نشریه دانشگاه علوم پزشکی خراسان شمالی
سال هفدهم شماره 1 (بهار 1404)

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders, the main factors of which are insulin resistance and obesity. The aim of this study was to investigate the effect of aerobic training on metabolic factors in women with PCOS.

A systematic search of English and Farsi articles published in PubMed, Web of Science, Civilica, Scopus, Sid, and Magiran databases was conducted until April 2024. The present meta-analysis was conducted to investigate the effect of aerobic exercise on metabolic factors in women with PCOS. The mean difference and 95% confidence interval (CI) were calculated using a random effect model. Heterogeneity was evaluated using the (I2) test. Publication bias was evaluated by visual analysis of the funnel plot and Egger's test.

In total, 10 studies with 12 interventions and 460 women with PCOS were meta-analyzed. The results showed that aerobic exercise significantly reduced body mass index, waist-to-hip ratio, and body fat percentage compared to the control group in women with PCOS (P<0.05). However, aerobic exercise did not significantly change glucose, insulin levels, and insulin resistance compared to the control group in women with PCOS (P>0.05).

The results of the present meta-analysis showed that aerobic training improved the metabolic status of patients with PCOS and these beneficial effects were not associated with changes in insulin resistance.

Natural supplements, such as royal jelly, are commonly used to improve health and well-being in the world and may be a successful treatment for damaged sperm exposed to environmental and chemical pathogens. Therefore, the present study was conducted with the aim of investigating the protective effects of royal jelly on sperm parameters using a narrative review method.

The present study was conducted using a systematic review approach. A comprehensive search was conducted in various databases, including ISI, Web of Science, Cochrane, Pubmed, Google Scholar, ProQuest, and Ovid, as well as Persian databases, including ISC, SID, and Magiran, from January 2010 to March 2023. The research was carried out using Persian keywords: “Male infertility,” “Sperm parameters,” “Royal jelly,” “Protective effect,” “Fertility promotion,” and “Clinical trial” and their equivalent English keywords. The search results were 58 articles, of which 11 articles were reviewed according to the objectives of the study.

Royal jelly consumption is effective on sperm parameters and can improve sperm viability, number, and motility. It also has a protective effect on the negative effects of heat stress, nicotine consumption, exposure to lead compounds, and the use of drugs, such as bleomycin and hydroxyurea.

Royal jelly, as a protective agent, improves sperm viability, number, and motility and is effective at medium and high doses. However, very high or low doses have little effect, and further studies are needed to determine the optimal dose. Human clinical research is needed to determine the effects and appropriate dosage of royal jelly on male fertility with sperm disorders.

Hyperlipidemia is a medical condition that is characterized by elevated blood lipid levels. This condition is often associated with an increased risk of cardiovascular diseases, such as heart attack and stroke. Traditional treatment approaches for hyperlipidemia include lifestyle modifications, dietary changes, and pharmacotherapy. However, some patients cannot achieve the LDL-C treatment goals, necessitating the development of novel lipid-lowering therapies with improved efficacy and safety profiles. Gene editing, which permanently alters gene expression, can revolutionize disease treatment. The CRISPR/Cas9 system has emerged as the preferred technology among various gene editing approaches due to its high efficiency and relative simplicity. Nowadays, CRISPR-Cas9 technology is frequently used in medicine and many other fields for targeted gene screening and gene therapy. However, challenges remain in the clinical application of CRISPR-Cas9, and a safe and efficient delivery system is required.

The search was performed in Scopus, PubMed, and Google Scholar using the following keywords: “Hyperlipidemia,” “CRISPR-Cas9”, “Genome Editing,” “Gene Editing,” “Lipid Nanoparticles,” and “LNPs.” We included all relevant in vitro, in vivo, and clinical trial studies published until November 2024.

It has been indicated that the use of lipid nanoparticles (LNPs) as delivery vehicles is promising. The LNPs enhance the stability of the CRISPR/Cas9 system and offer advantages, such as ease of production and high versatility, making them an ideal carrier with great potential.

This review provides an overview of the hopeful technology and the latest advances in the development of dyslipidemia treatments.

Urinomas are rare and uncommon lesions that occur in the ureter or around the kidney. The aim of this study was to report a case of a rare ureteral urinoma.

The patient was a 69-year-old woman who referred to a medical center complaining of left-side pain. The results of the patient's tests showed low creatinine and higher than normal urea. According to the abdominal and pelvic ultrasound findings, ureteral urinoma was diagnosed. The patient was discharged from the hospital after taking the prescribed medicines on November 26, 2022.

