Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Thickness measurement of suboccipital muscles using ultrasonography in patients with chronic non-specific neck pain: a reliability study
No full textPurposeTo investigate the intrasession (test) and intersession (retest) reliability of rehabilitative ultrasound imaging (RUSI) in measuring the thickness of rectus capitis posterior major (RCPM) and oblique capitis superior (OCS) in patients with chronic non-specific neck pain (CNNP).MethodsThirty-three CNNP patients (age 35 +/-\documentclass12pt{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}\end{document} 12.82 years, 24 women and 9 men) participated in the study. One examiner measured the thickness of the right and left RCPM and OCS in their resting position. For intrasession reliability, two measurements were conducted with an interval of 15 min. As for the intersession reliability, measurements were repeated with an interval of 3 to 4 days after the first session. Intraclass correlation coefficients (ICC), standard error of measurement (SEM), minimal detectable change (MDC), coefficient of variation (CV), and Bland-Altman plots were used for data analysis.ResultsThe ICC results for intrasession and intersession reliability ranged from 0.89 to 0.95 and 0.84 to 0.91, respectively. The SEM ranged from 0.35 to 0.57, while the MDC ranged from 0.97 to 1.58. The Bland-Altman plots demonstrated good agreement and no bias.ConclusionThe current study found RUSI to be a reliable instrument for measuring the thickness of RCPM and OCS in CNNP patients
Hypereosinophilic Syndrome Complicated by Eosinophilic Myocarditis: Embolic Stroke or Eosinophilic Stroke? A Case Report
No full textHypereosinophilic syndrome (HES) is traditionally described as chronic peripheral eosinophilia with involvement of various organs and systems, including the heart and nervous system. In this report, we describe cardiac involvement and border zone stroke in a patient with idiopathic HES. A 37-year-old woman presented with sudden right-sided weakness and slurred speech, which began four days before admission, accompanied by palpitations, retrosternal exertional chest discomfort, dry cough, and progressive shortness of breath over approximately two months. Preliminary studies showed an increased number of white blood cells with eosinophilia. Further diagnostic investigation revealed apicalthrombosis in both ventricles of the heart and moderate left ventricular systolic dysfunction. Magnetic resonance imaging of the brain indicated multifocal infarctions in the anterior and posterior border zones, as well as both cerebellar hemispheres, predominantly on the left side. Consequently, the patient was diagnosed with idiopathic HES and treated with corticosteroids, cyclophosphamide, anticoagulants, and medications for heart failure. She responded well both clinically and hematologically. Our case highlights the importance of multiple imaging modalities in diagnosing eosinophilic endomyocarditis and the impact of timely medical treatment to prevent disease progression
Investigating the Effect of Virtual Training of Communication Skills to Mothers Based on Interaction Analysis Approach on Girls' Life Satisfaction and Parent-Adolescent Relationship
No full textBackground: The critical changes and emotional fluctuations associated with puberty often lead to conflicts and communication challenges between adolescents and their parents. Adolescent girls, in particular, tend to experience more conflicts with their parents, especially their mothers, due to the sensitive nature of puberty and the involvement of heightened emotional dimensions. This underscores the importance of educational interventions aimed at improving communication skills to resolve conflicts and enhance parent-adolescent relationships. Objectives: The present study was conducted to evaluate the effect of virtual communication skills training for mothers, utilizing the interaction analysis approach, on the life satisfaction of girls and the quality of parent-adolescent relationships. Methods: This randomized controlled quasi-experimental study employed a parallel design, incorporating pre-test, post-test, and follow-up assessments. The study which was conducted in 2022, involved 66 mothers who were randomly assigned to either the intervention or control group. Participants completed the Life Satisfaction Questionnaire and the Parent-Adolescent Relationship Questionnaire at three time points: Before the intervention, immediately after the intervention, and one month post-intervention. The intervention consisted of eight consecutive weeks of virtual communication skills training using an interaction analysis approach, delivered to the mothers in the intervention group. Data were analyzed using SPSS version 16. Results: At the study's outset, the two groups were homogeneous regarding demographic variables. The results indicated a significant difference in the mean score of the parent-adolescent relationship in the intervention group, with scores of 67.94 ± 31.04 before the intervention, 126.19 ± 27.25 immediately after, and 93.06 ± 15.02 one month post-intervention (P < 0.001). Additionally, there was a significant difference in the mean score of life satisfaction in the intervention group, with scores of 15.06 ± 5.35 before the intervention, 26.63 ± 4.63 immediately after, and 22.44 ± 5.06 one month post-intervention (P < 0.001). Conclusions: The results of this study demonstrated that virtual training in communication skills for mothers, based on the interaction analysis approach, can enhance girls' life satisfaction and parent-adolescent relationships. Given that "girls' life satisfaction" and "parent-adolescent relationship" are critical psychological components, this approach may be utilized to improve adolescents' mental health and strengthen the relationship between adolescents and their parents. © 2025, Ghaffari et al
