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Ali Zarei Mahmoudabadi, David B. Drucker,
Volume 17, Issue 4 (2-2004)
Abstract

The aim of this study was to analyse polar lipids of Candida species isolated from Ahwaz (Iran) by Fast Atom Bombardment Mass Spectrometry (FAB MS). Nine isolates of Candida Sp. were identified by growth at 45°C, production of chlamydoconidia on cornmeal agar, colonial colour on CHROMagar Candida, germ tube production and ID 32C kits. Then polar lipids were extracted from freeze-dried cultures and analysed using FAB MS. The most intense carboxylate and phospholipid molecular species anions were of m/z 281 (CI 8:1) and miz 51 5 (PA 23:2). However, the most intense carboxylate and phospholipid analogues in Candida parapsilosis were 292 (Un) and 555 (PA 26:3), which differed from other yeasts. Isolates were grouped by single linkage clustering based on correlation coefficient for strain pairs calculated with carboxylate and phospholipid molecular species distributions. FAB MS can differentiate the C. albicans based on analysis of polar lipid distributions. These findings support that differentiation between C. albicans and other species is possible based on polar lipids.
Samaneh Gholami, Koroush Goodarzvand Chegini, Nematollah Gheibi, Kobra Mokhtarian, Mohsen Mohamadi, Reza Falak,
Volume 31, Issue 1 (1-2017)
Abstract

Background: Betatrophin, a novel secretory protein from liver and fatty tissues, is believed to be involved in lipid and glucose metabolism. However, its precise physiological role remains unclear. Here, we report the cloning, expression, and purification steps of mouse betatrophin in a prokaryotic system, followed by its structural analysis.
   Methods: Specific cloning primers were used to amplify the coding sequence of mouse liver betatrophin. The product was cloned into pET28 and expressed in E.coli BL21 (DE3) cells. The suitability of the refolding procedure was assessed by determining secondary structures of the initial and refolded proteins using circular dichroism spectroscopy.
   Results: The polymerase chain reaction resulted in a 549 bp nucleotide sequence, encoding a 183 amino acid polypeptide, with an apparent molecular weight of 21 kDa, which was expressed in an inclusion body. Following an optimization and refolding procedure, the recombinant protein was purified by anion exchange and metal affinity chromatography. CD spectra revealed that the refolded protein has suitable configuration.
   Conclusion: We believe that the produced betatrophin is suitable for further biochemical studies on glucose and lipid metabolism.
 
 


Atusa Rabiee, Behnoosh Vasaghi-Gharamaleki, Sayyed Ali Samadi, Younes Amiri-Shavaki, Javad Alaghband-Rad, Saba Seyedind, Soode Hosseini,
Volume 32, Issue 1 (2-2018)
Abstract

    Background: Past studies have documented working memory impairment in participants with high-functioning Autism Spectrum Disorders (IQ>70), but inconsistent findings have been reported. One possibility is the existence of verbal responses in the evaluation of working memory performance. The aim of the current study is to examine the working memory performance and its correlation with a prominent deficit in participants with high-functioning Autism Spectrum Disorders by non-verbal working memory tasks compared with typically developing samples.
   Methods: The current study is a cross-sectional, comparative study. The working memory performance of the 30 participants with high-functioning Autism Spectrum Disorders (7-16 years) and 30 typically developing was compared by working memory subtests of the Leiter International Performance Scale-Revised in Tehran, Iran. Two groups were matched for age and gender. ANOVA, ANCOVA, repeated measures ANOVA and Pearson’s correlation coefficient were used to analyze the data statistically. The significance value was set at p<0.05.
   Results: The results showed that if the effect of FSIQ (full-scale intelligence quotient) were controlled individuals with high-functioning Autism Spectrum Disorders exhibited significant impairment in the Reverse Memory subtest (p=0.001). Also, unpredictably Forward Memory (r=0.38, p=0.03) and Reverse Memory tasks (r=0.38, p=0.03) displayed a significant positive correlation with the Social interaction subscale of the Gilliam Autism Rating Scale (Second Edition).
   Conclusion: It seems that nonverbal working memory is impaired in persons with high-functioning Autism Spectrum Disorders. Results of the current study revealed that factors like complexity and cognitive load of tasks may influence working memory performance in individuals with high-functioning Autism Spectrum Disorders.
Amir Shabani, Mosleh Mirzaei Khoshalani, Seyedreza Mahdavi, Masoud Ahmadzad Asl,
Volume 33, Issue 1 (2-2019)
Abstract

