Introduction: One of the common undesirable postural abnormalities that poor mobility has brought to humans due to the significant growth of technology and widespread use of tools and communication devices is the excessive increase of the back arch (hyperkyphosis) and forward head deformity. Therefore, the aim of this research is to review the effects of rehabilitation exercises on people with kyphosis and forward head posture. Methods: The current study was a systematic review, searching for articles in Persian and Latin from the beginning of December 2005 to the beginning of April 2023, using the Wos, SID, Magiran, Scopus, ISC, PubMed and Google Scholar databases. Results: A number of seven articles in the field of rehabilitation exercises reported that corrective exercises improve forward head and kyphosis, as well as posture. One article indicated that the use of braces reduced trapezius muscle electrical activity in patients with kyphosis, which may delay fatigue onset. Conclusions: : The current review study showed that exercise protocols improve kyphosis and forward head complications, as well as improve pain and maintain proper posture in affected individuals.
Introduction: Thyroid nodules are highly prevalent. The role of insulin resistance in thyroid nodule formation has recently gained attention. While several studies have explored the relationship between metformin and insulin resistance, limited research has assessed the effect of metformin therapy on thyroid nodule volume and number. This study investigated the effect of metformin on the size and number of thyroid nodules. Methods: A total of 240 euthyroid women with thyroid nodules were divided into four groups. Group 1 received levothyroxine 100 μg/day, Group 2 received metformin 500 mg twice daily, Group 3 received a combination of both drugs for three months, and Group 4 served as the control group with no treatment. Thyroid ultrasound was performed at baseline and after three months. Statistical analyses included the Kruskall–Wallis, Wilcoxon, and Chi-square tests, examined the differences of the size of thyroid nodules and the mean of thyroid hormones levels between groups, for Each group included 60 people and to compare the percentage of differences between the groups, respectively. Also P value less than 0.05 was considered meaningful. Results: Results showed no statistically significant differences in thyroid hormone levels after treatment among the three groups except the levothyroxine group. Additionally, only the levothyroxine group showed a significant post-treatment decrease in TSH and increase in T4. Thyroid nodule size significantly decreased in the levothyroxine group and the levothyroxine-metformin combination group compared to the metformin-alone and control groups. Conclusions: This study indicates that metformin does not reduce the size of thyroid nodules, contradicting studies suggesting its potential antineoplastic effects on the thyroid. However, the study duration may be insufficient for definitive conclusions, necessitating further high-quality studies with larger sample sizes and longer follow-up periods.
Introduction: Hallux valgus is a common foot deformity causing lateral deviation of the first toe and progressive subluxation of the first metatarsophalangeal joint. The purpose of this study was to investigate the effect of kinesiotype and ankle strengthening exercises with a bosu ball on pain, balance and big toe angle in women with hallux valgus. Methods: This clinical trial study used a pre-test and post-test design. First, forty-five women with hallux valgus and flat feet were selected via convenience sampling and randomly assigned to three groups: a kinesiotape group (four weeks, three sessions/week, 24-hour tape application per session), a kinesiotape with Bosu ball ankle strengthening exercises (four weeks, three sessions/week, 30 minutes of exercises and 24-hour tape application per session), and a control group (no intervention). Pain, balance, and hallux valgus angle were measured using the Visual Analogue Scale (VAS), stork test, and goniometer, respectively. Data were analyzed using one-way ANOVA at a significance level (P ≥ 0.05). Results: After performing the exercises, comparing the data between the two groups before and after 4 weeks revealed a significant difference in pain, balance, and hallux valgus angle in the two groups of kinesiotape and kinesiotape along with the strengthening exercises of Boussou bathop compared to The control group showed (P = 0.001). Conclusions: A combined program of kinesiotape and Bosu ball ankle strengthening exercises may improve pain, balance, and hallux valgus alignment in women.
