Medical Journal of The Islamic Republic of Iran (MJIRI)

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Background: With the recent spread of virtual learning programs in universities, especially in the field of medical sciences, libraries play a crucial role to support these programs. This study aimed at investigating the skills required by librarians to support virtual learning programs in Isfahan University and Isfahan University of Medical Sciences.

  Methods: This was an applied survey study. The population of the study includes all librarians working in Isfahan University and Isfahan University of Medical Sciences. A sample of 89 librarians was selected by stratified random sampling. Data were collected by a researcher-made questionnaire, the validity of which was confirmed by specialists in the fields of librarianship and information sciences and virtual learning, and its reliability was determined to be 0.92, using Cronbach's Alpha. The questionnaire consisted of 51 items designed to evaluate the librarians' virtual learning skills using Likert scale. Descriptive and inferential statistics were used to analyze the findings.

  Results: The findings of this study revealed that librarians had low level of skills with respect to the online reference services, and familiarity with virtual learning environment. They also showed low and average level of skills with respect to their general information technology, communication skills, ability to teach electronic information literacy and ability to create access to electronic resources. The results revealed no significant difference between the librarians of the two universities, or between male and female librarians. However, librarians with educational background in librarianship and information sciences were significantly more skillful and competent than their colleagues.

  Conclusion: Despite the crucial role of libraries in supporting virtual learning programs, the librarians in Isfahan University and Isfahan University of Medical Sciences had low-level skills to play such an important role. Therefore, it is essential to provide on-the-job virtual training courses for librarians to improve their job performance and the quality of library services. 

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Background: Hospital infections have affected millions of people around the world and are considered as one of the most important issues related to patient safety. Therefore, this study was conducted to estimate the extra costs caused by hospital-acquired infections in hospitals.
   Methods: This retrospective cohort study was conducted in Tehran province, Iran, in 2017. Medical records of 235 patients hospitalized in one of Tehran hospitals were reviewed for the study.  They were divided into case (90 patients) and control (145 patients) groups. Data were analyzed using SPSS and STATA software.
   Results: Results revealed no significant relationship between age and gender with the incidence of nosocomial infection (p>0.05).  However, the chance of nosocomial infection is most affected by length of hospital stay and costs paid by patients. Moreover, nosocomial infection increases the length of hospital stay up to 25 days.  Our results revealed that the mean±SD hospital stay of infected and non-infected patients were 15.8±17.2 and 40.8±19.1 days, respectively. Furthermore, the total cost of patients without any hospital infection was 2451±3098 USD (83 674 480±105 765 500 Rials). On the other hand, the cost for infected patients was 3264±6078 USD   (207 497 500±111 430 700 Rials).
   Conclusion: Hospital-acquired infections can impose great costs on both patients and the health system. The results of this study indicated the importance of taking specific measures for infection control in hospitals.
 

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    Background: Cochlear implantation (CI) is an achievement that facilitates the acquisition of language skills in deaf children throughout the world. The use of this technology has a positive effect on all components of language acquisition (syntax, semantic, pragmatic, etc.). However, this positive impact is influenced by various factors. Understanding the strengths and weaknesses of studies on the development of language abilities can help improve these studies. Consequently, in the future, it will lead to the improvement of language rehabilitation in these children. Limited studies on children with CI in have been done so far. This article summarized the outcomes of scientific articles on the clinical efficacy of CI on Persian speaking children. This study also provided a clear picture of these studies by examining the quality of their methodologies and tools.
   Methods: Articles indexed in Google Scholar, Web of Science, Medline, Scopus and Iranian databases (Danesh Gostar, Magiran, and SID) were searched using keywords “language,” “Cochlear implant”, “Persian/ Farsi” in English and Persian languages with “and/or”.  Original articles investigated on children younger than 13 years old with hearing impairment and CI were included.
   Results: Five hundred and twenty-three articles were found based on the keywords. Among all of these, 485 were excluded due to the title and the abstract; we selected 38, of which 24 were repeated. Finally, 14 articles remained. We reviewed the articles based on the preferred reporting items for systematic review and meta-analysis (PRISMA) and checklist and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE).
   Conclusion: Similar to international studies, Persian speaking children with CI have slower language development than their peers with normal hearing, but they are better than their peers who use hearing aids. The results of reviewing on quality of the articles showed that the studies could not meet reasonable quality because of the lack of a standard test in different aspects of Persian language and the absence of patients’ databanks. These results also can be used by other nationalities that recently have started surveys on children with CIs.
 

