Isfahan University of Medical Sciences

Depression, a prevalent and debilitating mental health disorder, affects approximately 280 million people worldwide, according to the World Health Organization (WHO). It is estimated that 5% of adults, including 4% of men and 6% of women, experience depression, with the prevalence increasing to 5.7% in individuals over 60 years old. Despite the availability of pharmacological treatments, many individuals experience insufficient relief or adverse side effects, highlighting the need for alternative therapies. This review comprehensively examines the current scientific evidence on the mechanisms by which saffron (Crocus sativus L.) and its bioactive compounds-crocin, crocetin, and safranal-exert antidepressant effects. Key mechanisms include the modulation of neurotransmitter systems, anti-inflammatory properties, antioxidant activities, and the regulation of neurotrophic factors. Additionally, saffron’s impact on epigenetic modulation and gut-brain axis interactions are explored. Clinical studies supporting the efficacy of saffron in alleviating depressive symptoms are discussed, along with considerations for dosage, safety, and future research directions. This review aims to provide a thorough understanding of saffron’s potential as a natural antidepressant and its mechanisms of action, contributing to the growing body of literature on alternative treatments for depression.

The increasing production of waste has become one of the major environmental challenges of our time, particularly in waste management. While the composting process can transform municipal waste into a valuable product, the presence of plastics and microplastics (MPs) (< 5 mm) in the waste and their integration into the final compost and leachate pose significant environmental concerns. This is the first study to analyze the abundance of MP in the compost leachate from one of the Isfahan compost plant (S1), located in one of Iran’s major cities with high population density, during the summer season. MPs were counted using a stereomicroscope, and fourier transform infrared spectroscopy (FTIR) was utilized to identify polymer types. The results revealed an average abundance of MPs in the S1 leachate during the summer of 992.66 ± 100.85 items/L. Over 62% of the MPs identified in this study fell within the 1000–5000 μm size range, with a concentration of 610.28 ± 59.26 items/L. Polystyrene and polyamide emerged as the most frequently identified polymers (18.46% and 16.8%), and fragments were the most commonly observed shape among the MPs. This study underscores that compost leachate contains high concentrations of MPs that can disseminate into various environmental compartments such as groundwater, surface water, soil, and even air. Consequently, compost leachate should be recognized as a significant source of MPs entering the environment.

There is limited information regarding organochlorine pesticides (OCPs) residues in tobacco products found in the Iranian market, especially in various types of waterpipe tobacco. The purpose of this research was to evaluate the concentration of OCPs in various waterpipe tobacco—both fruit-flavored and regular—and compare it with cigarette tobacco. Additionally, by analyzing the OCPs levels in fresh tobacco compared to tobacco wastes, an estimate has been made for the quantity of pesticides released into smoke during consumption. Our results indicated that the average detection frequency (DF) of pesticide residues was 46% for fruit-flavored tobacco, 82% for regular tobacco, and 42% for cigarette tobacco. Hexachlorocyclohexane (HCHs) isomers were the predominant pesticides in all three types of tobacco with the mean of 43.11 ± 31.81, 89.63 ± 56.08, and 41.65 ± 35.37 ng/g for fruit-flavored tobacco, regular tobacco, and cigarette tobaccos, respectively. Both the levels and DF of pesticides in post-consumption wastes were significantly reduced compared to that in fresh tobacco (p < 0.05). For all tobacco types—fruit-flavored, regular, and cigarette—notable OCPs residues were released into the gas phase, with cigarette tobacco having the highest rate at approximately ~ 37% because of greater combustion temperatures. The research points out some limitations, particularly the disregard for bowl water and charcoal as elements of waterpipe waste, which could lead to an overestimation of pesticide levels in inhaled smoke. Further studies are needed on the environmental impact of tobacco wastes and promoting for better waste management practices as well as public awareness.