Introduction: Multiple sclerosis (MS) is the most common neurological disorder in young adults and balance problems due to MS may result in disturbances in upright posture, limitations in walking and turning, and ultimately falls in patients. The aim of this study was to investigate the effects of a combined physical exercises and cognitive-behavioral stress management intervention program on static, dynamic balance and balance confidence in PwMS. Methods: The statistical population included MS patients (aged 20–60 years with Expanded Disability Status Scale [EDSS] scores of 2–4) referred to the Arak MS Association. Thirty participants were selected via convenience sampling and randomly assigned to experimental and control groups. Participants underwent pretests using the Timed Up and Go (TUG) test, single-leg stance test, and the Activities-Specific Balance Confidence (ABC) Scale. Then, they participated in the combined motor and cognitive intervention program, and finally performed a post – test. Data were analyzed by Independent and Paired Student T-tests. Results: According to the results, the mean score of the experimental group in the TUG test (P ≤ 0.002), and standing on one-foot tests increased significantly in the post-test (P ≤ 0.001). There were no significant differences in mean ABC scores between the experimental and control groups on the post-test (P ≤ 0.153). Conclusions: The findings suggest that a combined motor and cognitive intervention program can effectively improve agility, dynamic and static balance in people with MS. Improving balance confidence may require a longer duration of training due to its subjective nature.
Introduction: Good governance, as one of the fundamental concepts in healthcare system management, plays a key role in enhancing the efficiency, effectiveness, and equity of healthcare services. This concept, Emphasizing principles such as transparency, accountability, participation, and legality, has been considered as a framework for improving policymaking and management in Iran's healthcare system. This study conducted in 2024 aimed to design and present a model of good governance in the healthcare system using a mixed approach of thematic analysis and Partial Least Squares (PLS) method. Methods: The research method included both qualitative and quantitative components. The qualitative phase, involved managers, health policy experts, specialists from the Ministry of Health and Medical Education, and academic scholars. Sampling was done using purposive and snowball sampling methods, with 17 participants selected until theoretical saturation was reached. In the quantitative phase, the Partial Least Squares (PLS) method was used for model fitting. The statistical population for this section included all experts and managers in Iran's healthcare sector, with a minimum sample size of 384 determined based on Cochran's formula. Results: The results of thematic analysis of the qualitative data and model fitting showed that the final good governance model in the healthcare system consists of seven main dimensions: effectiveness, efficiency, equity, transparency and accountability, participation, legality, and leadership. Each dimension comprised specific components, and the importance of each was confirmed in strengthening good governance. Conclusions: This study presents a comprehensive good governance model for the healthcare system, offering a framework for improving policymaking, management, and performance in this sector. The proposed model can be used as a strategic decision-making tool and improving management structures.
Introduction: Cisplatin, a widely used chemotherapy agent, offers therapeutic benefits for cancer treatment but often leads to adverse effects on neurogenesis and oxidative stress. On the other hand, physical activity has been proposed as a potential strategy to counteract these side effects. Therefore, the aim of the present study was to investigate the effect of an endurance training period on oxidative stress markers in the brain tissue of rats induced with cisplatin. Methods: In this study, 32 male rats with an average weight of 220 grams were divided into four groups: healthy control, cisplatin-injected control, endurance training, and cisplatin + endurance training. After 8 weeks of endurance training, the rats were dissected, and blood serum was separated to measure oxidant and antioxidant factors. Additionally, the brain was removed under sterile conditions for the examination of the desired markers. Data were analyzed using one-way ANOVA. Results: The results showed that cisplatin significantly decreased MDA and significantly increased TAC and CAT in the cisplatin-receiving control group. On the other hand, 8 weeks of endurance training significantly decreased MDA and significantly increased TAC and CAT. Moreover, no significant change was observed in serum SOD levels. In brain tissue, MDA levels significantly increased, and TAC, CAT, and SOD levels significantly decreased in the cisplatin-receiving group. Conversely, 8 weeks of endurance training reduced MDA levels and increased TAC, CAT, and SOD levels. Conclusions: Based on the findings of the present study, it appears that physical exercise has protective effects against cisplatin-induced oxidative stress in the brain, which may be attributed to its antioxidant capabilities
Introduction: This study aimed to investigate the effect of the backward gait training protocol on postural sway and balance in elderly men with a history of falls. Methods: A total of 28 healthy elderly individuals with a history of falls participated in this research. The backward gait protocol was considered the independent variable, and the mean parameters of postural sway, including range, center of pressure displacement, center of pressure velocity, and center of pressure acceleration, were examined as dependent variables. A Kistler force platform was used to assess postural sway. A mixed-design repeated measures ANOVA was performed at a significance level of 0.05. Results: No significant differences were found in the anterior-posterior amplitude and medio-lateral acceleration of the center of pressure between healthy elderly individuals and those with a history of falls (P > 0.05). However, individuals with a history of falls exhibited greater medio-lateral amplitude, anterior-posterior displacement, anterior-posterior velocity, and anterior-posterior acceleration of the center of pressure (P = 0.001). Conversely, they demonstrated lower medio-lateral displacement (P = 0.001) and medio-lateral velocity of the center of pressure (P = 0.005). Conclusions: Changes in center of pressure parameters may predict fall risk in the older adults. These parameters have varying sensitivities for detecting subtle differences in postural control. The responses of various parameters are influenced by compensatory mechanisms, weaknesses, and balance disorders. The backward gait protocol serves as a targeted intervention to improve balance and stability in elderly individuals at risk of falls.