The findings of this study can help the treatment staff to consider the possibility of diagnosing urinoma in patients who present with symptoms of fatigue and flank pain. Therefore, being aware of the symptoms of this disease will help diagnose these patients faster and prevent the disease from worsening.

Multiple sclerosis (MS) is one of the common and debilitating diseases of the central nervous system, during which a disorder occurs in the covering of neurons [myelin]. Approximately two million people worldwide are suffering from this disease. Therefore, the present study was conducted to compare the effectiveness of cognitive-behavioral and narrative therapies on death anxiety and body image of MS patients.

This study was conducted using a semi-experimental method of pre-test-post-test and follow-up on 45 patients with MS using a targeted sampling method and with records from the empowerment charity in 2023 in Tehran. The experimental group received one cognitive-behavioral therapy, and the experimental group received two narrative therapies weekly for 60 minutes, while the control group did not receive therapy. Research tools included the Death Anxiety and Body Image Questionnaire. Data analysis was conducted using statistical analysis of covariance (ANCOVA) and analysis of variance (ANOVA) with repeated measurements.

The results indicated that cognitive-behavioral and narrative therapies effectively reduced death anxiety (effect size of 0.622) and improved body image (effect size of 0.701) in MS patients at a significance level of 0.001. According to the Bonferroni test, there was no significant difference between the effectiveness of narrative and cognitive-behavioral therapies (P<0.01).

It seems that cognitive-behavioral and narrative therapies can be employed as complementary treatments along with other treatment methods for MS patients.

The presence of antibiotic residues in the environment has raised a global concern today, and the need to control their discharge is also considered an unavoidable issue. This study aimed to investigate the efficiency of a combined sonophotocatalytic process in the presence of magnetic iron nanoparticles for the degradation of the antibiotic ciprofloxacin from aqueous environments.

This research was an experimental study that was carried out on a laboratory scale and at room temperature. For this purpose, the effect of changes in the concentration of peroxydisulfate and the dose of magnetic nanoparticles, contact time, initial antibiotic concentration, and pH were investigated under ultrasonic and ultraviolet waves. Finally, the concentration of antibiotic ciprofloxacin was analyzed by spectrophotometer, and the variations in chemical oxygen demand (COD) were examined. Then, the characterization of nanoparticles was carried out.

According to the results obtained, the highest removal rate of the antibiotic ciprofloxacin was observed at pH=7, the amount of magnetic nanoparticles was 0.3 g/L, the concentration of persulfate was 4 mM, and the antibiotic concentration was 10 mg/L. In the aforementioned optimal conditions, the removal efficiency of ciprofloxacin was 92.5%, and the COD removal rate was 79.8%.

According to the experiments, the sonophotocatalyst process, along with the use of magnetic nanoparticles, is an effective method for the reduction of the antibiotic ciprofloxacin. Therefore, due to its high removal efficiency, cost-effectiveness, and simple operation, the use of this process is recommended for the removal of organic and resistant contaminants from aqueous solutions.

Considering the importance of prevalence and high complications of abdominal masses, this study was conducted to determine the prevalence of benign and malignant abdominal lesions and their relationship with demographic characteristics during a large 6-year study.

This analytical-cross-sectional study investigated the clinical records of 721 patients with subcutaneous and deep abdominal masses undergoing surgery in Amir Al-Mo’menin (AS) Hospital, Tehran, Iran, between the years 2012 and 2023, considering the inclusion criteria and using the convenience method. Moreover, demographic and pathology characteristics were extracted from these files.

Out of the total masses, 50 cases (6.9%) were malignant and the rest were benign. The most common benign masses were myoma (36.7%) and prostate hyperplasia (20.1%), and the most common malignant cases were bladder (16.0%) and ovarian (14.0%) in descending order. The age of people with malignant tumors was significantly higher than that of people with benign tumors (54.96 ± 15.23 vs. 45.42 ± 15.59 years; P<0.001). The prevalence of malignant cases in men was significantly higher than that in women (54.0% vs. 46.0%; P<0.001). However, there was no statistically significant relationship between the family history of abdominal mass (P=0.055) and the year of referral (P=0.259) with the type of mass.

Abdominal malignant masses are more common in older ages and men.