Background Mandala coloring is a distraction strategy to reduce the anxiety in children. However, it has received little attention for the management of anxiety in hospitalized children. This study aimed to examine the effectiveness of mandala coloring on preoperative anxiety in children. Materials and Methods This randomized controlled trial study was conducted using a pre-test–post-test design in two intervention and control groups. The 64 school-age children, who were admitted to the pediatric surgery ward in Mofid Hospital in Tehran, were allocated to the test and control groups, using a single-blind block randomized design. Children in the control group underwent routine preoperative visits. Meanwhile, the children in the intervention group, mandala coloring intervention was done at least one hour before entering the operating room for 15–20 minutes. The level of anxiety was measured through the Spielberger State-Trait Anxiety Inventory, before and after the intervention of both groups. Results were analyzed using t -test and Pearson correlation. Results In the intervention group, there was a statistically significant in post-intervention than the pre-intervention and the children reported a lower level of anxiety (t = 4.51, df = 31, P = 0.01). But, after the intervention, there was not a statistically significant between the intervention and control groups in terms of average trait (t = 1.31, df = 61.86, P = 0.194) and state anxiety levels (t = -0.152, df = 58.94, P = 0.879). Conclusions The results indicated that likely, mandala coloring intervention was not effective in reducing preoperative anxiety in children. Further studies are needed to more assess the effects of mandala coloring on anxiety of children undergoing surgery.

Background The COVID-19 pandemic put enormous pressure on healthcare providers and patients. Exploring the experiences of healthcare providers involved in this crisis can help prevent potential complications and manage similar crises in the future. This study aimed to explain the experiences of healthcare providers in providing care for patients with COVID-19. Materials and Methods This study enrolled 20 healthcare providers from three hospitals who cared for patients with COVID-19 in 2021 in Isfahan, Iran. Purposive sampling method was used to select the participants. Data were collected by conducting face-to-face interviews with the participants. The place and time of the interview was arranged considering the willingness and comfort of the participants. Data were analyzed using inductive content analysis approach based on the criteria proposed by Graneheim and Lundman. Results Analysis of the participants’ narratives led to four categories, including unexpected exposure, spiritual health as an agent of victory over the disease, corona phobia as the cause of exhaustion and impaired concentration in healthcare providers, and proper management as the requirement of disease control. Conclusions During crises caused by infectious diseases such as COVID-19, timely and appropriate planning, prediction and allocation of material, equipment, and human resources on the one hand, and attention to all aspects of employees’ health, including spiritual health, and the use of various ways to enhance their motivation and provide comprehensive support for the personnel on the other hand, can lead to the delivery of high-quality patient care and effective control of the crisis.

Background The childbirth experience encompasses a complex interplay of physical, emotional, and psychological factors, shaping a woman’s overall well-being and potentially influencing her future reproductive plans. The current study aimed to evaluate the influential factors of respectful maternity care and its relationship with women’s future fertility decisions. Materials and Methods This cross-sectional study was conducted on 308 postpartum women hospitalized in the postpartum wards of educational hospitals affiliated with Isfahan University of Medical Sciences between April and September 2021. Data were collected using convenience sampling method by a sociodemographic and obstetric checklist and a standard Respectful Maternity Care (RMC) questionnaire and analyzed with descriptive statistics and the linear regression model (95% confidence level). Results Our findings show that 50.65% of participants would like to have another child, and only 26.62% of them reach the desired number of children. The mean score of RMC was 66.55 (7.13), and variables such as duration of hospital stay, oxytocin induction, episiotomy, birth preparation classes, and level of education were the main predictors of RMC (p-value < 0.05). In addition, a positive correlation was found between the total score of RMC, the next intended fertility (r = 0.24), and ideal fertility in the best socioeconomic condition (r = 0.22). Conclusions This study demonstrates a strong association between hospital stay duration, oxytocin induction, episiotomy, birth class attendance, education level, and RMC. Addressing these factors can enhance maternity care quality, childbirth experiences, and ultimately contribute to optimal fertility outcomes.