Background: Mood Disorder Questionnaire (MDQ) and Bipolar Spectrum Diagnostic Scale (BSDS) are used to screen patients with bipolar disorders and have been examined in some psychiatric settings. The present study aimed to assess the validity and reliability of these 2 tools on inpatients in a general hospital.
   Methods: In a cross-sectional study in 2011, a total of 207 inpatients admitted to different wards of Rasoul Akram hospital, Tehran, were selected by systematic random sampling. Demographic questionnaire, MDQ, and BSDS were completed. Also, Structured Clinical Interview for DSM-IV axis I disorders (SCID-I) was performed for all participants within 72 hours. The SCID-I was used as the gold standard of psychiatric diagnoses to identify the predictive validity of the 2 screening tests. Sensitivity and specificity indices were identified using Roc curve. The 2 screening tools were recompleted by 20% of the patients (n=43) after 3-7 days to measure test-retest reliability using paired t test and correlation between measures in 2 separate occasions.
   Results: In this study, 101 female and 106 male (m=36.9±15.5 yrs.) patients were entered the study, of them 56 (32 males) had bipolar disorder according to SCID-I. The most common bipolar disorder was bipolar disorder type II (9.7%). Pearson’s test showed a high test-retest reliability for both MDQ (r=0.72, p<0.001) and BSDS (r=0.77, p<0.001). For MDQ, the scores 5 (sensitivity=0.60; specificity=0.73) and 6 (sensitivity=0.56; specificity=0.77) were the best cutoff points. Positive and negative predictive values for the mentioned cutoff points were 0.45 and 0.83 (for the score 5) and 0.48 and 0.82 (for the score 6), respectively. The best cutoff point for BSDS was 11 with the sensitivity, specificity, and positive and negative predictive values of 0.74, 0.69, 0.47, and 0.87.
   Conclusion: The Persian versions of MDQ and BSDS have acceptable validity and reliability to screen Persian patients with bipolar spectrum disorders in a general hospital.
 


Fateme Zahedi Abghari, Yousef Moradi, Mansoureh Akouchekian,
Volume 33, Issue 1 (2-2019)
Abstract

    Background: Autism Spectrum Disorder (ASD) is a neurological disorder characterized by massive damage in various fields of development. Impaired social interaction and communication skills, unusual behavior or interests, and repetitive activities are considerably disabling in these patients. There are several challenges in diagnosis of ASD patients such as co-existing epilepsy, difference in clinician attitudes and possibly multifactorial etiology of autistic behavior among children and adults. Research in recent years has emphasized a possible connection between mutations in PTEN and macrocephaly (head circumference > 97th centile).
   Methods: Articles in English Language were searched from international databases including Medline (PubMed), Google Scholar, Scopus, and CINHAL from January 1998 to January 2016.
   Results: The results showed that among 2940 patients with behavioral disorders, 2755 individuals had ASD, and 35 cases with macrocephaly had mutations in PTEN. About 77% of the articles (7/9) analyzed mutations in PTEN in patients with head circumference more than 2SD away from the mean, but did not check mutations in this gene in other ASD patients without macrocephaly. To the best of our knowledge, this study is the first systematic review on human PTEN mutations and classical autistic behavior.
   Conclusion: We conclude that the presence of macrocephaly may not be sufficient to examine the PTEN mutation in this group; however, surveying this gene in all cases of macrocephaly seems to be necessary.
 
