Iranian Journal of War and Public Health
Volume:15 Issue: 59, Spring 2023

Ultrasound is the initial imaging modality for the detection of salivary gland tumors. There is an argument for evaluating multiple characteristics for predicting tumors using this imaging modality because no single sonographic feature is adequate for differentiating between benign and malignant tumors. This study aimed to examine clinical and sonographic characteristics of major salivary gland masses using B-mode ultrasound and color Doppler and check the sensitivity and specificity for each parameter.
Instruments &

 Sixty-two patients with parotid and submandibular salivary gland tumors underwent preoperative ultrasonic and postoperative histopathological evaluation. Different characteristics were examined, such as tumor shape, size, echotexture, internal calcification, cystic changes, clarity of the boundaries of the Lesion, lymph node enlargement, as well as the distribution of blood supply in the lesion by color Doppler.

Histopathological examination revealed that 18 of 62 tumors were malignant and the rest 44 tumors were benign, and 68.2% of benign cases were pleomorphic adenomas. Mucoepidermoid carcinoma accounted for 61.1% cases. There was a significant difference between the malignant and benign tumors in calcification in the lesion, echogenicity, posterior echo enhancement, vascularity, and significant result in the shape of the lesion and homogeneity status (p<0.01).

Pleomorphic adenoma and mucoepidermoid carcinoma are the most frequent benign and malignant tumors, respectively. Older age and female gender are associated with a higher frequency of malignant salivary gland tumors.

Infection is one of the most important complications of neutropenia and contributes to the high rate of morbidity and mortality. This study aimed to investigate some bacterial and fungal infections in cancer patients with neutropenia.
Materials &

110 specimens from 10 normal humans as a control group and 100 specimens from neutropenic cancer patients were collected. The ELISA technique was used to assess the presence of neutropenia in patients. The diagnosis of bacterial infections was based on the bacteriological culture of isolated specimens (blood, sputum, and urine) and biochemical test, then Vitek-2 Compact.

60 specimens (60%) contained an infection. 44 samples (73.3%) had positive blood cultures, consisting of 25 (41.6%) in leukemia patients and 19 (31.7%) in breast cancer patients. 6 samples (10.0%) of bladder cancer patients had positive urine cultures. Positive sputum was seen in 10 samples (16.7%) of patients with lung cancer, while the cultures of 40 samples (40.0%) were negative. Ten E. coli (16.7%) was in patients with leukemia and bladder cancer, 15 Pseudomonas aeruginosa (25.0%) in patients with breast cancer and leukemia, and 25 Klebsiella pneumonia (41.7%) in the patients with leukemia, breast cancer, and bladder cancer. However, samples from patients with lung cancer contained 4 coagulase-positive Staphylococci (6.7%) and 6 Streptococcus pneumoniae (10.0%).

Neutropenia is more common in leukemic patients. Gram-negative bacteria are the greatest public bacteria isolated in the patients. Klebsiella pneumonia and Streptococcus pneumonia are the most common Gram-positive bacteria. All types of bacteria are resistant to most antibiotics.

 The present study aimed to provide a model of the mental health of veterans and identify its determining factors.
Information &

 The study method is based on correlational network data analysis. The data of 9244 veterans, including demographic characteristics and data related to mental health, were extracted in the second 6 months of 2020, and then the network indexes were calculated.

Age, number of children, percentage of veterans, percentage of neurological and mental disorders, physical functioning, bodily pain, and mental health were the variables that had the most strength. Age, number of children, pension, percentage of neurological and mental disorders, physical functioning, depression, anxiety, general health, physical role, physical functioning, social functioning, and vitality were the closeness factors in the mental health network of veterans. The Benit value for the variables of depression, age, mental health, physical role, physical functioning, and the number of children in the mental health network of veterans was non-zero. The variables of number of children, percentage of mental disorders, psychiatric diagnoses, especially depression, employment standby, physical problems, and vitality had the highest eigenvector values in the mental health network of veterans. The variables of the number of children, the percentage of mental disorders, depression, vitality, history of hospitalization, and the type of hospitalization had higher leverage (positive) with the mental health network.

The variables related to quality of life, along with age, number of children, percentage of neurological and mental disorders, and depression, are the main determinants of mental health.

