Review Articles
Mohamed Anas Patni; Mushirabanu Sharifmiyan Akikwala
Abstract
Background: Protein-energy malnutrition (PEM) remains a significant global health issue, particularly in low- and middleincome countries. Despite extensive efforts, challenges in prevention, diagnosis, and treatment persist, underscoring the need for ongoing research and innovation.Methods: T his n arrative ...
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Background: Protein-energy malnutrition (PEM) remains a significant global health issue, particularly in low- and middleincome countries. Despite extensive efforts, challenges in prevention, diagnosis, and treatment persist, underscoring the need for ongoing research and innovation.Methods: T his n arrative r eview i nvolved a c omprehensive literature search using PubMed, Scopus, Web of Science, and the Cochrane Library. Keywords related to PEM, biomarkers, nutritional interventions, technological innovations, and policy implications were applied. From an initial pool of 2,449 articles, 65 were selected based on relevance, quality, and contribution to recent trends and innovations in PEM research.Results: Advances in biomarkers—including inflammatory markers, micronutrient levels, metabolic indicators, and novelgenetic and epigenetic markers—have improved the early detection and monitoring of PEM. Nutritional interventions, such as ready-to-use therapeutic foods (RUTF), fortified foods, biofortification, micronutrient powders (MNPs), and lipid based nutrient supplements (LNS), have demonstrated effectiveness in both treatment and prevention. Technological innovations, including digital health platforms, point-of-care diagnostic tools, geographic information systems (GIS), wearable devices, and artificial intelligence (AI), are revolutionizing the management of PEM.Conclusion: Significant progress has been made in PEM research, yet challenges remain. Future studies should focus on validating and integrating biomarkers, optimizing nutritional interventions, leveraging technological advancements, and strengthening policy frameworks to enhance the effectiveness of these approaches. By addressing the multifaceted nature of PEM with innovative, evidence-based strategies, substantial progress can be achieved in reducing the global burden of malnutrition and improving health outcomes among vulnerable populations.
Review Articles
Fatemeh Ghodrati; Zahra Yazdanpanahi
Abstract
Background: The husband, as a life partner, may not always be involved in abortion decisions, or his participation may be limited to material, emotional, or legal considerations. To investigate the role and participation of men in abortion decisions in Iran and selected other countries.Methods: This ...
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Background: The husband, as a life partner, may not always be involved in abortion decisions, or his participation may be limited to material, emotional, or legal considerations. To investigate the role and participation of men in abortion decisions in Iran and selected other countries.Methods: This narrative review examined the role of fathers in abortion decisions from 1980 to 2023. Literature was searched using keywords including father, rights, abortion, Iran, and Europe.Results: Socio-psychological experiences of women regarding partner involvement in abortion vary across countries. Influential factors include the absence of spousal consent requirements, selective disengagement of the sexual partner, financial and emotional support from the husband, denial or rejection of pregnancy, psychological factors associated with the husband, cohabitation with parents, marital instability, national and cultural norms, and male attitudes toward reproductive decisions. In Iran, the father’s consent is legally required for abortion due to the attachment of parentage under Article 1158 of the Civil Code. Islamic law (Quran 4:34, An-Nisaa; 2:233, Al-Baqarah) further delineates the husband’s authority and obligation regarding child support.Conclusion: Male involvement in abortion decisions influences the normative environment in most countries. Providing fathers with a participatory role has protective effects on the health and well-being of fathers, mothers, and children. Nonetheless, Islamic and legal frameworks recognize the wife’s right to participate in pregnancy care and abortion-related decisions.
Original Article
Majid Golzarpour; Fateme Adelinejad; Farhad Nosrati Nejad
Abstract
Background: COVID-19 has had adverse effects on both physical and mental health. The increase in anxiety and stress caused by this disease has affected the well-being of parents and children. This study aimed to investigate anxiety related to COVID-19 in parents and its effects on children’s health, ...
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Background: COVID-19 has had adverse effects on both physical and mental health. The increase in anxiety and stress caused by this disease has affected the well-being of parents and children. This study aimed to investigate anxiety related to COVID-19 in parents and its effects on children’s health, with perceived social support as a mediating factor, in the metropolis of Mashhad, northeastern Iran.Methods: This cross-sectional study was conducted in 2021 in Mashhad, Iran. The study population comprised 435 individuals from families with children aged 5 to 18 years. Data were collected using the Corona Disease Anxiety Scale (CDAS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Child Health Questionnaire (CHQ). Statistical analyses were performed using SPSS version 26 and AMOS version 26.Results: The results showed that parental anxiety related to COVID-19 had a negative and significant relationship with both parents’ perceived social support (β=-0.220, P<0.001) and children’s health (β=-0.443, P<0.001). Additionally, the mediating role of social support in the relationship between parental anxietyand children’s health was significant (P<0.001).Conclusion: Strengthening social support—particularly through the expansion of school- and community-based psychosocial services and increasing parental awareness of its importance— reduces parental anxiety and indirectly enhances children’s physical and mental health. These interventions mitigate the transmission of stress from parents to children by fostering a supportive family environment and strengthening children’s psychological resilience. Therefore, integrating mental health support programs into schools and local community spaces is an indispensable component of child health policy in Mashhad, representing an effective and cost-efficient strategy for mitigating the long-term impacts of public health crises on future generations.