Hossein Moameri, Shahrzad Nematollahi, Mehdi Yaseri, Hasan Ahmadi Gharaee, Roya Karimi, Kourosh Holakouie-Naieni,
Volume 33, Issue 1 (2-2019)
Abstract

Background: The effect of maternal mental health during pregnancy on Cesarean section through implications of pre- and postnatal birth have narrowly been investigated. The aim of the present study was to investigate the effect of maternal mental health during pregnancy on the type of delivery in the suburbs of Bandar Abbas.
   Methods: This study used data of 200 mothers registered in a prospective cohort study on pregnant women in the suburbs of Bandar Abbas, South of Iran, during 2016-18. The presence of depression, anxiety, or stress in expecting mothers were measured by DASS-21 questionnaire and the outcome defined as having Cesarean section (Cesarean section) was measured at postpartum. The relative risk (95% CI) was calculated using Cox regression models. All analyses were performed using STATA statistical package, with a significance level of 5%.
   Results: Information of 196 mothers were collected (98% response rate); the mean age of the participants was 27.28 (±5.62) years. The prevalence of depression, anxiety, and stress was 13.8% (27), 40.4% (40), and 7.6% (15), respectively. Nearly 40% of mothers went through Cesarean section. Compared to mothers with good mental health, the risk of Cesarean section was 96% higher in depressed mothers (RR=2, 95% CI: 1.43–2.74) (p=0.001), 81% higher in anxious mothers (RR=1.81, 95% CI: 1.29-2.53) (p=0.003), and 75% higher in stressed mothers (RR=1.75, 95% CI: 0.86-3.56) (p=0.121).
   Conclusion: The findings of this study showed that poor mental health, especially anxiety and depression, during pregnancy could increase the risk of Cesarean section. Accordingly, screening protocols for mental health status and prenatal counseling sessions are suggested for pregnant mothers to increase their informed decision on types of delivery.
 
Maghsoud Sarebani, Mohammad Bagher Shiran, Ahmad Bitarafan-Rajabi, Fereidoon Rastgoo, Zahra Ojaghi Haghighi, Ali Abbasian Ardakani,
Volume 34, Issue 1 (2-2020)
Abstract

Background: Cardiac echocardiography and cardiac ECG-gated single-photon emission computed tomography (SPECT) are the most common modalities for left ventricle (LV) volumes and function assessment. The temporal resolution of SPECT images is limited and an ECG provides better temporal resolution. This study investigates the impact of frame numbers on images in terms of qualitative and quantitative assessments.
   Methods: In this study, 5 patients underwent echocardiography and cardiac ECG-gated SPECT imaging, and 5 standard views of the LV were recorded to determine LV walls boundaries and volumes. Also, 2 original images with 8 frames and 16 frames per cardiac cycle were recorded simultaneously in a single gantry orbit. Using the data extracted from the LV model, 8 extra new frames were created with interpolation between existing frames of the original 8-frame image. Three series of images (8 and 16 original and 16 interpolated) were reconstructed separately. LV volumes and ejection fraction (EF) were calculated using Quantitative Gated SPECT (QGS) software.
   Results: Compared to the original 8-frame gating, original 16-frame gated images resulted in larger end-diastole volume (EDV) (mean ± SD: 68.6 ± 27.11 mL vs 66.2±25.41 mL, p<0.001), smaller end-systole volume (ESV) (mean ± SD: 24.6±8.7 mL vs 26±7.3 mL, p<0.001), and higher EF (64% vs 60.2%, p<0.001). The results for the interpolated series were also different from the original images (closer to the original 16-frame series rather than 8-frame).
   Conclusion: Changing the frame number from 8 to 16 in cardiac ECG-gated SPECT images caused a significant change in LV volumes and EF. Frame interpolation with sophisticated algorithms can be used to improve the temporal resolution of SPECT images.
Shahin Saeidinejat, Nosrat Ghaemi Belhouri, Fahimhe Attarian,
Volume 34, Issue 1 (2-2020)
Abstract