Background The number of suicide attempts has increasingly grown over the last few years. Describing and stating the experiences suicide attempters have undergone and the consequences of such actions is of significant importance. Hence, this study was performed to uncover and communicate the experiences of young suicide attempters and their parents through a qualitative method and with a phenomenological approach. Materials and Methods This study was conducted based on the descriptive phenomenological method. The data collection method was an in-depth, semi-structured interview, and 8 adolescents and 8 parents were interviewed. The collected data were then analyzed using Colaizzi’s method. Results As a result of scrutinizing the data through Colaizzi’s analysis, 14 subthemes and 4 main themes (helplessness and feeling unsupported, poor self-esteem, generation gaps, and negative emotions and inappropriate emotional reactions) were derived. The lived experiences of adolescent suicide attempters and their parents indicate that suicide is a complex, painful, and bitter ordeal, and comprehending all of its aspects is not feasible and is hardly achievable. Conclusions The findings show that the adolescents were suffering from undesirable and irritating emotional experiences and agitation arising from different factors such as problematic and unsupportive emotional relationships inside and outside the family, generation gap, and losing control of negative emotions.

Background Infertility stigma is one of the well-known psychosocial problems and can disrupt the mental health of infertile women and their family relationships. This study evaluated the relation between infertility stigma and domestic violence in infertile women. Material and Methods This was a cross-sectional study that was conducted on 300 women who referred to the Fertility and Infertility Center of Isfahan, IRAN (2022–2023) using a convenient sampling method. Data gathering tools were WHO Standard Domestic Violence questionnaire and Female Infertility Stigma Instrument (ISI-F). Data were analyzed using SPSS software version 16 (Pearson correlation, Mann–Whitney, Kruskal–Wallis, and multivariate linear regression analysis). This article has been edited based on the STROBE checklist. Results The mean (SD) score of infertility stigma was 64.79 (14.70) (out of 100). The mean (SD) score of domestic violence was 10.94 (16.61) (out of 100). There was a significant positive relation between the score of infertility stigma and the total score of domestic violence, physical violence, mental violence, and sexual violence p <0.001. The highest correlation was found between mental violence and infertility stigma (r = 0.359). Economic status ( p = 0.001), infertility factor ( p = 0.007), and infertility stigma p <0.001 were predictors of domestic violence. Conclusions Infertility stigma was related with all the aspects of domestic violence. Infertility stigma was a predictor of domestic violence. It is necessary to plan interventions to deal with infertility stigma and domestic violence in infertile women. Psychological counseling should be considered along with infertility treatment.

Background The mortality rate of breast cancer has increased in women who are referred late in the advanced stages of their disease, while morbidity and mortality from cancer can be reduced through prevention programs, such as self-care behaviors and early detection. Therefore, more attention should be paid to primary prevention, self-care, and the role of women in breast cancer prevention. The aim of this study was to describe women’s experiences of self-care in breast cancer prevention. Materials and Methods In this descriptive-exploratory qualitative study, 38 participants, including 23 women who were eligible for breast cancer screening, eight service providers, and seven health policymakers, were selected by purposive sampling. Data were collected through semi-structured interviews and analyzed using conventional qualitative content analysis. To assess data trustworthiness, Lincoln and Guba’s criteria were used. Results The results of this study are summarized in one theme, three categories, and eight subcategories. The theme extracted from the data analysis was “the agency of women in self-care in breast cancer prevention,” which included three main categories: women’s understanding of the concept of self-care in breast health, subjective challenges in breast cancer prevention, and active management and follow-up of breast health status. Conclusions This study provided a new understanding of the experience regarding women’s self-care in breast cancer prevention. The experiences were in a wide range demanding comprehensive attention. Healthcare authorities/providers can use the findings of this study to develop strategies to support women regarding preventive self-care for breast cancer.