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Background: The COVID-19 pandemic has caused significant disruptions in the provision of non-communicable disease (NCDs) prevention and control services in many countries, and there is a concern that it would lead to long-term complications of the diseases. The aim of this study is to assess the changes in the provisions of selected NCD services before and after the COVID-19 epidemic in Iran’s primary healthcare system.
   Methods:  In this descriptive-analytical retrospective study, the number of eight NCD services provided during the first 10 months of the COVID-19 pandemic from Feb 2020 to Dec 2020 were compared with the same period in the previous year using the data from the Iranian integrated electronic health record system (SIB) and also the association between the number of deaths due to COVID-19 and a sample of NCD services were assessed using cross-correlation analysis. The statistical analysis was performed in Stata Software v.14.
   Results: The NCD services have decreased by an average of 18.89% compared to the same period in the previous year; this decline was much more severe at the beginning of the epidemic period (up to 75% in some services) and was greater in physician-provided services than in non-physician services. Also, examining the course of the selected services during this period, a gradual compensation was evident after the initial reduction.
Conclusion: The general trend of the selected services of prevention and control of NCDs in the PHC system of Iran within 10 months after the onset of COVID-19 showed a sharp decline and subsequent gradual compensation. Although the process of compensation in some services may be considered somewhat reassuring, in the case of some essential services, more effort and attention to the implementation of programs or compensatory policies seem necessary.

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Background: It is well established that upper and lower airways are often clumped together when diagnosing and treating a disease. This study was designed to determine the prevalence of upper and lower airway diseases and to assess the effect of sociodemographic factors on the prevalence and the comorbidity of these disorders.
   Methods: This cross-sectional population-based study included patients with ages ranging between 15 to 65 years, who were referred to allergy outpatient clinics in various provinces of Iran from April to September 2020.  A modified global Allergy and Asthma European Network (GA2LEN) screening questionnaire was filled out by local allergists of the 12 selected provinces in Iran.  Information about the patients and sociodemographic factors was also recorded. Statistical analysis was done by univariate statistical analyses and multiple logistic regressions in SPSS software Version 26.
   Results: Out of 4988 recruited patients, 1078 (21.6%) had the symptoms of allergic rhinitis (AR) and 285 (5.7%) met the criteria of asthma. The prevalence of acute rhinosinusitis (ARS) and chronic rhinosinusitis (CRS) was 21.6 % and 22%, respectively. The highest prevalence of AR and ARS was in Tehran with the arateof of 33.9% each.  Asthma was more prevalent in Khuzestan (14.2%) and CRS in Baluchestan (57.5%). Our analysis showed that the patients with asthma were most likely to have other allergic diseases as well—CRS (OR = 4.8; 95% CI, 2.02- 5.82), AR (OR= 2.5, 95% CI, 2.10-3), ARS (OR = 1.8; 95% CI, 2.10-3), followed by eczema (OR = 1.4; 95% CI, 1.13-1.67).We found that those individuals with CRS were most likely to have painkiller hypersensitivity (OR= 2.1; 95% CI, 1.21-3.83). Furthermore, smoking has been found more than 1.5 folds in patients with ARS. After adjusting variables, there was no correlation between education, occupation, and ethnicity with the studied diseases.
Conclusion: Rhinosinusitis is a common condition among Iranian patients. This study confirmed that inflammation of the upper and lower airways can occur simultaneously. Gender, education, occupation, and ethnicity were found to be irrelevant in the development of either AR, asthma, ARS, or CRS.

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Background: Studies examining narrative production skills in children with autism spectrum disorder (ASD) have demonstrated variable and inconsistent results. This study aimed to investigate to what extent narrative difficulties in children with ASD reflect difficulties with language.
   Methods: Accordingly, the spoken narrative skills of 16 children with ASD were compared with those of their 16 chronological age-matched (CAM) and 16 language-matched (LM) peers. A Kruskal-Wallis non-parametric test was then used to examine the differences between groups in regard to NTC, NSG and SI variables .For other studied variables (NTW, number of T-units, ATL and total score), one-way analysis of variances (ANOVA) was also used. 
   Results: At the level of microstructure, the results showed that productivity (number of total words, total clauses, and T-unites) and syntactic complexity (average of T-unit length and subordination index) were predominantly similar in ASD and LM children. However, children with ASD scored lower than their CAM counterparts (P < 0.001). At the macrostructure level, we found that the total score of story grammar elements and the number of story grammars in the narrative production of children with ASD were lower than those in both CAM and LM children (P < 0.001).
   Conclusion: The present study, thus, showed that creating a coherent narrative could be more demanding for children with ASD than productivity and syntactic complexity.

