenosis and ectasia are cardiovascular diseases characterized by dysfunction of endothelial cells. Studies have shown that impaired blood flow due to inflammation and deposition in the endothelial cell wall can be effective in disease occurrence and progression. Although the etiologies of these diseases have not been identified accurately, it has been shown that inflammation and coagulation can be the main causes in these patients. Objectives: The aim of this study was to evaluate the levels of fibrinogen, Interlukine-17A (IL-17A), and red distribution width (RDW) in patients with coronary artery disease (CAD) and ectasia. Methods: In this study, 140 patients with CAD admitted to Shariati Hospital of Tehran University of Medical Sciences, Iran, were included from from Jun 2020 to October 2021. Based on the severity of CAD, the participants were divided into two equal groups (n = 70 in each) of mild CAD (patients with CAD less than 50%) and multi-vessels CAD (patients with more than 50% stenosis in coronary arteries) according to the number of involved vessels (one, two, or three). Then, 5 cc of peripheral blood was collected from each patient in ethylenediaminetetraacetic acid (EDTA) containing tubes. IL-17A and fibrinogen were measured using enzyme-linked immunosorbent assay (ELISA) kit, and RDW was calculated by cell counter. Results: The mean age of participants was 63.0 ± 11.0 years in the mild group (35% males vs. 65% females) and 60.1 ± 12.1 years in the multi-vessels group (28% males vs. 72% females). The results showed that IL-17A, fibrinogen, and RDW levels in patients with ectasia and multi-vessels group were significantly higher than those in patients without coronary ectasia and mild CAD, respectively (P-value = 0.01 for fibrinogen; P-value = 0.05 for IL-17A; and P-value = 0.03 for RDW). Conclusions: According to our results, identification and evaluation of fibrinogen and IL-17A, along with laboratory indices including RDW can be helpful in diagnosing high-risk individuals. Ectasia can be prevented, and it is possible to increase the patients’ survival through using some preventive and therapeutic strategies.

Retrospective study of gingival involvement in pemphigus: A difficult to treat phenomenon.

Pemphigus is a group of autoimmune diseases characterized by flaccid lesions on the skin and mucous membranes. In pemphigus vulgaris, the most common subtype of pemphigus, lesions might be appeared anywhere on the oral mucosa, mostly in the buccal mucosa. However, the gingiva is a less frequently affected site. Here, we performed a retrospective study at Tehran University of Medical Sciences, covering a two-year period to identify pemphigus patients with active lesions confined to the gingiva. Considering 1787 initially evaluated pemphigus cases, 512 (28.6%) were found to have a history of gingival involvement. Among them, 31 patients had only gingival involvement during their last visit, including 29 (93.5%) women and only two (6.5%) men. The mean of disease duration in this group was 5.29 ± 3.46 years, and they had gingival involvement for a mean of 23.9± 19.3months. Of 28 patients, nine were negative for anti-Dsg3 and 24 were negative for anti-Dsg1. In 24 patients, who received rituximab, the mean pemphigus disease area index specifically for gingiva was 4.76 ± 0.74 at baseline, which had changed to 4.13 ± 0.75 and 3.26 ± 0.63 three and 6 months after rituximab administration, respectively. After 3 months, gingival lesions were either entirely resolved (n= 3), partially resolved (n= 11), remained unchanged (n= 2), or progressed (n= 7). Gingiva-confined presentation of lesions in pemphigus could be non-anti-Dsg1/3 dependent in some patients. Such patients do not respond well to conventional treatments and rituximab therapy. More studies on the pathogenesis of gingiva-confined presentation of pemphigus are required.

The epidemiology and etiology of onychomycosis in 2 laboratory centers affiliated to Tehran university of medical sciences during 2019-2020.

