Shiraz Emedical Journal
Volume:24 Issue: 4, Apr 2023

Prostatic adenocarcinoma is the second leading cause of death in males due to cancer. The prostate-specific antigen (PSA) serum level is the first marker for screening such patients.

The present study evaluated the comparison between the degree of staining of the PSA marker and some factors in the prognosis of prostate cancer.

The current cross-sectional study was performed on 97 tissue blocks from patients with prostate adenocarcinoma collected in 2019-2020 from the Pathology Department of Golestan Ahvaz Hospital archives. Clinical information such as age, tumor size, grade of tumor, lymph node involvement, and vascular and perineural invasion was extracted from patients’ pathology reports and recorded on a checklist. Then, PSA apical and intensity staining was studied using immunohistochemistry.

The mean age of patientswas 72.76 ± 8.19 years. The mean serum PSA level was 39.2 ± 8.90. In the present study, the highest PSA staining intensity in the samples was related to grade 1 with a frequency of 39 (40.2%), and then it was related to grade 4 with a frequency of 38 (39.2%), while the lowest frequency of staining intensity was related to grade 2 was with a frequency of 9 (9.3%). Regarding PSA apical staining, 58 samples (59.8%) were positive, and39 (40.2%) were negative. Astatistically significant comparison was shown between Gleason scoring and PSA apical staining (P < 0.001). The results indicate that increasing Gleason scoring decreases the staining intensity, and this correlation is significant (P < 0.05). The mean age in samples with positive staining of apical marker PSA is lower than in samples with negative staining of apical marker PSA but is not statistically significant (P = 0.38). In contrast, the serum level of the PSA marker is statistically significantly higher in samples with positive staining of apical marker PSA than in samples with negative staining of PSA (P < 0.001). According to the Spearman correlation coefficient test, the intensity of staining of the PSA marker decreases with age, and this correlation is significant (P = 0.032). However, according to the Spearman correlation coefficient test, staining intensity increases with increasing serum PSA level, and this correlation is statistically significant (P < 0.001).

It is also suggested that in future studies with a larger sample size, the comparison between apical marker expression and PSA marker staining intensity with clinicopathological factors, survival and mortality rates, response to treatment, etc., will be evaluated.

Today, prioritizing the spiritual well-being of medical students holds significant importance in numerous countries worldwide. An educational curriculum serves as a comprehensive written document that delineates educational objectives, content, as well as teaching and assessment methods.

This study aims to formulate and construct a curriculum for a master’s degree program in spiritual health.

The initial phase of this study aims to ascertain the existing state of spiritual health education programs by conducting a thorough literature review. In the subsequent phase, a focus group discussion was conducted with eight experts and scholars to deliberate on the spiritual health curriculum, utilizing Tyler’s curriculum development model as a framework. Finally, the nominal group process was employed to reach a consensus among the experts, ensuring the formulation of the final draft.

The spiritual health education curriculum was developed following Tyler’s curriculum planning framework, encompassing four distinct components. Part one outlines the goals of the spiritual health curriculum, while part two focuses on defining the content of the curriculum. Part three addresses the learning opportunities and strategies for teaching spiritual health within the curriculum. Lastly, part four involves the evaluation process to assess the effectiveness and impact of the spiritual health curriculum.

Spiritual health education has been recommended in various references. Recognizing discipline as spiritual health has fostered the growth of spiritual concepts in the healthcare environment, bringing attention to the needs of patients.

Abortion is the medical or surgical termination of pregnancy before the 20th week. However, dilation and curettage have been associated with hazards such as uterine rupture, heavy bleeding, and infection. Therefore, in recent decades, pharmacological therapies have become more widely accepted.

This research compared the medical abortion success rates of misoprostol/letrozole versus misoprostol/placebo.

This randomized clinical study was conducted at Mashhad University of Medical Sciences hospitals between 2018 and 2019, involving pregnant women who were candidates for medical abortion. The study population was divided into two groups based on whether they had undergone cesarean section (CS). Each group was randomly assigned to either a control or an intervention group. In the CS group, there were 52 patients in the intervention group and 52 in the control group. The control group received a regimen of misoprostol and placebo, while the intervention group received a combination of misoprostol and letrozole.

There was no statistically significant difference in age (31.59 ± 5.6 vs. 31.06 ± 4.6, P value = 0.605), gestational age by ultrasound (11.20 ± 3.3 vs. 10.29 ± 2.6, P value = 0.135), or blood pressure between the control and intervention groups. However, the analysis showed a statistically significant difference in the rate of complete abortion (12 (23.5%) vs. 28 (54.9%), P value = 0.001) between the two groups. In the non-CS group, there was a significant difference in age between the control and intervention groups. The study analyses also revealed a significant difference in the rate of complete abortion between the two groups (24 (46.2%) vs. 36 (72.0%), P value = 0.008).

Letrozole isrecommendedin combination with misoprostol for medical abortions because it increases the likelihood of complete abortion and reduces the duration of the abortion process.

Clinical decision-making and self-efficacy are essential parts of nurses’ professional work, which includes information analysis, and proper implementation of decisions in the clinical field.

The present study investigated the perspectives of anesthesia nursing students on clinical decision-making and clinical self-efficacy skills.

This cross-sectional study was done on 70 undergraduate anesthesia nursing students at Jundishapur University of Medical Sciences in Ahvaz, Iran, in 2021, who were recruited through the census method. The required data were collected using a questionnaire containing demographics, clinical decision-making, and self-efficacy in clinical performance. The collected data were analyzed in SPSS 16 using the chi-square test, Mann-Whitney U test, and KruskalWallis test at a statistical significance of 0.05.