Background: The clinical suspicion of Congenital Hypothyroidism (CH) is identified by abnormal results in the first test of Thyroid Stimulating Hormone (TSH) (5-9.9 mIU/L), and normal results in re-test (TSH<4 mIU/L). The CH has a contribution to physical and mental health. This study aimed to determine the Intelligence Quotient (IQ) score in children with suspected congenital hypothyroidism.
   Methods:  This research is a retrospective cohort study conducted in Mashhad, Iran. The IQ scores of 1976 children at the age of 6 were considered as an outcome variable. The history of CH screening for each newborn was assessed, then all suspected CH newborns that diagnosed healthy in re-test were considered as an exposed group, the effects of this situation on IQ score was assessed using logistic regression. All analysis was performed in STATA.
   Results: The averages of IQ score (p<0.001), weight (p=0.024), and height (p<0.001) in the exposed group were lower than the unexposed group. The exposed group was related to those whose parental education was less or equal to 12 years (p<0.001). Similarly, the history of CH and maternal education for ≤12 years were detected as risk factors for having an IQ score of <90 in children.
   Conclusion: Aside from the link between parental education and clinical suspicion of CH in neonates, our findings underline the possible strong effect of CH status and maternal education for ≤12 years on reducing IQ scores in the next years of child life.
Hasan Ahmadi Gharaei, Shahrzad Nematollahi, Hossein Moameri, Abdolhossein Madani, Mahbube Parsaeian, Dr Koroush Holakouie-Naieni,
Volume 34, Issue 1 (2-2020)
Abstract

Background: Due to the controversial effects of mental health disorders during pregnancy on infant health, the present study aimed to evaluate the effect of gestational depression, stress, and anxiety on the growth of offspring at six months of age in disadvantaged communities in South of Iran.
   Methods: The sample comprised of 470 pregnant women (response rate=98%) who are participated in the Bandar Abbas Pregnancy Cohort study. Maternal mental health was measured by the DASS-21 questionnaire during pregnancy. Data on infant growth was collected based on infant`s growth chart at six months of age. The relative risk of suboptimal infant growth was calculated by Modified Poisson regression models at 5% significant level.
   Results: The prevalence of depression, anxiety, and stress was 19.0%, 26.1% and 6.5%, respectively. At six months of age, the mean (SD) of infant`s weight (gram), height (cm) and head circumference (cm) were 7287.30 (1019.85), 63.23 (5.62) and 41.39 (2.70), respectively. Compared to normal mothers, the risk of suboptimal weight at six months of age significantly increased by 71% in mothers who were classified as having depression (Adjusted RR: 1.71, 95% CI: 1.07, 2.09). The presence of anxiety significantly increased the risk of suboptimal height at six months of age by 43% (ARR: 1.43, 95% CI: 1.07, 1.92). There were no statistically significant effects of ‎either depression anxiety or stress on the suboptimal head circumference at six months of age.
   Conclusion: Our results showed that mental health disorders of pregnant women might adversely influence the weight and height growth of offspring within the first six months of age. Screening protocols to early diagnose of mental health disorders during pregnancy, and to strict follow up of diagnosed cases postpartum are proposed.


Mahasti Alizadeh, Madineh Abbasi, Narges Bashirivand, Atefe Mojtahed, Salah Eddin Karimi,
Volume 34, Issue 1 (2-2020)
Abstract

Background: This study aimed to provide information on activities and experiences of Nongovernmental organizations in Tabriz regarding COVID-19 to develop a framework for effective measures and actions for other communities based on relevant achievements and experiences. 
Method: The Social determinants of health research center of Tabriz University of Medical Sciences coordinated the NGOs to deal with the consequences of COVID-19 disease by announcing, inviting, developing networks and preparing aims and objectives and action plans in participation with the NGOs.
Results: This cooperation and synergy among NGOs led to following results: providing public health education, fund raising to provide health service and food items for vulnerable families, advocacy by writing letters to the governor and the City Council and emphasizing the needs for controlling the epidemics.
 