Background and Objectives:Onychomycosis is caused by dermatophyte species, non-dermatophyte moulds (NDMs), and accounts for roughly 50% of all nail diseases. As the prevalence of onychomycosis is increasing, new epidemiologic documents may help with treatment and prevention. The present investigation aims to determine the epidemiological profile of onychomycosis in 2 mycology laboratories.Materials and Methods:A cross-sectional study conducted during eight months (2019–2020) on 169 patients with positive nail mycology tests referred to two mycological laboratory centers affiliated with Tehran University of Medical Science. The nail clippings were examined by direct smear and culture. Also, molecular assays were performed if needed.Results:10% of nail lesions referred to Razi Hospital (RH), and 30% of nail lesions referred to TUMS mycology laboratory were positive. Middle age (40–60) suffer more from onychomycosis. Aspergillus flavus, Trichophyton mentagrophytes, and Candida albicans were the most common etiologic agents in each of the three main classes of fungi causing onychomycosis. Females were more infected. NDMs were the predominant etiologic agents, and toenails were the most common site of onychomycosis.Conclusion:The pattern of etiologic agents and clinical signs of onychomycosis differs according to geographical region and age, so repeated epidemiological surveys of onychomycosis seem to be fundamental.

Tops and Trends in Iranian Cancer Research: A Bibliometric Analysis.

Detecting the main actors and important topics of Iranian cancer research is essential for Iranian policymakers, clinicians, and researchers. This study was conducted to demonstrate the trends and tops in Iranian cancer research from 1960 to 2018. A total of 22,370 Iranian cancer articles in Web of Science (WoS), PubMed, and Scopus, from 1960 through 2018, were extracted and preprocessed based on data mining techniques and analyzed using the collaboration network analysis, keywords analysis, and bibliometrics methods. The results reveal that, Tehran University of Medical Sciences (11.46%) among organizations, Asian Pacific Journal of Cancer Prevention (5%) among journals, Malekzadeh R (1.09%) among authors, and Breast cancer (10.37%) among topics ranked the first. The trend of Iranian cancer research represents three periods: 1) germinating period, from 1970 to 2000, 2) developing period, from 2002 to 2014, and 3) flourishing period, from 2014 to 2018. It is expected that this trend will continue. The results indicate an average 12.8% increase in the logarithm of the count of articles published by Iranian cancer researchers each year. The findings are contextualized with Price's publications trends principal for determining global and Iranian cancer research publication trends. The number of research papers published by Iranian researchers on cancer is increasing. In order to maintain the publication growth in this field, greater participation by other Iranian institutions is suggested. Although the quantity and quality of papers are increasing in some topics, certain topics and types of cancers should be still further studied and the Iranian policymakers should be encouraged to invest more in these topics.

Health benefits of using air purifier to reduce exposure to PM2.5-bound polycyclic aromatic hydrocarbons (PAHs), heavy metals and ions

In this study, the efficiency of air cleaners in removal of chemical components of PM2.5 (PAHs, heavy metals, and ions) in the indoor air of dormitories of Tehran University of Medical Sciences, Iran were assessed. 12 rooms were selected and randomly divided into two groups: sham air purifier system deployed room (SR) vs. true air purifier system deployed room (TR). 24-h PM2.5 samples were simultaneously collected in both TR and SR on PTFE filter papers at a flow rate of 5 L/min. The results showed overall removal efficiency of 76.5 ± 15.5%, 63.1 ± 22.5%, and 66.2 ± 24.8% for PAHs, heavy metals and ions, respectively. Moreover, the fraction of positive ions decreased when air purifiers were used in the rooms. The results showed that the smoking is an important influencing factor on the indoor air quality; smoking can leads to reduction in removal efficiency of PAHs, heavy metals and ions by 26%, 40%, and 51%, respectively. An air purifier could decreased the PM2.5 even lower than the WHO annual guideline level in non-smoker rooms. The present study revealed that use of indoor air purifiers can significantly reduce the risk of carcinogenicity and non-carcinogenicity attributed to heavy metals and PAHs, especially in places without a smoker.

Etiology of Childhood Lymphadenopathy: A Report by a Single-center (2016-2018)