Mean age of students was 21.70 ± 1.06 years. The median score of all students’ perceptions of clinical decision-making was 66.5 ± 6. Moreover, 60% of the students had a weak perception of clinical decision-making (systematic analytical). The median clinical self-efficacy score of all students was 87.50 ± 22. Also, 51.4% of the students had a moderate level of clinical self-efficacy.

There is insufficient perception of clinical decision-making and clinical self-efficacy among anesthesia nursing students at Jundishapur University of Medical Sciences in Ahvaz. Therefore, it is recommended to pay more attention to the curricula and educational programs in order to promote students’ perceptions.

The importance of improving quality and performance in higher education has led various universities to turn to effective methods of educational evaluation, such as auditing.

The present study evaluated the academic performance of the Tabriz Faculty of Management and Medical Informatics postgraduate students, an Iranian Center of Excellence in Health Management based on the Tennessee Academic Audit Model.

This descriptive-cross sectional study was conducted in 2019 with the participation of educational managers and faculty members of the same faculties in two phases consisting of self-assessment and external evaluation. After contextualization, the Tennessee comprehensive higher education audit checklist was used. Data were studied descriptively, and the results were reported as frequency (percentage) and mean ± standard deviation. Analysis of variance (ANOVA) and Tukey’s post hoc tests were used to evaluate the significance of the difference in academic performance between the educational groups. t-test was also used to evaluate the difference in performance scores in self-assessment and external evaluation phases. A P-value < 0.05 was considered significant.

The participants’ performance in the self-assessment phase was moderate (total score: 5.32), and their performance in the external evaluation phase was weak (total score: 2.75). The best and the worst self-assessment scores were in the dimensions of “overall assessment” and “follow-up of previous academic audits,” respectively. In the external evaluation, the dimensions of “contributions to the program and university goals” and “follow-up of previous academic audits” had the best and worst performance scores, respectively.

The results demonstrated that the Tabriz Faculty of ManagementandMedical Informatics of the Medical School needs to improve in terms of international standards. Therefore, managers and policymakers are required to implement interventions to address this gap.

The coronavirus disease 2019 (COVID-19) pandemic and its associated morbidities are a great global concern. Diabetes mellitus (DM) is associated with adverse clinical outcomes and high mortality in patients with COVID-19.

This study examined the frequency of DM, newly diagnosed hyperglycemia, and their impacts on hospitalized patients with COVID-19.

This retrospective study examined 810 medical records of PCR-confirmed COVID-19 patients admitted to Razi Hospital, Ahvaz, Iran. The clinical presentations, severity, and impacts of COVID-19 were compared between patients with and without DM. Disease severity was determined based on the NEWS2 scoring system.

This study included 810 medical records of COVID-19 patients, of whom 326 had pre-existing DM, and 484 were non-DM. The rates of diabetes and newly diagnosed hyperglycemia were 40.2% and 11.2%, respectively. The most common underlying diseases were hypertension (35.3%), ischemic heart disease (17.9%), and chronic kidney disease (11.9%), which were higher in people with diabetes than non-diabetics. The rate of acute kidney injury was higher in patients with diabetes than in non-diabetics (30.7% vs. 19.2%; P < 0.001) and in patients with severe COVID-19 than in those whose disease was not severe (27.8% vs. 21.5%; P = 0.04). The rates of severe COVID-19 (46.3% vs. 34.7%; P = 0.093), ICU admission (40.7% vs. 27.4%; P = 0.012), and mortality (18.5% vs. 10.5%; P = 0.079) were higher in patients with newly diagnosed hyperglycemia than in euglycemic patients.

This study showed that COVID-19 infection is linked with newly diagnosed hyperglycemia and pre-existing DM, both associated with severe COVID-19, more need for ICU admission, and mortality.

Librarians need to provide innovative services to different target groups.

This study aimed to determine the innovation status in the central libraries of Iranian medical universities.

This cross-sectional study was conducted in 2020. The study population consisted of 67 managers of the central libraries in Iranian medical universities. Datawerecollected using a researcher-made questionnairewhosevaliditywasconfirmedbyexperts; its reliabilitywas also confirmed with an alpha coefficient of 0.98. The data analysis was performed with descriptive and inferential statistics using SPSS version 24 software.

The mean innovation score in the studied libraries was 3.5 ± 0.74 in the dimension of organizational innovation and 3.2 ± 0.73 in service innovation, both of which were relatively desirable. However, the innovation level in the technological dimension was 2.7 ± 0.54, which was a relatively unfavorable situation. There were no significant relationships between gender (P = 0.88, 0.16, 0.17), age (P = 0.287, 0.708, 0.981), education degree (P = 0.561, 0.943, 0.935), work experience (P = 0.284, 0.656, 0.782), and education level (P = 0.605, 0.122, 0.033) and the types of innovation in medical libraries.

In the digital era, libraries need to focus on innovation, redefine their plans, do strategic planning to change their roles, and take practical steps to provide services for their users’ needs.

Haemophilia is one of the hereditary recessive diseases linked to sex-induced coagulation disorder and is characterized by bleeding episodes. This report presents a rare involvement of the distal phalanx hemophilic pseudotumor.

A 21-year-old man was crushed by a closing door 18 months before. The distal phalanx was fractured, and a large hematoma developed under the nail plate, which separated the nail plate from its bed. Eighteen months after the injury, plain radiographs demonstrated an expansile lesion with extensive destruction of the distal phalanx. Regarding the patient’s history and abnormal clotting tests, the development of a hemophilic pseudotumor was considered at the distal phalanx due to the enlarging nature of the coagulum, which induced compression and pressure necrosis on the adjacent bone and structures.

Hemophilic pseudotumors in the small bones are rarely reported. After a minor traumatic injury in hand, exact management and coagulopathy control are important to prevent further complications.