Implants are one of the common treatments in dentistry. This treatment has various complications such as inflammation around the implant, failure of the coating, and screw loosening. Several factors contribute to screw loosening, including abutment type and collar height. Therefore, this study aims to compare the amount of loosening in two types of abutments—InOcta and SynOcta abutments. In this laboratory study, 20 titanium fixtures of the Dentis brand were divided into two groups. Each group consisted of 10 fixtures. The fixtures were mounted vertically in acrylic blocks with dimensions of 20 × 6 × 10 mm. After installing the SynOcta and InOcta abutments, the screws were torqued to 30 N·cm and re-torqued after 10 minutes. Subsequently, the samples were transferred to a chewing simulator. A compressive force of 90 N was applied for 10,000 cycles at a frequency of 75 rpm. After loading, the torque required to loosen the screws was measured, and the loosening torque was calculated. The data were analyzed using an independent t-test, and a significance level (p-value) of less than 0.05 was considered. The mean de-torque for the tissue level InOcta abutments was calculated to be 25.75 N.cm, while the mean de-torque for the SynOcta abutments was 21.98 N.cm. A comparison using the t-test showed that the mean de-torque for the InOcta abutment group was significantly higher than the SynOcta group (p < 0.001). The final results of the experiments indicate that under laboratory conditions, the de-torque of the abutment screw in the tissue level SynOcta group is significantly lower than that in the InOcta group (p < 0.001).

Background and objective There is limited research on the use of ankle-foot orthosis (AFO) with dual-task training. The aim of the study was to assess impact of orthotic use during dual-task training in patients who have had a stroke during walking. Study Design The quasi-experimental study Methods Eleven hemiplegic people after stroke, aged 35–65 years, underwent gait training with dual task for 10 daily sessions over 4 weeks, guided by a physiotherapist while wearing an AFO. Gait was measured under 2 conditions—only dual-task walking and dual-task walking with the AFO—at baseline and after 4 weeks of training using a motion capture system. The gait parameters were compared before and after intervention in each condition and between 2 walking conditions after intervention using paired t test. Results After 4-week intervention, there was no significant difference in any gait parameters between 2 walking conditions. In dual-task walking alone, several gait parameters were significantly increased compared to baseline, including peak ankle plantarflexion angle, peak knee flexion angle in loading response, peak knee extension moment in response loading, and peak hip flexion moment in preswing. In dual-task walking with AFO, peak knee flexion angle and peak knee and hip extension moments in loading response phase were significantly increased after intervention compared to baseline. Conclusions Although the dual-task training has had a positive effect on some aspects of gait kinetics and kinematics in patients who have had a stroke, the AFO had no additional effect on dual-task walking.

Background Approximately half of all adverse events occur in the operating room, highlighting the critical role of non-technical skills in operating rooms. Effective non-technical skills among operating room nurses can significantly reduce the occurrence of such events. Moreover, self-efficacy in non-technical skills may directly impact professional performance and patient safety. Therefore, this study aimed to investigate the impact of intraoperative non-technical skills training on scrub practitioners' self-efficacy. Methods In a randomized controlled trial, 30 scrub practitioners were assigned to the intervention group and 30 to the control group through random allocation. The intervention group underwent training in non-technical skills using a combined technique of lectures and simulated video scenarios delivered in two two-hour training sessions. Meanwhile, the control group received no training. The data collection tool was a two-part questionnaire. The first part collected demographic data (age, gender, work experience, and educational level), while the second part assessed scrub practitioners' self-efficacy in intraoperative non-technical skills. The questionnaire was administered online in two phases, with a one-month interval between them, through the Telegram application to the participants in both groups. The data were analyzed using descriptive statistics, independent t-tests, and paired t-tests. Results The demographic variables of the intervention group did not show significant differences compared to the control group. The independent t-test revealed no significant difference in overall self-efficacy between the intervention and control groups before the training (P = 0.513). However, after the training, a statistically significant difference was observed (P = 0.025). There were no significant differences among the self-efficacy components between the intervention and control groups before the training (P > 0.05). However, after the training, self-efficacy in the two skills of situation awareness and communication and teamwork showed statistically significant differences (P < 0.05). Conclusion Non-technical skills are crucial for scrub practitioners to perform their tasks safely and efficiently. Training can enhance the self-efficacy of scrub practitioners in their non-technical skills. Therefore, it is necessary to incorporate non-technical skills training into the educational curriculum and continuing education programs for scrub practitioners. Trial registration The IRCT code (IRCT20150715023216N15) was obtained from the Iranian Clinical Trials Registry website on 2023/08/05 before sampling.