Introduction: The study discusses the impact of thiamine on the kidney tissue of rats that have been exposed to copper oxide nanoparticles. The research examined how thiamine correlates with the level of kidney damage caused by the intrusion of nanoparticles. Methods: In this experimental study, forty male Wistar rats were randomly divided into four groups (10 rats per group). Two groups of rats were used as the control group (I) and the thiamine group (II). Rats of group III were administered an intraperitoneal injection of 25 mg/kg body weight of copper oxide nanoparticles for 14 days. Rats in group IV received the same dose of copper oxide nanoparticles along with thiamine (30 mg/kg body weight). Results: The histopathological findings showed disruption of the arrangement of convoluted tubules and their disintegration and widening of the tubular lumen, cell separation and tubular necrosis in the majority of the renal tubules in-group III. In the group treated with copper oxide nanoparticles along with thiamine (IV), the pathological changes were slight and the majority of the tubules had retained normal structure. Statistically significant differences in the levels of some serum biochemical parameters (catalase, superoxide dismutase, TBARS, and TAC) were observed in groups III and IV on day 14 when compared to the control group. Conclusions: This study demonstrated that thiamine can be utilized as an effective compound to reduce the damage caused by nanoparticles to kidney tissue and may lead to significant improvement in the health of kidney tissue in individuals suffering from damage caused by these nanoparticles.
Background: Thyroid cancer is one of the most common types of endocrine malignancies. FASL is one of the most important apoptosis ligands expressed by tumor-infiltrating lymphocytes. This death ligand plays an important role in the elimination of cancer cells by inducing apoptosis in the Fas/FasL pathway, and its disruption induces tumorigenesis. This study investigated the association of the FASL gene polymorphism - INV2nt-124A/G (rs5030772) with the risk of thyroid cancer in the East Azerbaijan region. Materials and Methods: In this case-control study, 115 patients with thyroid cancer and 125 healthy individuals without a family history of cancer from Tabriz city were studied. Five milliliters of peripheral blood were collected from each of these participants. Proteinase K method was used for DNA extraction and FASL gene polymorphism (rs5030772) was analyzed by ARMS-PCR technique. The results were analyzed using Javastat statistics package online software. Results: The genotype frequencies of AA, AG and GG were 40.35%, 49.12% and 10.53% in patients and 41.6%, 52.8% and 5.6% in the control group, respectively. Genotypic and allelic frequencies did not show significant differences between the patient and control groups (p>0.05). By examining the clinicopathological characteristics of the patients, no significant relationship was seen between the clinical characteristics of the patients and the distribution of the genotypes of this polymorphism (p<0.05). Conclusion: The results of this study indicate that the FASL gene polymorphism - INV2nt-124A/G (rs5030772) cannot be considered as a risk factor for thyroid cancer in the studied population in in East Azerbaijan province.
