Repository of Research and Investigative Information Isfahan University of Medical Sciences
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National Regulations and Management Systems for Implementation and Monitoring of Food Safety in Iran: A Narrative Review of Literature
No full textThe countries establish and enforce food safety regulations to safeguard the health and well-being of their citizens worldwide. Iran has enacted a new regulation on food safety for expansion a national food safety control system and diminishing the national and international concerns. However, a rapid understanding of the management system is lacking in Iran. This study aimed to discuss the components of the food safety management system (FSMS) in Iran and present the weakness and strengths of the Iranian food monitoring structure. For this purpose, it was conducted a narrative review of articles referenced in PubMed, Scopus, Web of Science, Irandoc, and the Iranian Scientific Information Database until February 1, 2024. Furthermore, it was included websites and review papers in Persian and English that describe strategies of national and international FSMS and protocols in different countries. It was concluded that there is a gap in the integrated tracking system throughout the food chain and a single organization responsible for monitoring the food chain to prevent parallelism. This study provides comprehensive suggestions and recommendations to improve the structure of the legislative organization to ensure safe and qualified foods to consumers in Iran. © 2025 International Journal of Environmental Health Engineering
Is School Function in Children with Down Syndrome the Same as Their Normally Developing Peers? A Preliminary Study
No full textBackground: Active participation in school is an effective way to foster children's cognitive and social development. Children with Down syndrome (DS) face various challenges in the school environment due to different impairments in body functions and structures. Methods: In this cross-sectional study, a convenience sample of 51 children with DS was recruited from five schools for exceptional children, and their normally developing peers were recruited from four regular schools in Isfahan, Iran. Parents and teachers completed a demographic information questionnaire, and only teachers completed the School Function Assessment (SFA). Results: Children with DS had a moderate level of participation (criterion score=60.04). Their school function scores were significantly lower than those of their normally developing peers. No significant relationship was found between gender, age, or educational level and school function scores in children with DS (P>0.05). Conclusion: The school functions of children with DS significantly differed from those of their normally developing peers. Children with DS performed significantly better in physical tasks than in cognitive-behavioral functions. The weakest cognitive-behavioral functions requiring particular rehabilitation interventions are task behavior/completion and safety. © 2025 The Authors. Published by JRSR. All rights reserved
The Role of Resilience and Defense Styles in Caregiver Burden Among the Mothers of Children with Cancer: A Descriptive-Correlational Study
No full textBackground: The diagnosis of childhood cancer can be considered a multidimensional crisis for parents, particularly mothers. Objectives: This study aimed to determine the predictive role of defense styles and resilience in the caregiver burden experienced by mothers of children with cancer. Methods: This descriptive-analytical study focuses on mothers of children with cancer who were hospitalized in the pediatric wards of Seyed al-Shohada Hospital in Isfahan, Iran. A total of 136 participants were selected using convenience sampling. The study utilized the Defense Styles Questionnaire (DSQ-40), the Zarit Burden Scale (ZBS), and the Connor-Davidson Resilience Scale (CD-RISC) to collect data. The data were analyzed using STATA16. Results: On average, mothers had a caregiver burden score of 38.65 and a resilience score of 93.51. The majority of mothers (62.5) exhibited neurotic defensive styles. The regression test results indicated a significant inverse relationship between caregiver burden and resilience (P = 0.002), as well as a significant relationship between the child’s sex and caregiver burden (P < 0.05). Conclusions: Based on the study's findings, it is recommended that counseling and psycho-cognitive programs be designed, developed, implemented, and evaluated to enhance the resilience of mothers of children with cancer and thereby reduce their caregiver burden. © 2024, Javeri et al
The role of gut microbiota and probiotics in managing hypertensive disorders of pregnancy
No full textHypertensive disorders of pregnancy (HDP) represent a significant cause of maternal morbidity and mortality globally, impacting around 10 of pregnant women. This review investigates the intricate interplay between gut microbiota and HDP, focusing on how changes in microbial composition may affect blood pressure control. Recent research suggests that dysbiosis, marked by diminished microbial diversity and alterations in specific bacterial communities, correlates with hypertension. The potential of probiotic supplementation as a therapeutic approach to restore gut health, improve metabolic processes and alleviate hypertension symptoms during pregnancy is highlighted. The review outlines various mechanisms by which gut microbiota may help reduce HDP symptoms, particularly through the production of short-chain fatty acids known for their anti-inflammatory effects. Although the findings are encouraging, additional studies are required to comprehensively elucidate the roles of different bacterial species in blood pressure regulation and to validate probiotics as a standard treatment for HDP. © 2025 MA Healthcare Ltd