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Background: Children with autism spectrum disorders (ASD) show prominent deficits in pragmatic aspects of language such as spoken narrative. Deficits in spoken narrative in school years lead to deficits in reading comprehension. Therefore, this randomized clinical trial research examined the influence of narrative intervention on spoken narrative and reading comprehension abilities in children with ASD.
   Methods: In the current double-blind, randomized clinical trial study, 21 students with ASD from second to seventh grade participated in the study. Two intervention methods were provided three times a week and a total of 24 sessions of 45 minutes. The experimental group received the Supporting Knowledge in Language and Literacy (SKILL) program and the control group received Traditional Language Therapy (TLT). The score of macrostructures, microstructures, perspective-taking index, narrative complexity, Story knowledge index, and reading comprehension score were measured pre and post-intervention. ANCOVA was used for between- within-group comparisons analysis.
   Results: The experimental group indicated significant improvement in macrostructure (P < 0.001, η² = 0.614), microstructure (P = 0.012, η² = 0.303), narrative complexity (P < 0.001, η² = 0.585), story knowledge index (P < 0.001, η² = 0.574) and perspective taking index (P < 0.001, η² = 0.553) compared to the control group. However, the difference between the two groups in reading comprehension skills was not significant in post-intervention (P = 0.457, η² = 0.031).
   Conclusion: The results showed the efficacy of the three stages of the SKILL program compared to TLT in spoken narrative. Also, the results of the study showed that the SKILL program and TLT have the same effect on improving reading comprehension.
 

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Background: This research marks the exploration into comparing the effectiveness of two reading interventions in improving reading outcomes for third to fifth-grade Farsi-speaking students with dyslexia.
   Methods: In this  randomized control trial study,  twenty students in Tehran were randomly assigned to a multi-component group and a comprehension-based intervention group, each receiving 36 sessions of 45 minutes. The effectiveness of the interventions was evaluated using adjusted mean differences with a one-way ANCOVA.
   Results: The results revealed the comprehension-based intervention's superior effect size across most outcomes, except for the letters string. The effect size was large for word reading 0.93 (CI -0.002 to 1.85), medium for phoneme deletion 0.67 (CI -0.23 to 1.5), small for text comprehension 0.25 (CI -0.62 to 1.13), and trivial for both rhyme identification 0.1 (-0.77 to 0.98) and non-word reading 0.11 (CI -0.76 to 0.98). The multi-component intervention had a greater effect size on letters string than the other intervention, although it was small -0.21 (CI -1.09 to 0.66).
   Conclusion: The study concluded that comprehension-based intervention was more effective for Farsi-speaking students with dyslexia in grades 3-5, emphasizing the need for diverse intervention approaches to address their specific needs.
 

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Background: There is limited research on the sonographic view of people with skeletal malocclusions. Therefore, this study aimed to evaluate the sonographic findings of the masseter muscle in patients with skeletal malocclusions.
   Methods: In this descriptive study, 48 patients aged 15-20 years with skeletal class I, II, and III malocclusions (n = 16) who were referred to Mashhad Dental School for treatment were selected. The masseter muscle was evaluated by ultrasound, including transverse and longitudinal scans on both sides of the face in resting and contraction states. The age, gender, muscle thickness, muscle pattern (Malocclusion were classified based on A-point, nasion, B-point (ANB): 0< ANB <4 as class I, ANB > 4 as class II, ANB < 0 as class III), side of chewing, and body mass index (BMI) parameters were measured for each patient. Paired t-tests compared masseter muscle states; ANOVA assessed differences among malocclusion groups.
   Results: The most commonly observed pattern in the masseter muscle of patients with class III skeletal malocclusions was type II, and in people with class II malocclusions was type I. There was a positive and significant correlation between the thickness of masseter muscle and BMI in each group separately (P < 0.001). However, the masseter muscle pattern did not show a significant correlation with BMI, gender, and age. A significant difference was observed between the thickness of the masseter muscle in the resting and contracted states in each group (P < 0.001).
   Conclusion: This study showed that skeletal malocclusions can affect the pattern and internal structure of the masseter muscle in the anterior-posterior dimension of the face. Ultrasound can be a suitable diagnostic tool for these patients.