Bronchial asthma is a life-threatening disease with a multifactorial etiology. It was shown that immunological dysregulations play an essential role in the exacerbation of the patient’s attacks. Toll-like receptors act as a bridge in the transmission of different signals associated with the regulation of immune responses. According to numerous research, TLR2 causes different outcomes in asthma. TLR2 and TLR4 overexpression seems to predispose to an increase in the frequency of dyspneic attacks. Therefore, this study aimed to learn more about the function of TLR2 and TLR4 and investigate their underlying association with allergic airway inflammation in asthmatic patients.
Materials &

In this case-control study conducted at outpatient clinics in a Specialized Allergy Center in Basrah City, South of Iraq, 70 asthmatic patients and 70 healthy individuals were investigated. 4ml of venous blood was drawn and divided into two parts: 2ml was used for RNA extraction and qRT-PCR, and another 2ml was used for the serological tests. Data analysis was done by SPSS 26 software.

The mean serum levels of TLR2 and TLR4 were significantly higher in the asthmatic group (28.33±13.00ng/ml and 46.30±20.32ng/ml, respectively) than in the control group (7.33±3.73ng/ml and 26.28±14.32ng/ml, respectively). Also, the expression level of TLR2 and TLR4 was significantly higher in the asthmatic group (p<0.05).

TLR2 and TLR4 are increased in patients with bronchial asthma compared to healthy individuals. Elevated levels of both biomarkers may act as a trigger for increased secretion of other cytokines, leading to exacerbation of asthmatic signs and symptoms.

Post-traumatic stress disorder in people traumatized by war includes a set of clinical symptoms such as cognitive, emotional, behavioral, and physical symptoms. This study aimed to determine the effectiveness of training the therapeutic reconsolidation process model on improving executive functions, increasing cognitive flexibility, and modifying schemas related to post-traumatic stress disorder in neuropsychiatric veterans above 25%.
Materials &

This semi-experimental study in a pre-test, post-test design with a control group and a 45-day follow-up was conducted on the neuropsychiatric veterans above 25%. 40 people were randomly selected and assigned into the experimental (n=20) and control (n=20) groups. The therapeutic reconsolidation process model training was held for the experimental group in 12 sessions (90 minutes once a week). The research tools included the Post-Traumatic Stress Disorder Checklist, Leahy Emotional Schema Scale, Wisconsin Card Sorting Test, Stroop Color and Word Test, and Cognitive Flexibility Questionnaire. Data were analyzed using SPSS 24 software.

In different study stages, there was a significant increase in the mean scores of response inhibition in the Stroop test, subscales of cognitive flexibility, compatible emotional schemas, and correct answers in the Wisconsin test, and a significant decrease in the mean scores of incompatible emotional schemas and incorrect answers in Wisconsin test, in the experimental group compared to the control group (p<0.05).

The therapeutic reconsolidation process model is effective in improving executive functions, increasing cognitive flexibility, and modifying schemas related to post-traumatic stress disorder in neuropsychiatric veterans above 25%.

Multiple sclerosis is a chronic demyelinating disease, which is considered an autoimmune disease impacting the central nervous system. Patients with MS may have certain orofacial manifestations and oral microbiological changes as a result of different treatment modalities. This study aimed to investigate the changes of Candida albicans in normal oral flora during different modalities of treatment and compare them with healthy individuals.
Materials &

120 Patients were volunteered and divided into four groups of 30 people: 1) patients with MS taking Natalizumab or Tysabri, 2) patients with MS taking Betaferon, 3) patients who were recently diagnosed with MS and were in a variety of progressive stages, 4) healthy individuals (control). The swap samples were taken from the participants, particularly from the oral cavity. PCR real-time program investigated the presence of Candida albicans. All patients were examined under standardized conditions by a single examiner, and the oral cavity was examined in an artificial light using a mouth mirror.

Regarding the presence of Candida albicans, there was a significant difference between the naive MS patient group and healthy individuals (p=0.036). However, the difference between the Tysabri group and the healthy group was not significant (p>0.05), while in the Betaferon group, the presence of Candida albicans significantly increased (p=0.0001).

Oral Candida albicans increase in naive MS patients compared to healthy individuals. This increase indicates that oral Candida albicans may involve in MS development. On the other hand, orofacial manifestations decrease in all MS treatment groups.