MECardNet: A novel multi-scale convolutional ensemble model with adaptive deep supervision for precise cardiac MRI segmentation
No full textAccurate segmentation of the left ventricle, right ventricle, and myocardium is essential for estimating key cardiac parameters in diagnostic procedures. However, automating Cardiovascular Magnetic Resonance Imaging (CMRI) segmentation faces challenges from diverse imaging vendors and protocols. This study introduces MECardNet framework as an innovative multiclass CMRI segmentation model, representing a prominent advancement in the field. MECardNet leverages a Multiscale Convolutional Mixture of Experts (MCME) ensemble technique with Adaptive Deep Supervision, seamlessly integrated into the U-Net architecture. The MCME framework improves representation learning in the U-Net workflow. It does this by adaptively adjusting the contribution of U-Net layers in the ensemble for better data modeling. Additionally, MECardNet incorporates a cross-additive attention mechanism, an EfficientNetV2L backbone, and a specialized compound loss function, leading to enhanced model performance. Through 10-fold Cross-Validation (CV) analysis on the ACDC dataset, MECardNet surpasses baseline models and state-of-the-art methods, showcasing promising performance levels with evaluation metrics such as Dice Similarity Coefficient (DSC) of 96.1 ± 0.4 , Jaccard coefficient of 92.2 ± 0.4 , Hausdorff distance of 1.7 ± 0.1 and mean absolute distance of 1.6 ± 0.1. Further validation on the M&Ms-2 dataset and a local dataset confirms promising performance of MECardNet, with DSC of 94.3 ± 0.7 and 94.5 ± 0.6 , respectively. The proposed MECardNet framework establishes a new benchmark in CMRI segmentation by outperforming existing models, offering efficient and reliable computer-aided technologies for cardiovascular disease diagnosis, with the potential for significant impact in the field. Researchers can access MECardNet repository and results on GitHub1 for comprehensive exploration and utilization. © 2024 Elsevier Lt
The Effect of Intranasal Administration of Remifentanil at Different Doses on Electroconvulsive Therapy-Induced Hemodynamic Changes in Adults
No full textBackground: Remifentanil seems to play an important role in reducing heart rate (HR) and blood pressure during electroconvulsive therapy (ECT)-induced seizures. The majority of studies have focused on the role of the intravenous administration of this drug in combination with other anesthetics; however, the effect of intranasal administration of this drug has received less attention so far. We evaluated the effect of the intranasal administration of remifentanil at different doses on ECT-induced hemodynamic changes. Methods: This double-masked clinical trial was conducted on 80 ECT candidates divided into four groups. Before starting the ECT, the four study groups, namely REM-25, REM-50, REM-75, and control, intranasally received remifentanil at 25, 50, and 75 μg and placebo, respectively. Anesthesia induction drugs were injected 1 minute after the intranasal administration of remifentanil or placebo. Patient’s HR, diastolic blood pressure (DBP), mean arterial pressure (MAP), systolic blood pressure (SBP), and peripheral capillary oxygen saturation (SpO2) were evaluated and recorded before and 1, 5, 10, and 20 minutes after the end of convulsive movements. Results: The patients’ SBP and MAP with 137.30 ± 14.37 mm Hg and 100.50 ± 11.06 mm Hg, respectively, had the highest mean in the control group as compared to three remifentanil groups 5 minutes after ECT (P value = 0.042). In addition, the increase in patients’ HR in the REM-75 group, with an average of 7.70 ± 12.54 bpm, was significantly lower than that of the REM-25 and REM-50 groups, with means of 16.15 ± 13.80 bpm and 13.15 ± 8.03 bpm, respectively. Moreover, the controls, with an average of 23.00 ± 11.74 bpm, had the greatest increase in HR (P value < 0.05). Conclusion: The intranasal administration of remifentanil at different doses did not affect the length of ECT-induced seizures; however, its maximum dose (75 μg) showed the greatest decrease in patients’ SBP, MAP, and HR five minutes after administration. © 2025 The Author(s);
Evaluation of the Accuracy of the Glycated Hemoglobin (HbA1c) Index Measured by the Clover A1c Self Analyzer Device Compared to Standard Methods
No full textBackground: Given that HbA1C is a critical indicator in the diagnosis and control of diabetes, various methods exist for its measurement. This study aimed to determine the accuracy of the HbA1C index measured by the Clover A1c self analyzer device in health centers of Isfahan province compared to the HPLC method. Methods: In this cross-sectional study, samples were taken from 99 patients. Three blood samples were taken from each patient: one venous blood sample and two capillary blood samples. The HbA1C measurement from the venous blood sample was performed using the standard HPLC method, while the capillary blood samples from the right and left hands were measured using the Clover A1c self analyzer device. The concordance of the measurements from the two devices was assessed using the Intra-cluster correlation coefficient (ICC) and the Bland-Altman method. Findings: A comparison of the results reported by the two devices showed that the mean serum HbA1C measured by the reference device was 7.97 ± 1.50. The mean HbA1C measured by the Clover Self device on the right hand was 7.51 ± 1.29, and the mean on the left was 7.59 ± 1.28. The concordance of the measurements from both hands by the Clover Self device with the reference device was ICC = 0.938 with a 95 confidence interval (0.913 - 0.957) (P < 0.001). Conclusion: The results of the present study indicate excellent concordance between the results obtained from the two devices, confirming the validity of the Clover Self device. © 2025 Isfahan University of Medical Sciences(IUMS). All rights reserved