Introduction: Considering parents' preferences and opinions is an important factor in dentists' choice of treatment techniques. Despite the relatively low attitude of parents towards the use of the "parental presence/absence" technique, dentists still use this technique during pediatric dental treatment. The present study was conducted with the aim of simultaneously investigating the dentists' attitudes regarding the "presence/absence of parents" technique during the treatment of 4-10-year-old children and determining the factors affecting this attitude. Methods: In this cross-sectional study, the attitudes of 83 dentists regarding the "presence/absence of parents" technique were evaluated using an investigator-designed questionnaire. The questionnaire scored dentists' attitudes regarding the above technique and evaluated the background factors affecting the child's attitude. Data were analyzed with a significance level of 0.05. Results: The mean attitude score of the participants was 60.61±12.99. Also, 55.4% of participants considered this technique "unsuccessful". The factors "type of treatment", "child's age", "child's behavior", "parental behavior" and "implementation of the presence/absence technique", significantly affected the participants' attitudes. Conclusions: Dentists do not hold a highly positive attitude toward the "presence/absence of parents" technique. According to dentists working in pediatric dentistry, this technique has low success in guiding children’s behavior.
Introduction: An echogenic intracardiac focus (EIF) is one of the most common non-structural findings on fetal ultrasound, typically detected between 18 and 20 weeks of gestation. EIF is often considered a soft marker in prenatal screening. However, its association with maternal risk factors—particularly endocrine disorders such as hypothyroidism—remains unclear. This study aimed to evaluate the prevalence of hypothyroidism in pregnant women carrying fetuses with EIF and to investigate its correlation with other clinical variables. Methods: In this cross-sectional study conducted from September 2022 to September 2023 at Amir-al-Momenin Hospital in Semnan, Iran, 100 pregnant women with fetuses diagnosed with EIF confirmed by fetal echocardiography were evaluated. Maternal demographic data, medical history, and fetal sex were collected and statistically analyzed. Results: The mean maternal age was 41.55 ± 4.0 years, and the mean gestational age was 21.4 ± 3.65 weeks. Hypothyroidism was observed in 7% of the mothers and showed a statistically significant association with the presence of fetal EIF (P = 0.00). Furthermore, hypothyroidism was also significantly associated with underlying maternal diseases and fetal sex. However, no significant association was found between hypothyroidism and maternal age or gestational age. Conclusions: The findings indicate a noteworthy prevalence of hypothyroidism among pregnant women carrying fetuses with EIF. These results highlight the importance of evaluating maternal thyroid function during pregnancy, particularly in cases where EIF is detected. Further research is recommended to clarify the underlying mechanisms and potential outcomes of this association.
Introduction: High sensory processing sensitivity in the face of psychological pressures predisposes individuals to substance craving, while resilience, as a protective factor, plays a role in reducing this vulnerability. The present study aimed to examine the structural relationship between sensory processing sensitivity and substance craving with the mediating role of resilience among substance-addicted prisoners. Methods: The study population included all substance-dependent clients in the Delijan Prison in 2022. A convenience sample of 200 participants was selected based on the research constructs. Data collection tools included the Aron and Aron Sensory Processing Sensitivity Questionnaire (1997), the Connor-Davidson Resilience Scale (2003), and the Salehi Fardhadi, Berefan, and Ziaei Substance Use Cravings Questionnaire (2008). Structural equation modeling (SEM) using SmartPLS version 2 and SPSS version 19 was employed to test the hypotheses. Results: The results of the study indicated that the proposed model exhibited a good fit to the data, and high sensory processing sensitivity was directly and indirectly (through resilience) associated with an increased risk of substance craving in addicted individuals (P < 0.05). Conclusions: The findings of this study indicate that sensory processing sensitivity and resilience play a significant role in substance craving in addicted individuals. Overall, the results of this study emphasize the importance of considering cognitive-emotional factors in the design and implementation of treatment and prevention programs for addiction, as well as in reducing the risk of substance craving.
Introduction: Today, declining birth rates and families’ reluctance to have children for various reasons pose challenges for both individuals and societies. One of the key factors influencing fertility is individuals’ attitudes toward this issue, with religious beliefs being among the most fundamental perspectives. The Islamic faith, in particular, has addressed this matter in numerous verses and narrations. This study aims to explore Islamic religious sources’ viewpoints regarding fertility. Methods: The research is based on an extensive review of authentic library documents and data from various databases such as PubMed, Scopus, ScienceDirect, as well as search engines like Google Scholar. The findings indicate that, in addition to several verses in the Quran, Islamic texts related to the Imams, such as Nahj al-Balagha and Sahifa Sajjadiya, explicitly encourage childbearing and population growth, while condemning population decline. These sources identify four general factors—individual, economic, political system, and social-cultural status—that influence population increase or decrease. Conclusions: Given the valuable Islamic resources regarding childbearing and the existing challenges in societies related to population decline and aging, it is possible to take significant steps to improve individuals’ and families’ attitudes toward childbearing by reinforcing Islamic lifestyles and religious beliefs.