Religious Fasting and Diabetes: A Review of Recent Guidelines and Research
No full textBackground: Each year, millions of Muslims with diabetes fast during Ramadan, which brings with it specific metabolic challenges such as hypoglycemia, hyperglycemia, dehydration, and ketoacidosis. Methods: We reviewed diabetes management during Ramadan based on the American Diabetes Association's latest recommendations in 2025 and other authoritative sources. Findings: Conducting a comprehensive risk assessment and educating diabetic patients before fasting are crucial for reducing metabolic risks. Careful adjustment of the medication regimen and continuous glucose monitoring, especially in the final hours of fasting, are essential to prevent complications such as hypoglycemia, dehydration, and ketoacidosis. Adopting a person-centered approach to managing fasting and avoiding strenuous physical activity in the final hours will increase safety and improve health outcomes in fasting diabetic patients. Conclusion: The increase in Muslim patients with diabetes who fast during Ramadan has increased the willingness of reputable scientific communities to collect evidence and provide clinical guidelines based on it and has contributed significantly to improving the management of these patients. © 2025 Isfahan University of Medical Sciences(IUMS). All rights reserved
Examining the diagnostic accuracy of interproximal chemical caries using X-ray and artificial neural network (ANN) modeling
No full textThe diagnostic accuracy of interproximal chemical caries and microchemical corrosion is significantly improved through advanced analytical techniquesthat facilitate early detection and characterization of demineralization, enabling timely interventions and effective preventive strategies in dentistry. Radiographs were used to detect proximal caries, and various metrics were measured, including AZ value, specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), and positive and negative likelihood ratios (LR+, LR-). The results revealed that the normal size - normal shape group had the highest sensitivity, NPV, and AZ value, while the normal size - square shape group had the highest specificity and PPV. This suggests that different jaw shape options can influence the diagnostic accuracy of interproximal caries. An artificial neural network (ANN) was shown to estimate the PPV, NPV, and +LR based on varying sensitivity and specificity. The results indicated that manipulating sensitivity and specificity impacted the estimated values, with higher specificity leading to increased PPV and positive effects on the LR+. Both sensitivity and specificity contributed to the improvement of the NPV. The prediction errors of the ANN were evaluated using linear regression and exhibited an acceptable level of error compared to empirical test results. However, it is important to note that neither the positive nor the negative likelihood ratio was sufficiently large for all groups, indicating that the jaw shape option alone may not significantly enhance the detection accuracy of interproximal caries. The micromechanical analysis of customizing the jaw shape option demonstrated its potential influence on the detection of interproximal caries While certain jaw shape options showed improved metrics, additional factors beyond the jaw shape option may be necessary to achieve optimal diagnostic accuracy in dental imaging. © 2025, Iranian Chemical Society. All rights reserved
Dapagliflozin in patients with chronic kidney disease: a systematic review and meta-analysis on randomized, double-blind, placebo-controlled multicenter trials
No full textIntroduction: Sodium-glucose cotransporter-2 (SGLT2) inhibitors reduce the mortality rate, hospitalization, and cardiac morbidity in diabetic patients. However, their safety in chronic kidney disease (CKD) individuals is still debatable. Objectives: The present study aims to evaluate the effect of dapagliflozin on primary composite outcomes and mortality rate in CKD patients using a systematic review and meta-analysis approach. Materials and Methods: In this meta-analysis, Cochrane, Web of Science, Scopus, and PubMed databases, along with the Google Scholar search engine, were queried until March 2023. Data were analyzed by STATA software version 14 at a significance level of P < 0.05. Results: A total of nine randomized clinical trials (RCTs) articles were reviewed, with a sample size of 16720 in the dapagliflozin group and 13 476 in the placebo group. Dapagliflozin use (10 mg/d) compared to placebo improved primary composite outcomes in CKD patients by 39 (OR=0.61, 95 CI: 0.57, 