Background The anatomical relationship between the optic nerve canal (ONC) and posterior paranasal sinuses is crucial for understanding potential complications in craniofacial and endoscopic sinus surgeries. This study aimed to assess the prevalence of various ONC types in relation to posterior paranasal sinuses among Iranian ethnicities using computed tomography (CT) scans. Methods This retrospective cross-sectional study was conducted at XX Hospital in X, X, from March 2020 to March 2022, involving Iranian patients aged 18–70 with normal paranasal sinus CT scans. Exclusion criteria included congenital/acquired abnormalities and invalid scans. Two experienced radiologists independently reviewed scans, categorizing ONC types based on previous works done by DeLano. Data were analyzed for frequency, percentage, and mean age, employing ANOVA and chi-squared tests for statistical significance (p < 0.05). Results A total of 326 patients (652 sides) were included, with a mean age of 37.6 (± 16.62) years and a gender distribution of 49.1% males and 50.9% females. The most prevalent ONC type was type 1, observed in 79.8% of left and 76.7% of right ONCs, followed by type 2 (8.6% left, 10.4% right) and type 3 (4.9% left, 3.7% right). Bilateral similarity in ONC types was noted in 303 (92.9%) patients. A significant difference in left-side ONC types by gender was found (p = 0.047), with type 4 being least prevalent in males (3.8%) and type 3 in females (3.7%). Conclusion The study highlights a predominance of type 1 ONC among Iranian ethnicities with a notable bilateral consistency in ONC types. The gender-specific differences observed on the left side warrant further investigation into anatomical variations and must be taken into consideration before endoscopic sinus surgeries and other trans-sphenoidal approaches.

Background Ultra‐processed foods (UPFs) may lead to dysbiosis of gut microbiota, which significantly contributes to the development of disorders of gut–brain interaction (DGBI). However, knowledge regarding the association of UPFs with DGBI is scarce. Therefore, we aimed to evaluate the association of UPFs with DGBI and its common subtypes in Iranian adults. Methods In this cross‐sectional study, a total of 1892 adults were included. Dietary intake of participants was evaluated using a validated version of a dish‐based food frequency questionnaire, and UPFs were defined using the NOVA system classification. DGBI, including heartburn, functional dyspepsia (FD), and irritable bowel syndrome (IBS), were examined using the ROME IV questionnaire. The odds of suffering from any DGBI and its subtypes across the tertiles of UPFs were assessed using logistic regression. Results After controlling for potential confounders, being in the highest versus lowest tertile of UPFs consumption was associated with increased risk of DGBI (OR = 1.62; 95% CI: 1.20, 2.17) and IBS (OR = 1.89; 95% CI: 1.01, 3.55). However, UPFs consumption was not significantly associated with odds of FD and heartburn in the fully adjusted model. In stratified analysis by sex, females in the highest tertile of UPFs consumption had higher risks of DGBI, IBS, and FD than those in the lowest tertile. In males, in the fully adjusted model, no significant association was found between UPFs consumption and risk of DGBI and its subtypes. Conclusion Higher consumption of UPFs was significantly associated with an increased risk of total DGBI and IBS in Iranian adults. However, considering the limitations of the available evidence regarding processed foods and DGBI, further large‐scale prospective studies are needed to provide more data.

Background: Mental Disorders are the leading cause of disability, worldwide. This disability is more important in patients with Severe Mental Disorders due to the gradual onset and progression, tendency to relapse and reduced functioning. Considering these factors affect reentry of these patients into society, social participation is an important issue in most countries. For this purpose, this study will be carried out with the aim of development and evaluation effectiveness of interprofessional service package for promoting social participation of patients with Severe Mental Disorders (SMD).