Introduction: The present study was conducted with the aim of analyzing excess deaths during the COVID-19 pandemic in the population covered by Maragheh university of Medical Sciences. Methods: This descriptive-analytical study extracted the number of recorded deaths and their information, including age, sex, and date of death, by year from march 2020 to march 2021 and march 2021 to march 2022, from the cause-specific registration and classification system of mortality in Maragheh County. The number of expected deaths for 2020 and 2021 was calculated based on the number of deaths recorded from march 2018 to march 2020 in this system. Specifically, the number of deaths stratified by age, gender, and date of death from march 2018 to march 2020 was extracted, and after standardization, mortality rates were calculated. These rates were then adjusted to the population of 2020 and 2021 to estimate the expected number of deaths for these two years. Results: from march 2020 to March 2022, 3821 deaths were recorded in the causal system. Given the expected number of 2958 deaths, 863 (29.17%) excess deaths occurred. The excess death rate among men was 24.59% and among women was 35.41%. The 60-69 year age group had the highest excess death rate. Overall, 96.06% (829 cases) of the excess deaths during these two years were attributed to COVID-19, with rates of 97.85% among men and 94.36% among women. The highest number of excess deaths occurred in the third quarter of 2020, which was 72.17% higher than the expected deaths for that period. Conclusions: The excess death rate was higher among older age groups and in the female group. Furthermore,the occurrence of excess deaths increased during the COVID-19 infection waves. Therefore, adopting appropriate policies to prevent disease waves and implementing care and treatment strategies for older age groups will prevent many excess deaths.
Introduction: Imaging of the vascular system supplying the brain parenchyma is a diagnostic tool in the evaluation of stroke patients. This study aimed to compare the results of digital subtraction angiography with color Doppler ultrasound of the carotid arteries in patients with ischemic stroke. Methods: In this cross-sectional-analytical study, the medical records of patients with ischemic stroke admitted to Imam Khomeini Hospital from July 1401 to July 1402 were reviewed to collect data. Demographic information, along with the results of color Doppler ultrasound and digital subtraction angiography of the patients, were extracted and evaluated. Results: This study included 48 patients with ischemic stroke with a mean age of 12.8 ± 0.67 years. Hypertension was present in 68.8%, diabetes mellitus in 20.8%, and smoking in 25% of patients. Based on the results of digital subtraction angiography and color Doppler ultrasound, the most common vascular abnormality was plaque (79.2%). Vascular stenosis and occlusion were present in 91.7% of patients. Color Doppler ultrasound in examining the right and left internal carotid arteries had a sensitivity of 94.9% and 92.8%, specificity of 66.7% and 38.9%, positive predictive value of 92.1% and 70.3%, and negative predictive value of 75% and 77.8%. Conclusions: Color Doppler vascular ultrasound demonstrated high sensitivity and specificity in detecting the presence and severity of stenosis in internal carotid arteries of ischemic stroke patients, supporting its use as a non-invasive and cost-effective method in clinical practice.