Preoperative planning for glioma tumor resection and radiotherapy treatment requires proper delineation of the tumor and surrounding brain tumor regions. The present study aimed to investigate the importance of various diffusion parameters, especially the mean kurtosis (MK), in discriminating between recurrent tumors, edema, and normal areas.

A total of 19 patients with high-grade glioma underwent postoperative diffusion imaging. The authors extracted diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) models to evaluate the data in manually delineated regions of interest (ROI) and used their derived parameters to characterize edema, tumor, and normal brain areas. The Wilcoxon test was used to determine the significance of the parameters in the three groups: recurrent, edema, and normal. Moreover, the Mann-Whitney test was employed to determine the significance between the two groups of recurrent and normal, as well as between recurrent and edema.

Considering the p-value less than 0.05, the apparent diffusion coefficient (ADC), mean diffusion (MD), and MK parameters were significantly different between some of the three groups. The ADC and MD indicated significant differences between the two recurrent and normal groups, with P-values of 0.041 (P<0.05). In addition, there was a significant difference in MK between the two recurrent and normal groups with P-values of 0.02 (P<0.05).

Diffusion parameters are promising in differentiating between recurrent and normal areas in high-grade gliomas after surgery and after treatment

Considering the severe psychological changes in adolescence and its effects on mental health, the present study aimed to investigate the effectiveness of emotion-focused therapy (EFT) with and without emotion-focused family therapy (EFFT) on emotion processing, basic psychological needs, anxiety, and depression in adolescents.

This quasi-experimental study employed a pre-test and post-test design with a two-month follow-up. The statistical population consisted of females aged 12 to 18 experiencing depression and anxiety. A total of 26 participants were selected through convenience sampling and randomly assigned to two groups of 13. One group received 16 sessions of EFT, while the other group received 16 sessions of EFT combined with EFFT. Data were collected using the Buckler Emotional Processing Scales (EPS-25), the Deci and Ryan Basic Psychological Needs Scale (BNSG-S), and the Depression and Anxiety Syndrome Questionnaire (DASS-21) at pre-test, after the eighth session, at the end of the intervention, and two months post-intervention. The obtained data were then analyzed using SPSS software (version 26) through multivariate mixed variance analysis and Bonferroni post hoc tests.

The results indicated significant differences in anxiety, depression, basic psychological needs, and emotional processing scores over time for both intervention methods (P<0.0001). Additionally, there was a significant difference between the two interventions regarding their effectiveness.

Despite the effectiveness of both interventions, the group receiving EFFT had a greater decrease in anxiety, depression, and emotional processing scores and a greater increase in basic psychological need scores.

Healthcare workers should have acceptable ehealth literacy. This study was conducted to determine the effect of an educational intervention based on the Freire educational model on the ehealth literacy of healthcare workers in Bojnurd City.

The present study was an interventional and quasi-experimental research conducted among all healthcare providers working in health centers in the city of Bojnord. Participants were selected through a census method and divided into two groups: an intervention group (n=40) and a comparison group (n=40). The data collection tool included a two-part questionnaire consisting of a demographic information form and a standard ehealth literacy questionnaire. Interventions were conducted based on Freire's model in 5 combined training sessions, including theoretical, practical, and virtual face-to-face sessions for the intervention group. The questionnaires were completed by the subjects before, immediately after, and two months after the educational intervention. The data were analyzed using SPSS24 software and appropriate statistical tests.

Based on the results of the study, there was no statistically significant difference between the mean scores of ehealth literacy in the intervention and control groups before the educational intervention (P=0.064). However, a statistically significant difference was observed between the mean ehealth literacy scores in the intervention group compared to the control group immediately and two months after the educational intervention (P<0.05).

As a result, the educational intervention based on the Freire education model is effective in improving the level of ehealth literacy of healthcare workers. Therefore, it is essential to plan and take action to empower healthcare workers in this field so that they can take steps to improve the health of their society.

Transferring a patient from one care team to another is called handoff, which has a crucial role in care quality and patient safety. This study aimed to audit compliance with handoff standards of trauma patients admitted to the hospital by emergency medical service personnel.

This descriptive cross-sectional study, which focused on trauma patients, was carried out in a northeastern city during the first half of 2023. The sampling process was observational and event-based. The instrument of research was a researcher-designed checklist covering various dimensions of patient handoff standards. The validity was assessed by using qualitative face and content validity methods, while reliability was evaluated through inter-rater agreement. The data were analyzed through SPSS software version 24.