The Effects of Probiotic Supplementation on Functional Constipation Following Colonoscopy: A Double-blinded Randomized Controlled Trial
No full textBackground: Functional constipation (FC) is characterized by infrequent and hard bowel movements, often accompanied by difficulty and pain during the passage. It has been suggested that an imbalanced microbiome contributes to the development of FC. One potential intervention is post-colonoscopy probiotic supplementation, which could create a favorable environment for FC patients. Objective: This study aimed to investigate the effect of probiotic supplementation on relieving constipation in FC patients. Methods: The current study was a double-blinded, randomized, placebo-controlled clinical trial (RCT) involving 78 patients with FC. Participants were randomly assigned to either the probiotic (n=39) or placebo groups (n=39). They received two capsules of either probiotic or placebo for 12 weeks. The assessment of bowel habit was based on ROME-IV criteria, which included anal obstruction feeling, defecation frequency, hard stool, painful defecation, force pushing, manual maneuvers, incomplete emptying, and total score. In addition, primary outcomes also included variables related to the Bristol Stool Form Scale (BSFS). Results: Probiotic supplementation significantly decreased the ROME-IV total score and its other components, with the exception of defecation frequency, when compared to the placebo group (13.93± 0.57 vs. 17.77± 0.60; P<0.001). Furthermore, the risk of type I stool (RR: 0.036; 95 CI: 0.004-0.331) and II stool (RR: 0.076; 95 CI: 0.019-0.309) was significantly decreased in the probiotic group. Conclusion: Despite some controversies surrounding the effects of probiotic supplementation on FC treatment, this RCT concluded that probiotic supplementation can improve bowel habits in FC patients. Clinical Trial Registration Number: Clinical Trials (IRCT ID: IRCT20210817052219N1). © 2025 Bentham Science Publishers
Probiotic soy beverages: a functional beverage on lipid profile, oxidative stress and kidney function: a systematic review of randomized controlled trials
No full textPurpose: Probiotic coadministration with soy beverages has been shown to have favorable results in human health. This study aims to conduct a systematic review of randomized clinical trials to examine the effect of probiotic soy beverages (PSB) on human health aspects such as lipid profile, oxidative stress and kidney function. Design/methodology/approach: The study was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Relevant articles were extracted from PubMed, SCOPUS, Web of Science, Science Direct and Google Scholar up to April 2024. This paper searched all databases using the following keywords: (“Soy milk” OR “Soy beverage” OR “Fermented soy milk” OR “Soy Fermented Beverages”) AND (“Probiotic” OR “Probiotics”). The literature search did not consider language, age and publication date restrictions. Findings: A total of 2,183 subjects were included in this review. PSB beneficially decreased low-density lipoprotein cholesterol and total cholesterol levels and increased high-density lipoprotein cholesterol. PSB beneficially affected superoxide dismutase, glutathione peroxidase, glutathione reductase and glutathione. PSB decreased serum creatinine and increased estimated glomerular filtration rate. Cystatin-C and progranulin decreased significantly in the PSB group. PSB had no significant effect on anthropometric indices, while decreased systolic and diastolic blood pressure. Originality/value: This study provides a brief overview of the effect of PSB on lipid profile, oxidative stress, inflammation and kidney function for the first time. © 2024, Emerald Publishing Limited
The Prevalence of Health-Promoting Behaviors among Sixth-Grade Elementary Students in Isfahan City, Iran
No full textBackground: Health-promoting behaviors encompass a range of behaviors that empower individuals to take charge of their health and other members of society. Considering that many high-risk behaviors are formed early in life, this study aimed to investigate health-promoting behaviors and the factors influencing them among sixth-grade elementary school students in Isfahan City, Iran, in 2023. Methods: This cross-sectional study was conducted with participation of 201 boy and girl elementary school students selected through two-stage cluster random sampling. Health-promoting behaviors were assessed using a standard questionnaire, Health-Promoting Lifestyle Profile (HPLP), and a demographic characteristics questionnaire also was used. Data analysis was performed using descriptive and inferential statistical tests with SPSS software. Findings: The average score for health-promoting behaviors was 137.33 ± 18.97. The highest average score was observed in the self-actualization dimension, which was 31.89 ± 4.35, while the lowest average score was in the stress management dimension, at 12.98 ± 3.12. Overall, 5.5 of students were classified as having good health, 73.5 were at an average health level, and 22.7 were categorized as having undesirable health. A significant difference was found between girls and boys only in the dimension of self-actualization; no significant differences were observed in the other dimensions. Conclusion: Considering that few students were in good health, it is necessary to develop a health promotion behavior training program for this age group to enhance their physical and mental health. © 2025, Isfahan University of Medical Sciences(IUMS). All rights reserved