In global healthcare systems, nurses are recognized as the main pillars of care, but their voices, despite their vital role, are often lost amidst a cacophony of loud silences. This silence does not signify tranquility, but rather reflects hidden pressures, unexpressed fears, and an imposed passivity in the face of structures that limit the freedom of expression. "Organizational silence," a concept recognized for years in the fields of management and organizational psychology, has become a global crisis in nursing. According to a qualitative meta-synthesis, over 91% of nurses have experienced organizational silence at least once in their professional careers [1]. The causes of silence among nurses are multifaceted. Part of it stems from defensive silence, meaning a nurse refrains from speaking up before superiors or in hierarchical structures for fear of negative consequences. At other times, we encounter acquiescent silence, where the nurse believes that speaking out is futile and will not bring about any change. Previous experiences of having concerns ignored or autocratic leadership styles reinforce this feeling [1,2]. Furthermore, in some cultures, such as Japan or Egypt, prioritizing group harmony over individual expression leads to the normalization of silence [3]. Silence is not just an individual reaction but a response to an inefficient work environment. Nurses who feel their voices are not heard eventually experience job burnout, decreased motivation, and ultimately, leave the profession [2,3,4]. In a study from Spain, half of the nurses surveyed had considered leaving the profession [3,5]. Job burnout not only harms the nurse's mental health but also reduces the quality of patient care. Fatigue, reduced concentration, and impaired communication with patients increase the risk of clinical errors [1,6]. This vicious cycle of silence and its consequences creates a downward spiral in healthcare organizations: Silence on staff or resource shortages → Increased stress and workload → Job burnout → Decreased quality of care → Intensified dissatisfaction → More silence. If nurses feel that their concerns are ignored even when expressed, silence becomes an adaptive strategy [4]. Meanwhile, the financial impact of nurse turnover is also significant. According to estimates, the turnover cost for a single nurse in the United States is over $44,000, and hospitals lose an average of $3.6 to $6.1 million annually due to nurse turnover [7]. This substantial figure provides an economic incentive for systemic interventions to reduce silence and retain human resources. Solving this problem is not possible through individual training or psychological resilience alone. Although strengthening skills like professional assertiveness can be effective, it will not be sustainable without structural and cultural support [4]. Creating psychological safety in the workplace—where nurses can freely express their concerns without fear of punishment—is a vital starting point for change [6]. Leaders of healthcare organizations play a key role in shaping or dismantling a culture of silence. When managers interact with nurses with empathy, a listening ear, and responsiveness, trust is built, and the space for expression becomes safer. A transformational leadership style, participation in decision-making, and the creation of professional growth paths are among the most important factors in retaining nurses and reducing silence [8]. There is also a need for macro-level policymaking at national and international levels. Programs like the "Global Nursing Workforce," which focuses on supporting the sustainability of the profession, can be effective in addressing the root causes of the problem [7]. Moreover, new guidelines from bodies such as The Joint Commission on preventing workplace violence (effective July 2024), which define requirements for reporting and accountability, can serve as models for combating silence on other issues as well [8]. Ultimately, organizational silence in nursing is not just a communication issue; it is an alarming indicator of the ethical, psychological, and systemic health of healthcare institutions. This phenomenon should be considered an "organizational vital sign." The healthcare system has a duty not only to listen but to act. The voices of nurses must lead to decisions, policies, and structural reforms, so that their silence is no longer loud, but is transformed into an effective cry on the path to improvement.
Introduction: The sinuosus canal and its branching accessory canals have crucial importance across different races for minimizing neurovascular problems in dental implantation. Methods: This study was performed as a retrospective analysis, employing Cone beam computed tomography(CBCT) images of 174 patients who attended a private oral and maxillofacial radiology center in Arak from 2018 to 2020. The CBCT images were examined with Romexis software. Quantitative variables were reported as mean ± standard deviation, whereas qualitative variables were presented as frequency percentages. The data were analyzed using the independent T-test. The correlation between quantitative data was examined using Pearsons correlation coefficient and logistic regression analysis. One-way ANOVA was performed to analyze variables including age groups and the location of accessory canals. Results: 65.5% of the participants had a canalis sinuosus, demonstrating a considerable prevalence of canalis sinuosus in the studied population. Age and gender did not significantly correlate with the prevalence of accessory and sinuosus canals (P > 0.05). However, a significant difference was observed in the mean diameter of the canalis sinuosus between males and females (P = 0.01). The most common location for the termination of accessory canals on the left side in females was posterior to the lateral incisor (48.3%), whereas in males, it was posterior to the central incisor (45.8%). On the right side, the most common place in females (45.5%) and males (36.4%) was also posterior to the central incisor. Conclusions: The prevalence of sinuosus and accessory canals in different populations and races is more closely related to sample size and race and requires investigation across different races to reduce neurovascular complications.