Conclusion: NGOs can increase public awareness, change social policies, and provide services and facilities to the vulnerable groups of people to deal with these problems.
Bahman Cheraghian, Seyed Jalal Hashemi, Seyed Ahmad Hosseini, Hossein Poustchi, Zahra Rahimi, Sara Sarvandian, Amal Saki Malehi, Meysam Alipour, Sareh Eghtesad, Jafar Fatahiasl, Arash Bayat, Hanieh Raji, Nader Saki,
Volume 34, Issue 1 (2-2020)
Abstract

Background: The Hoveyzeh cohort study (HCS) is a population-based cohort study that conducted in Hoveyzeh County (South-west Iran). HCS focus on common chronic diseases, disorders and risk factors of NCDs in the Arab ethnicity.
   Methods: A total number of 10009 participants (35-70 years old) were recruited in this prospective cohort study from May 2016 to August 2018. The HCS data were gathered by trained interviewer through interviewer-administered questionnaires. Also anthropometric measurements, physical examinations, clinical assessments, ophthalmology evaluation, auditory examinations, respiratory and cardiovascular assessments was conducted by means of standard instruments.  Biological samples including blood, urine, hair, and nail collected and stored in the biobank.
   Results:  The overall participation rate was 82.7%. The prevalence of obesity was 27.4% in males and 47% in females. Cigarette smoking prevalence was 20.9% (40.6 % in men and 7.6 % in women). Prevalence of major non communicable diseases such as diabetes, hypertension, metabolic syndrome, cardiac ischemic, myocardial infarction and stroke was 22.2%, 26.4% 31.9 %, 13.6%, 1.85% and 1.6% respectively. 
   Conclusion: Considering the high prevalence of obesity and smoking in the population of Hoveyzeh and since the important role of these risk factors in development of common non communicable diseases, this issue should be taken into consideration and the necessary interventions in this context must be considered to modify lifestyle. The HCS is the only comprehensive cohort in the region, enabling it to provide valuable evidence about NCDs for a wide geographical area covering millions of people in both Iran and Iraq.
Elham Haghighifar, Fatemeh Norouzi, Razie Kamali Dolatabadi,
Volume 35, Issue 1 (1-2021)
Abstract

Background: Uropathogenic Klebsiella pneumoniae is one of the well-kown uropathogens that have the main rule in biofilm formation. Increased prevalence of ESBL enzyme is one of the therapeutic problems. However, the aims of this study were to characterize  the ability of biofilm formation and ESBL-producing isolates produced by urinary tract infection’s K. pneumoniae to identify the prevalence of this type of infection in the studied area.
   Methods: Between the 500 nonrepetitive clinical isolates, 128 isolates were detected as K. pneumoniae. Biofilm production of these isolates was showed by Merrit and Christensen method. The standard Kirby-Bauer disk diffusion method was used for antimicrobial susceptibility testing.  The phenotype ESBL was confirmed by double disc synergy test (DDST). Genotypic identification of ESBLs did by molecular detection. The statistical analysis was done  using software IBM SPSS Statistics (SPSS Inc) and chi-square and Fisher exact tests.
   Results: The result of microtiter plate was observed and it was found that 86 (67.2%) isolates had weak biofilm, 24 (18.8%)  moderate biofilm, and 18 (14.1%) strong biofilm. Also, 57 (44.5%) out of 128 isolates were diagnosed as MDR. The highest frequency of resistance was identified for cefotaxime 60 (46.9%) and tetracycline 60 (46.9%), and the lowest rate was for amikacin 16 (12.5%). The results of DDST showed 55 of 128 (43%) produced ESBL enzymes. PCR detection in ESBL-producing isolates showed contained blaTEM  33 of 55(63.1%), and blaVEB  13 of 55 (23% ). Also, 1 of 55 (2%) had both blaTEM and blaVEB. Also, 5 of 13 (38.4%) isolates that had the blaVEB gene were also MDR and had weak biofilm (8/13; 61.5%),  intermediate biofilm (3/13; 23%),  and strong biofilm (2/13; 15.4%).
   Conclusion: To decrease treatment complications and mortality rate of drug-resistant bacterial infections, rapid detection of β-lactamases genes and evaluation of these properties and infection management programs can help to prevent the transmission of drug resistant-strains.
 