A total of 361 trauma patients were analyzed. The findings showed that the average score achieved by emergency medical personnel was 13.48, which was lower than the maximum achievable score of the tool. Among the nine key dimensions, the highest average score belonged to the explanation of the process (4.73), while the lowest was related to the mechanism of injury (0.27).

The findings revealed that the score for compliance with handoff standards of patients was significantly lower than the average achievable score in most areas. Therefore, developing standard protocols and auditing compliance with handoff standards and their effect on the quality of patient care can be a crucial step toward enhancing patient safety.

Caring burden is a situation that the caregiver faces during the care of a person with a spinal cord injury. Considering the significant level of stress and care burden created for caregivers in providing care, the concept of resilience becomes important. Considering to importance of the issue, this study was conducted with the aim of determining the relationship between resilience and the care burden of caregivers of people with spinal cord injuries referring to the Iranian Spinal Cord Injury Support Association in 2021.

This research was a cross-sectional descriptive-correlation study. The samples were 196 caregivers of people with spinal cord injuries who referred to the Iranian Spinal Cord Injury Support Association in 2021 and were selected through a continuous sampling method and based on the inclusion criteria. In this study, the demographic form of caregivers and two questionnaires, Connor-Davidson Resilience Scale and Zarit Caregiver Burden, were used. The data were analyzed in SPSS version 26 software using descriptive statistics, statistical tests of Spearman's correlation analysis, independent t-test, and analysis of variance with a significance level of P = 0.001.

The average score of resilience and care burden in caregivers of patients was 63.81±17.32 and 31.07±17.85, respectively. There was a significant negative correlation between resilience and care burden (r=-0.434), so ​​increasing care burden decreased resilience (P<0.001). The results of a one-way analysis of variance showed that there was no statistically significant difference between the location of the lesion and the resilience score (P=0.175) and the caregiving burden score (P=0.540).

The results of this research showed that with a decrease in the resilience of caregivers in people with spinal cord injuries, the burden of caring for them increased. Therefore, reducing the care burden and not caring for the person alone in these people can improve the caregivers' resilience against the surrounding problems and stresses.

Due to the widespread prevalence of cancer, the number of parents with cancer who have a dependent child is increasing. Cancer in parents creates challenges for teenagers in the family and exposes them to mental and physical problems caused by the diagnosis of cancer in parents. In order to prevent negative consequences in children, it is necessary to understand more regarding the impact of parental cancer on children and their psychosocial needs. The present research was conducted to explain the psychosocial problems of adolescents whose parents suffer from cancer.

The current research was conducted using the qualitative content analysis approach. A total of 18 teenagers with cancer-afflicted parents were selected by targeted sampling method from the medical education centers of Tehran, and semi-structured interviews were conducted with them. At the same time as the data was collected, the findings were analyzed using the content analysis method and with the help of MAXQDA10 software.

After analyzing the interviews, 12 subcategories and five main categories, including "Mental rumination," "caregiving pressure," "parental cancer-related problems," "volatile social interactions," and "obstacles and facilitators of adaptation to the disease," were extracted, which can depict teenagers' experiences of having a parent with cancer.

The results of this research indicated that teenagers face many challenges in the field of coping with their parents' cancer. The results of the current study can be applied to help formulate and implement educational intervention programs to reduce teenagers' mental conditions.

One of the methods of informing industrial workers about occupational hazards in the workplace is the use of safety signs, which are installed in the required places according to the type of workplace hazards. Therefore, the purpose of this study is to investigate the level of understanding of safety signs among industrial workers.

In this cross-sectional descriptive-analytical study, the level of understanding of safety signs was measured on 150 industrial workers in North Khorasan Province. The data were collected using the ISO 9186–1:2007 questionnaire and the American National Standards Institute ANSI Z535.5 criteria for understanding safety signs. After collection, the data were analyzed using SPSS 21 statistical software.

The results of the study showed that 52.6% of the subjects belonged to the age group of 31 to 50 years. The average level of understanding of safety signs was 15.78±15.20. The highest level of correct understanding was related to the "No Smoking" sign, while the lowest level was related to the "First Aid Kit" sign. The relationship between age, work experience, training, and level of education was significantly related to the level of understanding of safety signs (P< 0.05); however, no significant relationship was observed with shift work.

The understanding of safety signs among industrial workers was at an acceptable level standard. It is necessary to design understandable safety signs with the themes of "Wear a face shield," "First aid kit," "Danger of toxic substances," and "Emergency exit."