Introduction: Mancozeb a widely used fungicide, is extensively applied to protect fruits, vegetables, and crops. It has various toxic effects on humans. The aim of the present study was to investigate the effects of mancozeb exposure on the ovaries of small laboratory mice. Methods: Twenty-four immature small white laboratory mice were randomly divided into a control and a mancozeb group, each comprising 12 mice. Each group was divided into three subgroups of days 17, 24, and 31. Mice in the mancozeb group received 100 mg/kg/day mancozeb via gavage for 14 days, and the control group received an equivalent volume of distilled water daily. On day 28, mice were anesthetized for ovary collection, and microscopic sections were prepared and stained from the ovaries. Histomorphometric examination was performed by counting and measuring follicles. Results: Findings showed that mancozeb exposure resulted in a decrease in the number of mature follicles, an increase in immature follicles, and a reduction in follicle diameter in the experimental group compared to the control group. Conclusions: Mancozeb disrupts follicle development, potentially leading to reduced fertility in female mice.
Introduction: Some intracranial surgeries must be performed while the patient is awake. Awake craniotomy is an intracranial surgical procedure in which the patient remains in a state of controlled consciousness while the surgery is performed. The aim of this study was to present a case of intracranial surgery to remove a tumor in the right frontal cortex using awake craniotomy. Case Report: This report describes the anesthetic management of a 22-year-old male undergoing craniotomy with a fully awake technique. This was the first case of craniotomy performed entirely awake (from the beginning to the end of the operation) at Arak University of Medical Sciences and Valiasr Hospital in Arak, After preoperative preparation and evaluation, scalp nerve blocks targeting the cranial nerves innervating the scalp and head muscles were administered at specific sites. Mild sedation was provided using oxygen supplementation, followed by surgical incision. The lesion was examined intraoperatively while the patient remained awake, and the tumor was safely excised under full wakefulness. A combination of local and regional anesthesia and light intravenous sedation was utilized. Two types of local anesthetics, lidocaine 1.5% and bupivacaine 2.5%, were used for anesthesia, as well as intravenous sedatives and anesthetics such as propofol, remifentanil, and dexmedetomidine were administered for sedation. Throughout the operation, the patient was awake and breathing spontaneously, and the function of the brain nerves during the operation could be evaluated. Finally, the patient's surgery was performed without any complications and in stable condition, and the patient was transferred to the intensive care unit in good general condition, awake and fully alert. Conclusions: Although maintaining analgesia and hemodynamic and adequate ventilation during fully awake craniotomy poses challenges, this technique is critical for intraoperative monitoring of cranial nerve function and preventing neurological deficits. By precisely administering scalp nerve blocks and carefully titrating sedatives (propofol, remifentanil, dexmedetomidine), we successfully performed the procedure under full wakefulness. With this method, potential surgical complications are prevented, and the patient also experiences satisfactory painlessness. Applying this technique was satisfactory for our patient.
Introduction: The present study was conducted to investigate the effectiveness of acceptance and commitment-based therapy on the lifestyle of improving the health and emotional distress of women undergoing infertility treatment with the in vitro fertilization (IVF) method. Methods: The method of this study was semi-experimental with a pre-test-post-test design with a control group and a follow-up stage. The statistical population of the study included women undergoing infertility treatment with the IVF method referring to the infertility center of Imam Khomeini Hospital in Tehran in the first six months of 2012. In this research, 27 women undergoing infertility treatment with IVF method were selected by voluntary sampling method and replaced by random method in test and control groups. The experimental group underwent acceptance and commitment therapy (10 sessions) for two and a half months. A health-promoting lifestyle questionnaire (HPLP) and an emotional distress questionnaire (Lavibond and Lavibond, 1995) were used as research tools. The data were analyzed using a mixed analysis of variance and Bonferroni post hoc test. Results: It showed that the treatment based on acceptance and commitment to the lifestyle level improves health (Eta = 0.56, F = 19.74) and has a significant effect on the dimensions of emotional disorders such as depression (P < 0.0001, Eta = 0.58, F = 0.58). F = 34), anxiety (P > 0001; Eta = 0.59; F = 35.69), and stress (P > 0.0001; Eta = 0.61; F = 40.12) of women undergoing infertility treatment with the IVF, and has been able to lead to increase a healthy lifestyle, reduce depression, anxiety, and stress in these individuals. Conclusions: Acceptance and commitment therapy, utilizing six psychological acceptance processes, cognitive breakdown, self under context, interaction with the present, specified values, and committed behavior, can be used as an effective treatment to reduce emotional distress in women undergoing IVF infertility treatment.
