مجله پزشکی دانشگاه علوم پزشکی تبریز
سال چهل و پنجم شماره 4 (پیاپی 166، مهر و آبان 1402)

 Risky driving behaviors increase the risk of injury and death due to crash. Vast strata of behaviors are considered as risky behavior in the literature. The aim of this scoping review was to extract and determine various behaviors tagged as risky driving behavior.

 Based on Arkesy and OMalley framework, a scoping review study was conducted. Literature search was done through PubMed, Embase, Scopus and Web of Science databases. Snowballing of references and hand search of related journals were also used. Time limitation for search was defined from 1st January 2000 to 30th December 2019. Screening process was done independently by two researchers. Data was systematically extracted from the included articles using a predetermined extraction table.

Literature review resulted in 3761 articles. After the screening process, 45 articles were included in the study. Majority of included articles were from United States (n=13), followed by Iran (n=5), Australia (n=4) and China (n=4). Speeding (reported in 70% of included studies), drunk driving (52%), aggressive driving (44%), tailgating (41%) and not-using seat belt (37%) were the most frequent behaviors tagged as risky driving behaviors in the included studies.

 Regarding the discrepancies in understanding, definition, and categories of risky driving behaviors, it is of great importance to develop a unified standard definition and categorize risky behaviors which would facilitate global movements to reduce risky driving behaviors through effective interventions.

Practical Implications:

 The results will guide the policymakers to clearly develop suitable policies in national, regional or local levels to prevent and reduce the negative results of risky driving behaviours.

  Breast cancer with a complex inheritance pattern is a major cause of cancer death among women worldwide. Single nucleotide polymorphisms (SNPs), the most common genetic variations, influence interindividual predisposition to disease and treatment outcomes with drugs. Evidence suggests that CD40 polymorphism contributes to pathogenesis of cancer. The co-stimulatory molecule CD40 plays a prominent role in immune regulation. This study aimed to test the association between polymorphisms in the CD40 gene and breast carcinogenesis in Arak, Iran.

In this case-control study, three SNPs (rs1883832, rs4810485, rs3765459) were genotyped by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method. We included 80 patients with breast cancer and 80 healthy controls. Statistical analysis was performed by SPSS (version 26) using Chi-Squared test at P˂ 0.05.

  Our data showed a statistically significant association between the two CD40 SNPs (1s1883832 and rs4810485) and breast cancer risk (P=0.038 and P=0.000, respectively). There was no significant association between rs3765459 and breast cancer risk (P=0.190).

  We witnessed that CD40 gene polymorphisms (rs1883832 and rs4810485) contributed to breast cancer. So, they are associated with breast cancer risk.

The obtained data revealed a significant relationship between the rs1883832 and rs4810485 polymorphisms and the risk of breast cancer. Thus, these polymorphisms could be used as biomarkers to predict breast cancer.

The present study was conducted with the aim of investigating the relationship between vitamin D deficiency and the serum levels of calcium, magnesium and phosphorus.

  In this descriptive sectional study, infants who were admitted to the neonatal and NICU of Tehran Children's Medical Center Hospital with any diagnosis during 2018-2020 with vitamin D deficiency or insufficiency were included in the study. Serum levels of calcium, magnesium and phosphorus, and their relationship with vitamin D deficiency were recorded and investigated.

  Among 400 included infants, 197 neonates (49.3%) had vitamin D deficiency and 203 (50.7%) had vitamin D insufficiency. The average serum level of vitamin D in studied infants was 11.477±3.55 ng/ml. There was no statistically significant relationship between the serum level of vitamin D in newborns and the serum levels of magnesium and phosphorus (P value = 0.118 and P value = 0.511), but there was a statistically significant relationship between the serum level of vitamin D and the serum level of calcium (P=0.0001). There was no statistically significant relationship between the level of serum vitamin D in newborns with the age and the gestational age of the newborn (P = 0.132 and P = 0.651). Still, a direct and significant statistical relationship was observed with the newborn's weight (P = 0.049). The average length of hospitalization in the examined infants was 16.39 ± 16.36 days. Pearson’s correlation coefficient indicated the presence of an inverse and significant correlation between the level of serum vitamin D in infants and the duration of hospitalization (P=0.036). In such a way with the reduction of vitamin D serum level, the time of hospitalization increased.

  This study showed a statistically significant relationship between low vitamin D serum levels with calcium serum levels. 

Practical Implications: 

 In infants with low weight or hypocalcemia, there is a possibility of vitamin D deficiency. Vitamin D check is recommended to start treatment earlier and decrease the duration of hospitalization and other complications.

The irisin and betatrophin hormones are involved in insulin resistance. Considering the muscle weakness of elderly diabetics, this study aimed to investigate the effect of 21 weeks of strength training on betatrophin and irisin serum levels in type 2 diabetic elderly men.

This semi-experimental study was conducted on type 2 diabetic men with an average age of 70.85±2.90 years. The strength training protocol was performed twice a week for 21 weeks. The exercises consisted of three stages: 1- muscle endurance, 2- muscle hypertrophy, and 3- maximum strength training. Fasting blood glucose levels and serum levels of insulin, betatrophin, and irisin were measured in two phases before and after the exercises.

The serum levels of insulin, irisin, and betatrophin in the diabetes control group were lower than in the healthy group (P<0.05) and 21 weeks of strength training increased the serum levels of insulin, irisin, and betatrophin, and decreased body weight and fasting blood glucose levels in elderly diabetic men compared to the control group (P<0.05).

Strength training improved metabolic disorders in diabetics and increased secretion of irisin and betatrophin following exercise which indicated that exercise may have a protective mechanism in diabetes.