Background Colorectal cancer (CRC) is a high incidence cancer and health problem influenced by many factors emphasizes on the importance of identifying risk factors which can be modified. A dietary approach to stop hypertension (DASH) style promotes a balanced nutrition approach that might have effects on CRC. The aim of this study was to analyze existing evidence on the DASH diet's association with CRC. Methods Databases, including Scopus, Web of Science, and PubMed, were searched to identify eligible studies up to March 2025. Observational studies investigating the association between adherence to the DASH diet and CRC were included. Effect sizes (ESs) and their confidence intervals (CIs) from fully adjusted models were extracted for the meta-analysis. A random-effects model was employed to calculate the combined ES and assess the relationship between the DASH diet and CRC. The publication bias was assessed using Egger’s test and heterogeneity between studies was examined using the I² statistic. Results Fourteen studies were included in this study. Adherence to DASH diet reduced CRC risk (RR = 0.81, 95% CI: 0.73–0.89). Subgroup analyses found consistent effects across cohorts and various factors, with no publication bias. For rectal cancer (RC), adherence to DASH dietary pattern reduced risk of RC (RR = 0.75, 95% CI: 0.66–0.86), particularly in males and cohort studies. Colon cancer risk was also reduced (RR = 0.83, 95% CI: 0.79–0.88), with stronger effects in males and cohort studies. For colorectal adenoma, DASH showed a significant risk reduction (RR = 0.42, 95% CI: 0.22–0.80). Conclusions Our results highlight that following the DASH diet has a significant effect on lowering the risk of CRC which aligns with previous research. These findings support recommendation of following the DASH diet pattern reduces the burden of CRC. PROSPERO, registration ID: CRD42024569140.

The COVID-19 pandemic posed unprecedented challenges to healthcare providers globally. The firsthand lived experiences of healthcare professionals who worked on the frontlines are invaluable. This study explores the experiences of frontline physicians during the early waves of the COVID-19 pandemic. This is a descriptive qualitative study conducted in Isfahan, Iran, during September and October 2020, in anticipation of the third wave of COVID-19 pandemic. Thirteen physicians from COVID-19-designated hospitals affiliated to the Isfahan University of Medical Sciences were purposively selected for semi-structured interviews. Data were analyzed using content analysis method. Our study identified seven main categories with 17 subcategories, encapsulating healthcare professionals’ experiences during the pandemic. These categories include (1) clinical decision-making in fog, (2) an unprepared health system, (3) defects in the education and research system, (4) homecare as a missing component in the healthcare system, (5) culture as a barrier, (6) poor interdisciplinary collaboration, and (7) concerns and mental rumination due to COVID-19. The findings of this study provide valuable insight into the experiences and decision-making processes of healthcare professionals throughout the COVID-19 pandemic, emphasizing the need for comprehensive support and better preparedness for probable future health crises.

Introduction: One of the diagnostic problems of pathology is to differentiate between oral verrucous carcinoma (OVC) and oral squamous cell carcinoma (OSCC). Fascin increases the invasion of normal and neoplastic cells by stabilizing cytoplasmic filamentous actin. The present study aimed to investigate the expression of fascin in OSCC and OVC. Methods: This descriptive-analytical cross-sectional was conducted on 25 blocks of OSCC, 22 blocks of OVC, and 10 blocks of healthy mucosa as a control group. After immunohistochemical staining, samples were observed by two maxillofacial pathologists simultaneously, and the percentage of stained cells, intensity of staining, and the location of stained cells were obtained. Results: There was no significant difference in the gender (p=0.123) and age (p=0.276) distribution of participants in the groups. There was a significant difference in the distribution of the involved area in the patients of the studied groups (p<0.001). There was a significant difference in the intensity of staining and the percentage of stained cells between the studied groups (p<0.001). Conclusions: The percentage and intensity of staining were higher in the OSCC, OVC and, control groups, respectively. It seems that Fascin expression has an important role in predicting OVC and OSCC.