Ghobad Moradi, Fatemeh Gholami, Mohammad Aziz Rasouli, Fahimeh Bagheri Amiri, Yousef Moradi,
Volume 35, Issue 1 (1-2021)
Abstract

Background: Given the various reports of the clinical spectrum of the disease, the aim of the present study was to determine possible scenarios of Coronavirus 2019 (COVID-19) iceberg using published articles.
   Methods: The present study was a rapid review of all international databases, including PubMed (Medline), Scopus, Web of Sciences, Embase, and Cochrane Library from January 1 to October 30, 2020.
   Results: In this review, 7 scenarios were considered for COVID-19 iceberg, in which the range of fatality percentage was estimated to be 0.5% to 7%, the range of asymptomatic cases 1% to 88.6%, the range of cases with mild symptoms 8% to 78%, no symptoms 1 % to 90 %, the range of intensive care unit (ICU) admission was 0.5% to 14.2%, and finally the intubation percentage was estimated to be 0.2% to 12.2%. The Scenarios Diamond Princess Cruise Ship and Iceland are closer to the reality of the clinical spectrum of COVID-19 around the world, which represent 0.6% and 0.5% of deaths, 0.7% and 1% of intubations, 2.5% and 9.7% of ICU admissions, 1.1% and 6% of hospitalizations, 15% and 31% of cases with mild symptoms, and finally 56.9% and 75% of asymptomatic cases of COVID-19, respectively, which should now be considered as the basis of the clinical knowledge of the disease. 
   Conclusion: Understanding the clinical spectrum and natural knowledge of the disease and paying attention to asymptomatic or mild-symptom cases can help to make better decisions and develop more effective interventions to control COVID-19.

Mahta Alsadat Aarabi, Kianoush Abdi, Mohammad Saeed Khanjani,
Volume 35, Issue 1 (1-2021)
Abstract

Background: COVID-19 has become a global pandemic and has inevitably affected the whole world. This effect is greater on people with ASD (ASD) and their families. Depression, attempts to cope with change, and having difficulty interacting with others are some of the challenges people with ASD often face. The aim of this study was to review the psycho-social consequences of COVID-19 in people with ASD and their families.
    Methods: This study is a Literature Review. Extensive electronic search results for the keywords ASD, COVID-19, Coronavirus, psychological, psychosocial, and consequence in Google Scholar, PubMed, Scopus, ProQuest, Science Direct, SID and Magiran in 2020, eventually provided a total of 130 articles. After reviewing the titles of the articles, we excluded 85 articles as they were duplicated and/or irrelevant. Finally, based on the inclusion and exclusion criteria, 17 articles remained.
   Results: In general, the change in routine and uncertainty caused by COVID-19 have caused distress for people with ASD and will worsen their symptoms and mental health. Excessive stress worsens the mental health of caregivers, and as this burden increases, they report higher rates of social harm, depression, and anxiety that affect their daily functioning.
   Conclusion: The COVID-19 epidemic affects all strata of society. People with ASD are particularly vulnerable to the psychosocial effects of this epidemic. COVID-19 increases anxiety, distress, depression, financial problems, loss of a job, and even marital conflict. Access to necessary services and transmission problems are also the result of rapid social and environmental changes.
Anahita Behzadi, Mohsen Bayati, Salman Bashzar, Ebrahim Jaafaripooyan,
Volume 36, Issue 1 (1-2022)
Abstract