Stationary movements by performing strength activities, through the development of skeletal muscles of diabetics, improve insulin sensitivity and harvest more glucose in the body. In addition, these exercises can be a protective mechanism to prevent or delay the complications of type 2 diabetes by increasing irisin and betatrophin levels.

 With the spread of the contagious disease of COVID-19, the necessity of quarantine came to prevent the transmission of the disease. For this reason, patients suffered from social isolation. On the other hand, in order to control and treat the disease, it was necessary to provide self-care training. The present study was designed with the aim of comparison of the effect of self-care training program in two methods of multi-media education and tele-nursing on social isolation in patients with COVID-19 in Bandar Abbas city.

 This study was performed as a quasi-experimental study on 88 patients with COVID-19 referred to comprehensive health service centers in Bandar Abbas in 2021. The research samples were selected through convenience method and were divided into two groups of multimedia training and tele-nursing using block random allocation. First, social isolation in patients with COVID-19 was assessed using the questionnaire in two groups and then self-care training was provided using multimedia and tele-nursing methods. At the end of day twenty-one, social isolation was measured again and the data was entered into SPSS software version 26 and analyzed.

  There was no significant difference in pre-intervention assessment in term of social isolation score between the two groups (P>0.05). The results of the multiple covariance analysis test showed that by controlling the effect of the pre-test of each dimension of social isolation, the mean score of the loneliness, social disability, social anxiety and social tolerance dimensions after the intervention in the telenursing group was significantly lower than that of the multimedia group (P<0.001).

 Educational methods such as multimedia education and tele-nursing for awareness and self-care education, along with other medical care, can reduce social isolation. Therefore, it is necessary to consider a self-care education program and provide information about the necessary care during COVID-19 disease for patients in comprehensive health service centers and to use tele-nursing for more effective self-care education.

Practical Implications:

 Research findings can be applied in self-care training programs in infectious diseases such as COVID-19.

Paying attention to the spread of Corona in the last few years and the problems related to the health of hospital employees is very important. This research was conducted with the aim of modeling health-oriented behavior patterns based on abnormal personality traits with mediating role of health beliefs in the period of the COVID-19 pandemic.

The research method of this study was descriptive-correlation and structural equation modeling. The statistical population included the personnel of Al-Zahra State Hospital in Isfahan, of which 385 people were selected based on a convenience sampling method. The research tools included the personality abnormal dimensions questionnaire (PID-5), the health belief scale and health-oriented behavioral patterns. Pearson's correlation coefficient (with SPSS.23 software) and structural equation modeling (SMART PLS.3) were used for data analysis.

There was a relationship between abnormal personality traits and health-oriented behavior patterns during the COVID-19 pandemic period (β=0.47 and P<0.01). There was a relationship between health beliefs and health-oriented behavioral patterns during the COVID-19 pandemic period (β=0.223 and P<0.01). However, the mediating role of health beliefs in the relationship between abnormal personality traits and health-oriented behavioral patterns was not significant (β=0.026 and P<0.05).

Abnormal personality traits had a direct effect on health-oriented behavioral patterns.

Practical Implications:

 Paying attention to the destructive role of the corona virus in all aspects of people's lives, especially the medical staff and the role of medical staff in caring for and improving the physical and mental condition of patients can show its importance in the results of this research.

 Considering the importance of physician-nurse relationship in emergency departments and its role in improving the quality of services, patient satisfaction, job success and staff satisfaction, this study was conducted to investigate nurses' attitude about the professional doctor-nurse relationship and career success of the nurses in emergency departments.

 This study is a descriptive study in which 197 nurses working in the emergency departments of hospitals affiliated to Tabriz University of Medical Sciences participated. Data collection tools included demographic characteristic; physician-nurse professional communication questionnaire and nurses' career success questionnaire. The collected data were analyzed using descriptive and inferential statistical tests with SPSS ver.21 statistical software.

  The findings showed that the mean (SD) of the professional physician-nurse relationship from the perspective of participating nurses was 3.07 (0.54). Cooperating dimension with the mean score of 3.34 (0.79) had the highest score and imposing opinions and tasks dimension with the mean score of 2.62 (0.85) had the lowest score. Also, the mean (SD) score of nurses’ career success was 4.21 (0.40) with the highest mean in the dimension of system assistant 4.33 (0.55) and the lowest mean in the effective dimension 4.08 (0.41).

Considering the importance of the professional physician-nurse relationship, it is necessary to pay more attention to the effective factors in its promotion by implementing interventions such as professional communication skills training and effective interaction in strengthening the professional relationship of the treatment team.

Practical Implications: 

 The results of this study can be used to improve professional communication between health care team members and their work success. As a result, in addition to increasing job satisfaction and improving the psychological condition of personnel, the safety of patients will also be increased and the amount of injuries caused by communication defects will be decreased.

This study aimed to investigate a case of neuro-Behçet’s disease misdiagnosed as acute ischemic stroke or multiple sclerosis (MS). The studied case was a 29-year-old man with subacute onset of hemiparesis, dysarthria, and ataxia who was diagnosed as acute ischemic stroke at first. Due to no significant improvement, the patient was managed as an MS case, but he did not experience any improvements again. We noticed a history of oral and genital aphthous and cascade sign appearance in his brain MRI. Then, Behçet’s disease with secondary parenchymal involvement of brainstem was confirmed. The patient received infliximab, which resulted in clinico-radiological recovery.

Practical Implications.

 Given the prevalence of Behçet’s disease in the Middle East, the possibility of its diagnosis should be considered in patients with atypical history or imaging for ischemic stroke or MS.