0.65) while reducing the mortality rate by 31 (OR=0.69, 95 CI: 0.63, 0.76). In an analysis by treatment length, no statistically significant change was noted in early composite outcomes (OR=0.70, 95 CI: 0.48, 1.01) and mortality rate (OR=0.75, 95 CI: 0.39, 1.45) between patients who were on dapagliflozin for less than two years and the placebo group. However, patients receiving dapagliflozin for two years and above had significantly improved primary composite outcomes (OR=0.60, 95 CI: 0.55, 0.66) and mortality rate (OR=0.69, 95 CI: 0.61, 0.79) compared to the placebo group. Conclusion: Dapagliflozin use, compared to placebo, improved the early composite outcomes and mortality rate in CKD patients. Prescribing a daily dose of 10 mg for a treatment duration of over two years seems safe in these patients. © 2025 The Author(s)
Public health system response to emerging infectious respiratory outbreaks in Iran
No full textBackground: Emerging infectious respiratory diseases present significant challenges to public health systems worldwide. The recent COVID-19 pandemic has revealed critical weaknesses in Iran’s healthcare infrastructure, particularly regarding surveillance and testing capabilities. During the pandemic, Iran faced severe consequences, including a high death toll and overwhelming demands on its healthcare system. This situation highlights the urgent need for a stronger public health system in the country. Objective: This study identifies interventions implemented in Iran’s public health system during respiratory disease pandemics, their context, mechanisms and outcome. Methods: A qualitative realist study was conducted using semi-structured interviews with 21 public health experts across various sectors. Data were analyzed through content-directed analysis using the CIMO (Context-Intervention-Mechanism-Outcome) approach and the SPRP (Strategic Preparedness and Response Plan) framework. Data collection occurred from March to June 2024. Results: Analysis revealed that factors such as individual behaviors, social capital, institutional settings, and political pressures significantly influenced intervention outcomes. Key interventions included enhanced risk communication strategies and the establishment of specialized respiratory disease centers. However, bureaucratic inefficiencies and resource limitations hindered effective responses. Additionally, continued investment in local diagnostic production is essential for maintaining national laboratory and vaccination capabilities. Conclusions: The findings underscore the necessity for systemic reforms in Iran’s public health framework to enhance preparedness for future pandemics. The realist approach provided insights into the complexities of intervention effectiveness, emphasizing the importance of context in shaping health outcomes. Strengthening primary healthcare and fostering inter-sectoral collaboration are essential for building a more resilient public health system capable of addressing emerging respiratory diseases effectively. © 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group
Effects of transcranial direct current stimulation along with cognitive training on cognitive functions and activities of daily living in patients with Parkinson's disease: A pilot randomized controlled trial
No full textBackground: Cognitive impairment is one of the most common symptoms of Parkinson's disease (PD). In recent years, the effect of transcranial direct current stimulation (tDCS) have been investigated on various disabilities related to PD, including sensory and motor deficits and fatigue. Aim: To investigate effects of transcranial direct current stimulation (tDCS) along with cognitive training on attention, working memory, reaction time (RTI), response inhibition, and activities of daily living performance. Methods: This pilot randomized, single-blinded, and sham-controlled trial was performed on 32 people with PD who were blocked randomized equally into intervention and control groups. Intervention group received ten 20-min sessions of tDCS during ten 45-min sessions of cognitive training, while control group received ten 20-min sessions of sham-tDCS during ten 45-min sessions of cognitive training. Anodal electrode of tDCS (2 mA) was placed over left dorsolateral prefrontal cortex (DLPFC), while cathode was over right supraorbital region. A blinded assessor performed pretest, posttest, and follow-up assessments using the Unified Parkinson's Disease Rating Scale and four subtests of the CANTAB computer test including Match to Sample Visual Search, spatial span task, stop signal task, and RTI. Results: The results showed significant differences within groups over time in the mean scores of attention (F = 24.73, p = 0.00), working memory (F = 19.06, p = 0.000), RTI (F = 8.63, p = 0.005), response inhibition (F = 15.75, p = 0.000), and activity of daily living performance (F = 6.73, p = 0.013). Conclusion: tDCS (anodal electrode over the left DLPFC and cathodal electrode over the right supraorbital region) along with cognitive training could facilitate improvement of cognitive functions and activities of daily living performance compared to routine cognitive exercises in people with PD. © 2024 Japanese Society of Neurology and John Wiley & Sons Australia, Ltd