Shooting is one of the most important skills for military forces, and mastery in this skill is valuable. People are very different both physically and in terms of behavioral brain systems and personality traits. Therefore, the present study aimed to predict the shooting accuracy of soldiers based on their physical fitness factors and their brain-behavioral personality traits.
Instruments &

The current research was a cross-sectional descriptive study that was conducted on 84 soldiers who were selected from 120 units of the Islamic Republic of Iran Army. Physical fitness factors were evaluated using appropriate tests and brain-behavioral personality traits with Carver scale. Also, each soldier's shooting accuracy score was recorded. For data analysis, Pearson's correlation coefficient and multiple logistic regression were used in SPSS 26 software.

There was a direct and significant correlation between physical fitness and shooting accuracy of soldiers (r=0.569; p=0.001), as well as between personality traits and shooting accuracy (r=0.663; p=0.001). Physical fitness explained 34% of the variance of shooting accuracy, and personality traits explained 51% of the variance of shooting accuracy.

Physical fitness and personality traits predict 51% and 34% of the variance of shooting accuracy, respectively.

Considering the increase of dermatomycoses and the emergence of new strains resistant to antifungal treatment, it is important to find an alternative treatment of natural origin. This study aimed to extract and purify β-carotenoid from two types of Rhodotorula diobovata and Rhodotorula mucilaginosa and test its reactivity toward some yeasts isolated from dermatomycoses infection.
Materials &

Rhodotorula samples were isolated from extreme environmental soils, and after cultivation, they were identified genetically and apparently. Then their pigments were extracted and purified. Beta-carotene was detected by ultraviolet and infrared regions. The activity of β-carotene was tested using three different concentrations using the agar diffusion method against four isolates of Candida and Cutaneotrichosporon dermatis pathogenic species by comparing its reactivity with the antifungal Nystatin.

All tested isolates, including Candida albicans HAM25, Candida dubliniensis, Candida tropicales HAM13, and Cutaneotrichosporon dermatis Judy 4, showed resistance against β-carotene purified from R. diobovata and Nystatin at the concentration 0.01mg/ml. However, β-carotene and Nystatin showed activity against all isolates with concentrations of 0.02 and 0.03mg/ml. The purified compound from R. mucilaginosa showed activity against all isolates in three concentrations, according to concentration and type. There was a significant difference between the antifungal activity of both purified β-carotene and Nystatin (p<0.0001).

Both isolates of Rhodotorula diobovata and Rhodotorula mucilaginosa produce β-carotene, and the preference quantitatively is to isolate R. diobovata first. The activity of β-carotene against all tested yeast isolates are higher than the antifungal Nystatin.

Sodium-glucose transporter inhibitors 2 are a new drug group used for patients with diabetes mellitus. These are a very effective group in the management of type 2 diabetes, but side effects such as urinary tract infections and foot ulcers do appear, which is specific to canagliflozin. Therefore, the current case report focuses on patients taking canagliflozin who presented with foot and leg ulcers.
Patient &

The patient was a 69-year-old man who went to the hospital after falling at home and was diagnosed with pneumonia and lower limb ulcers. The patient had a history of ischemic heart disease, chronic kidney disease, multiple sclerosis and type 2 diabetes mellitus (regarding canagliflozin). A complete laboratory examination was performed, and appropriate treatment was done, but unfortunately the patient died due to multiple comorbidities.

It seems that the risk of peripheral vascular ischemia is increased in type 2 diabetes patients taking canagliflozin. This case was mainly highlighted to confirm the fact that using canagliflozin is associated with increased incidence of lower limb amputation, particularly toes.

There may be is a relationship between canagliflozin and lower limb ulcers in patients with type 2 diabetes mellitus who are older than 65 years.

Scoliosis is one of the secondary complications in amputation veterans, which requires periodic evaluations. The gold standard for evaluating the spine is radiography, which has caused many concerns due to the high doses of X-ray radiation. For this reason, therapists are finding for an alternative method for this tool. Ultrasound is a non-invasive tool with different methods for this purpose. The current research aimed to determine the best method for measuring the curvature of the spine of scoliosis patients by ultrasound.
Information &

A systematic search was performed from 2000 to 2022 in Scopus, PubMed, Web of Science, and Embase databases to find articles that examined the reliability and validity of ultrasound to assess the curvature of the spine in people with scoliosis. COSMIN checklist scale was used to survey the quality of researches.

18 articles were reviewed. In most studies, correct methodological quality was not reported to evaluate internal consistency, measurement error, construct validity, hypothesis testing, cross-cultural validity, responsiveness, and interpretability. Finally, four methods of measuring spinous process angle, spinous process-transverse process angle, transverse process-upper articular process angle, and lamina center method were found for ultrasound.