Background: Global payment system is a kind of case-based payment system which pays for 60 commonly surgical operations by the average cost for each specified surgery case in Iran. The aim of the study was to determine the effect of this payment system on the number of services provided for each global surgical case versus fee-for-service (FFS) for the same operation.
   Methods: This is a retrospective study based on data from a large referral teaching hospital in Iran in the period of 2012-2015. Information related to 46 surgeries was performed which both global and FFS documents were gathered (N=7672). Statistical analysis was done on variables including Length of stay (LOS), Blood test (BT), Radiology (RA) and a mixed variable named VC (visit and consult number). Data were analyzed by a zero-inflated negative binomial regression model using STATA 11.
   Results:  Descriptive analysis showed the mean of each service was significantly (P<0.001) higher in the FFS document’s group rather than the global payment group. Regression estimates showed the amounts of each service including LOS, BT, RA and VC were significantly (P<0.001) higher in FFS surgery than global documents for the 15 selected surgery. LOS and BT have shown a significantly higher amount in 100% of surgeries for FFS above global document. Same as for Radiology test and VC variables, there were significantly higher amounts in 93% of surgeries for FFS above global hospital documents.
   Conclusion: The findings can reinforce the presence of a relationship between providing more clinical services in FFS document form and providers’ incentives to adjust profits against their Costs. The significantly higher service provision in FFS documents can be controlled with a prospective global payment mechanism.
Nafiseh Faghih, Maliheh Arab, Afsaneh Tehranian, Behnaz Ghavami, Behnaz Nouri, Donya Khosravi,
Volume 36, Issue 1 (1-2022)
Abstract

Background: Visual Inspection with Acetic Acid (VIA) is an inexpensive option for cervical cancer screening.  In this study, we evaluated the role of the VIA as well as of the clinical symptoms/signs to find the best case-finding method for Cervical Intraepithelial Neoplasia (CIN) 2+.
   Methods: In a cross-sectional study, we extracted from records the demographic characteristics, clinical symptoms/signs, and indications for colposcopy referral of patients with CIN 2+ in pathology. Patients were divided into 1- Abnormal Pap smear, 2- Positive VIA, 3- abnormal Pap smear with clinical symptoms/signs, 4-VIA positive with clinical symptoms/signs, 5- only clinical symptoms/signs. The sensitivity of each method was studied to determine their effectiveness as a screening method.
   Results: Out of 146 patients who underwent colposcopy, 38 patients had it due to abnormal Pap smears, 37 due to positive VIA, 21 due to abnormality of both these tests, and 50 due to clinical symptoms/signs despite having normal screening tests. The sensitivity for VIA and Pap smear was 73.39% (17.48%-83.31%) and 40.41% (32.47%-48.86%) respectively. Presence of at least one of the three clinical symptoms/signs and a positive VIA found 78.8% of CIN 2+ cases. Presence of at least one of the three clinical symptoms/signs and abnormal Pap smear identified 84.2% of the cases.
   Conclusion: To find high-grade CIN, focused attention to the clinical symptoms/signs, even in the presence of normal Pap smear, can increase the sensitivity of Pap smear and VIA. In low resource settings, a simple, highly sensitive method like VIA can be used in addition to or as an alternative to other means.
Mohammad Amin Khajehazad, Masoomeh Faghankhani, Ali Asadi, Elnaz Golalipour, Seyed Vahid Shariat, Morteza Naserbakht, Hamid Bahador, Shahram Agah, Golnoosh Ansari, Farzaneh Barzkar, Hamid Baradaran,
Volume 36, Issue 1 (1-2022)
Abstract