Background: Lymphadenopathy is an enlargement of a lymph node. Pathologic Lymphadenopathy is when there is a symptom of infectious and noninfectious abnormalities or malignant diseases. Most Lymphadenopathies are benign and are associated with a short period of symptoms. Concerning diagnosis and management of adenopathy, especially in the case of children, research is still underway. For this reason, our study investigated and analyzed the causes of lymphadenopathy in children.
 Materials and Methods: This is a retrospective study conducted at the Pediatric Department of children's medical center of Tehran University of medical science. In this study, 130 children with cervical lymphadenopathy aged under 12 years underwent lymph node biopsy. Then under general anesthesia and evaluation of a senior pathologist, the lymph node was excised and biopsied.
 Results: During the study, twenty-five cases were excluded. Fifty-three patients (50.47%) demonstrated infection history, 22 cases (21%) had neoplasia, and reactive inflammatory changes with nonspecific origin were seen in 42 cases (40.0%). We observed chronic lymphadenitis in 3(2.9%) cases, and finally, 1(1.0%) case was metastatic. Mean lymph node size proved to be greater than two cm in metastatic (2.22cm), lymphoma (2.33cm), and granulomatous (3.17cm) lymphadenopathies. The average lymph node size turned out to be 1.53 cm in reactive lymph nodes (P =0.021). The diagnosis was obtained by excisional biopsy and histopathology.
 Conclusion: Acute infections are the most common reason for lymphadenopathy in pediatric conditions. It is better to be suspicious of malignancy with a high index in cases of cervical lymphadenopathy, especially if the lymph node size is higher than 2 cm. History, clinical features, and paraclinical tests can be used for lymphadenopathy in children.

Students\u2019 perception of educational environment based on Dundee Ready Education Environment Measure and the role of peer mentoring: a cross-sectional study

ObjectiveThe curricular reform at Tehran University of Medical Sciences (TUMS), Iran, has been implemented since 2011 when peer mentoring program started. The program is believed to have a crucial role in students’ perception of the educational environment (EE). We aimed to determine how students perceive the educational environment and compared the mentees and non-mentees’ perception of EE.MethodsA cross-sectional descriptive study was conducted among 190 first-year medical students enrolling at Tehran University of Medical Sciences from March to September 2019. A questionnaire was used to collect information on students’ age, gender, marital status, dormitory status, and their mentoring status including satisfaction of mentor-mentee relationship. The study also employed Dundee Ready Education Environment Measure (DREEM). The collected data were then entered and analysed using SPSS version 20. To compare the perception of EE between mentees and non-mentees, we used independent t-test.ResultsThe mean (SD) for total DREEM score for EE was 144.1 (19.3), which signifies a more positive than negative educational environment perception. Nonetheless, the mean scores of total DREEM was not significantly different between students with or without mentors (P =0.390). The overall mean score for student perceptions of learning for mentees was 32.47 (4.5) while for those without a mentor, the score was 31.70 (4.9) (P =0.491). The items concerned with “emphasizing factual learning” and “teacher-based teaching” were rated the least. The item “having an appropriate support system” was scored significantly different between students with or without mentors (P =0.009).ConclusionsSince having an appropriate support system was significantly different between groups, we suggest curriculum designers focus on the above-mentioned issue under caption for improvement during the reform programs.

Association Between PIC3KA and CRNDE Gene Expression and HPV Involvement With Risk Factors and Clinical Characteristics of HNSCC Patients

Introduction: Head and Neck Squamous cell carcinoma (HNSCC) is the sixth common cancer worldwide. An important feature of HNSCC is its poor prognosis. Factors such as smoking and alcohol consumption, HPV infection and genetic factors play a role in HNSCC pathogenesis. This study aimed to investigate the relationship between PIC3KA and CRNDE gene expression levels and HPV involvement with risk factors and clinical characteristics of patients. Materials and Methods: In this case-control study, the expression of PIC3KA and CRNDE genes in the tumor tissues and adjacent non-cancerous tissues of 50 HNSCC patients were evaluated by Real-Time PCR. Also, HPV infection was evaluated by Reverse Line Blot method. Finally, the association of these two parameters with the demographic and clinical characteristics of patients was statistically evaluated. Ethical Considerations: This study was registered with the Ethics Committee of Tehran University of Medical Sciences under code IR.TUMS.DENTISTRY.REC.1397.021. Results: The results of the present study showed that the expression of CRNDE (P = 0.0005) and PIK3CA (P = 0.0322) genes in tumor tissue had a significant increase compared to adjacent non-cancerous tissue. Increased PIK3CA expression was significantly associated with smoking, location, stage, size, and grade of the tumor, whereas increased CRNDE expression was associated with alcohol consumption and lymph node involvement. It was also found that HPV infection was associated with larger tumor size and more advanced stage (P = 0.02). Conclusions: Considering the association of PIK3CA expression with parameters such as stage, size and grade of the tumor, it can be concluded that the expression of these two genes is involved in the progression of HNSCC disease. In addition, according to the present results, HPV infection is also associated with disease progression.