Ultrasound by measuring the center of the lamina is a simple and very reliable method to evaluate the curvatures of the spine of people with scoliosis and can be a suitable alternative to the gold standard of radiography.

Multiple sclerosis is a chronic demyelinating disease that is considered an autoimmune disorder affecting the central nervous system. This study aimed to investigate the pathogenic changes in the natural flora of the mouth in MS patient during different treatment modalities and compare them with healthy individuals.
Materials &

120 patients were volunteered and divided into four groups of 30 people: 1) patients with MS taking Natalizumab or Tysabri, 2) patients with MS taking Betaferon, 3) naive MS patients without medications, 4) healthy individuals (control). The changes in oral bacteria (Staphylococcus aureus, Porphyromonas gingivalis, and Bacteroides fragilis) were investigate using real time-PCR.

The prevalence of S. aureus was significantly higher in the Naive MS group (p=0.016), Betaferon group (p=0.001), and Tysabri group (p=0.0001) compared to the healthy group, as well as in Tysabri group compared to the Naive MS group (p=0.005). The prevalence of P. gingivalis was significantly higher in the Betaferon group (p=0.002) and Tysabri group (p=0.0001) compared to the healthy group, as well as in Tysabri group compared to the Naive MS group (p=0.020). The prevalence of B. fragilis was significantly higher in the Naive MS group (p=0.008), Betaferon group (p=0.015), and Tysabri group (p=0.008) compared to the healthy group.

Oral bacteria are involved in MS development. Furthermore, MS patients are more susceptible to periodontal disease due to high P. gingivalis presence, and these patients need to receive extra care to prevent periodontal disease.

The present study aimed to examine the neuroprotective effects of semaglutide during endotoxemia and its role in modulating pro-inflammatory mediators.
Materials &

Twenty-four adult male Swiss albino mice, 8-12 weeks old, weighing 25-35g, were randomly divided into four equal groups (n=6), including sham (laparotomy without cecal ligation and puncture, sepsis (laparotomy with CLP), vehicle (equivalent volume of distilled water before CLP), and semaglutide (40µg/kg/day before CLP). The brain was used for tissue evaluation of TNF-α, IL-6, IL-1β, TLR4, and P-STAT3, as well as for histological examination.

The tissue levels of TNF-α, IL-6 and IL-1β in the sham group were significantly lower than the sepsis and vehicle groups (p<0.05). In the semaglutide group, tissue levels of TNF-α, IL-6, and IL-1β were significantly lower than the sepsis and vehicle groups (p<0.05). The tissue levels of TLR4 and STAT3 in the sham group were significantly lower than the sepsis and vehicle groups (p<0.05). Also, tissue levels of TLR4 and STAT3 in the semaglutide group were significantly lower than the sepsis and vehicle groups (p<0.05). Histopathologically, semaglutide considerably reduced brain damage compared to the sepsis and vehicle groups.

Semaglutide can reduce brain dysfunction during CLP-induced polymicrobial sepsis in male mice through its modulating effects on TLR4STAT3 downstream signaling pathways and subsequently reducing inflammatory cytokines TNF-α, IL-6, and IL-1β.

Patient experience, along with clinical performance and safety, is known as a critical criterion for improving healthcare performance. This study aimed to assess the validity of the Persian version of the Picker Patient Experience Questionnaire.
Instrument &

This descriptive cross-sectional study was condcted in Nikan Gharb and Nikan Aqdasiyeh hospitals in Tehran from April to May 2022. The Persian version of the Picker Patient Experience Questionnaire was prepared based on the translation-retranslation method. The face and content validity of the questionnaire was evaluated with the opinions of 10 experts. To check the tool validity, all patients discharged from the two hospitals were interviewed by phone from April 21 to May 21, 2022. The main dimensions and constructs of the questionnaire were determined by the exploratory factor analysis method. The questionnaire reliability was evaluated using the test-retest method by participation of 30 subjects.

By checking the validity of the questionnaire, the items were included in 7 aspects which were in accordance with the main sections of the questionnaire (information and education, coordination of care, emotional support, respect for patient preferences, physical comfort, involvement of family and friends, and continuity and transition). The tool reliability for the 7 aspects by Cronbach's alpha was in the range of 0.744 to 0.911, and for the whole questionnaire was 0.804.

The Persian version of Picker Patient Experience Questionnaire has the necessary validity to evaluate the experience of hospitalized patients in Iranian hospitals.