Background: Empathetic communication improves the physician-patient relationship and enhances patient and physician satisfaction. This study aims to evaluate the impact of empathic communication skills training on physicians’ self-perceived performance and patient satisfaction regarding the empathetic quality of their relationship with their physicians.
   Methods: In this single-group before-after experimental study, we recruited 50 internal medicine residents at a large teaching hospital. We assessed the residents’ empathy using the Jefferson Scale of Empathy before and 3 weeks after an 8-hour workshop on empathic communication skills. We also recruited 50 of their patients before and another 50 patients 3 weeks after the training to assess the patient’s perceptions of their physician’s empathy using the Consultation and Relational Empathy scale. Physicians’ and patients’ mean scores on empathetic care at the beginning of the study were then compared using paired t-tests with their scores after the workshop.
   Results: The residents’ mean score on Jefferson Empathy Scale increased from 81.1 (95%CI:78.8-83.3) at baseline to 96.8 (95%CI:93.6-100) following the workshop (p < 0.001). Before the empathetic communication skills training, patients assessed their doctors' empathy at 68.3 (95%CI:63.5-73.2). After the intervention, this improved to 84.9 (95%CI:82.2-87.5) (p < 0.001).
   Conclusion:  In this study, both the residents and their patients stated that the residents' empathy skills had significantly improved after an empathetic communication workshop for internal medicine residents.
 
Simin Dehghani, Navid Mirzakhany Araghi, Sima Dehghani, Marzieh Pashmdarfard,
Volume 37, Issue 1 (2-2023)
Abstract

Background: Due to the limited access of clients in non-urban areas to rehabilitation and the difficulty of specialized counseling in such conditions, the need for telehealth services has increased. The purpose of this study is to evaluate the effectiveness of Tele occupational therapy in common disorders of children and adolescents.
   Methods: In this systematic review study, a research method published from 2010 to 2022 focusing on the effectiveness of tele-rehabilitation and its impact on children and adolescents with different physical disabilities was done in Google Scholar, PubMed, Scopus and EMBASE databases. 467 articles were obtained in the review, and finally, 18 articles were reviewed.
   Results: In children with CP, Tele occupational therapy will be effective on gross motor function and balance skills, but the impact on the executive function needs more studies. In children with ASD, it will be effective on behavioral problems, but the effect on pro-social behavior needs further studies. In children and adolescents with other movement disorders, it will have an impact on the progress of their physical activity and in children and adolescents with Traumatic Brain Injury (TBI), it will be effective, but the effectiveness of MitiiTM programs needs further studies.
   Conclusion: The findings of this study showed that tele-occupational therapy could be performed in line with face-to-face occupational therapy, and it can lead to the satisfaction of families, but there is still a need to assess the effectiveness of various interventions and tools on different disorders, outcomes and settings.
 
Sahar Ehteshami, Navid Mirzakhani, Marzieh Pashmdarfard,
Volume 37, Issue 1 (2-2023)
Abstract

Background: Due to the prevalence of autism spectrum disorder (ASD), these children must be screened as soon as possible and receive the necessary and appropriate treatment. The purpose of this study was to examine all the ASD screening tools and examine their psychometric properties in available languages.
   Methods: This was a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to review the articles published between 2000 and 2023 and were published in PubMed, EMBASE, ProQuest, and Scopus databases. English keywords were as follows: autism spectrum disorders (ASD), screening/screen, tools, psychometric properties, validity, reliability, translations, pervasive developmental disorders (PDD), and children. The COnsensus -based Standards for the selection of health Measurement Instruments (COSMIN) checklist were used to investigate the psychometric properties of the studies.
   Results: Among the 476 primary studies, 35 ASD screening tools (132 articles related to the psychometric properties of 35 ASD screening tools in different languages) were identified based on our criteria, and their psychometric properties were examined. Various tools, including performance-based, direct observation, interactive play, and parent and teacher reports tools, were included in the list of tools.
   Conclusion: Considering that each of these tools has advantages and limitations, they need to be selected and used according to the goals of the researchers and the therapists. Another important point is that many of these tools still need more extensive studies in relation to their psychometric properties.
 
Mohyeddin Teimouri Sangani, Noureddin Nakhostin Ansari, Zahra Soleymani, Nahid Jalilevand, Mitra Sohrabi, Reyhane Mohamadi, Katayoon Razjouyan,
Volume 37, Issue 1 (2-2023)
Abstract

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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