Original Article
Mohammad Bagher Heydari; Yahya Salimi; Masoumeh Abbasi; Parnia Bagheri
Abstract
Background: Medical errors are considered inevitable events in healthcare systems and represent a major challenge in global health, particularly in developing countries. This study aimed to investigate the types of medical errors and their associated factors in Kermanshah Province, western Iran, in 2020.Methods: ...
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Background: Medical errors are considered inevitable events in healthcare systems and represent a major challenge in global health, particularly in developing countries. This study aimed to investigate the types of medical errors and their associated factors in Kermanshah Province, western Iran, in 2020.Methods: A cross-sectional study was conducted using data from all patients referred to public and private healthcare centers with complaints related to clinical or medical errors. Complaints were filed with the Kermanshah Medical System Organization in 2020. Data were collected using a checklist and medical error registry software.Results: The operating room ward accounted for the highest proportion of reported errors (44.09%), followed by the delivery ward (20.43%) and the emergency ward (6.45%). Poisson regression analysis revealed that age group, type of service center, and the interaction between medical negligence and type of shift were significantly associated with the number of errors.Conclusion: Greater attention should be paid to hospital performance, and medical protocols should be revised to prevent errors and their associated financial and human consequences. Our findings suggest that healthcare organizations should prioritize conditions during night shifts, particularly when additional medical staff are involved. Implementing enhanced safety protocols or support systems during these periods may mitigate the elevated risk of errors and improve overall patient safety.
Original Article
Marjan Sarami; Maryam Poursadeghfard; Alireza Salehi
Abstract
Background: Migraine is one of the most prevalent types of headache worldwide, imposing a considerable financial and health burden. This study aimed to assess the prevalence of migraine and its environmental risk factors among workers inindustrial settings.Methods: This cross-sectional study was conducted ...
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Background: Migraine is one of the most prevalent types of headache worldwide, imposing a considerable financial and health burden. This study aimed to assess the prevalence of migraine and its environmental risk factors among workers inindustrial settings.Methods: This cross-sectional study was conducted from March to May 2022 among male workers at the South Pars Gas Complex in Iran. Participants were randomly recruited to complete a questionnaire that included demographic data, a standardized migraine diagnostic tool (based on the ICHD-3), and predisposing factors. Environmental and medical factors previously identified as potential triggers of migraine were examined in detail.Results: The overall prevalence of migraine was 14.9% (95% CI: 12.5–17.5; n=119/801), and probable migraine was 2.4% (95% CI: 1.4–3.7; n=19/801). Only a quarter of affected workers had been previously diagnosed or evaluated for migraine. Significant predictors of migraine included altitude difference between residence and workplace, poor sleep quality, and smoking. The most frequently reported triggers were weather (34.6% hot, 17.6% cold), sleep disturbances (27.5%), chemical odors (19.6%), stress (18.8%), and noise (7.2%). The most commonly used analgesic among participants was acetaminophen.Conclusion: Migraine appears to be more prevalent among industrial workers compared to the general population, with multiple environmental factors contributing to its occurrence.
Original Article
Bahador Shahriari (Sarkari); Zahra Gholami; Mostafa Omidian; Elham Rezaei; Qasem Asgari; Alireza Safarpour; Mohammad Saleh Bahreini
Abstract
Background: Toxoplasmosis is a common zoonotic infection affecting both humans and animals. Its prevalence varies widely across regions depending on geographical, climatic, dietary, and social factors. This study aimed to assess the seroepidemiological status of toxoplasmosis among residents of Kavar ...
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Background: Toxoplasmosis is a common zoonotic infection affecting both humans and animals. Its prevalence varies widely across regions depending on geographical, climatic, dietary, and social factors. This study aimed to assess the seroepidemiological status of toxoplasmosis among residents of Kavar district, Fars Province, southern Iran.Methods: A t otal o f 1,413 a dults r esiding i n K avar d istrict participated in this community-based survey. Venous bloodsamples (5 mL) were collected from each participant, and sera were tested for anti-Toxoplasma gondii antibodies using an in-house ELISA. All positive samples were subsequently retested with a commercial ELISA kit for confirmation. Datawere analyzed using descriptive statistics and chi-square tests to examine associations between seropositivity and demographic or health-related variables.Results: Of the participants, 708 (50.1%) were men and 705 (49.9%) were women. The largest age group was 46–55 years (n=579, 41%), while the smallest was 56–70 years (n=374, 26.5%). Anti-Toxoplasma antibodies were detected in 155 individuals, yielding a seroprevalence of 11%. No significant associations were observed between seropositivity and age, sex, occupation, or pre-existing health conditions. However, a significant correlation was found between toxoplasmosis and exposure to cats.Conclusion: The study revealed a notable seroprevalence (11%) of toxoplasmosis among residents of Kavar district, which is lower than the national average reported in Iran. These findings highlight the need for targeted health education and preventive strategies, particularly regarding cat exposure, to reduce the risk of infection in this region.
Original Article
Elahe Mousavi; Amirmohammad Merajikhah Merajikhah; Mahnaz Moghadari Koosha Moghadari Koosha; Shima Bahramijalal; Hossein Vakilimofrad
Abstract
Background: The mastery learning model (MLM) is an active learning approach that enhances students’ scientific knowledge and practical skills in surgical technology (ST). Given that more than half of the courses in this field are clinical, full mastery of the material can significantly improve ...
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Background: The mastery learning model (MLM) is an active learning approach that enhances students’ scientific knowledge and practical skills in surgical technology (ST). Given that more than half of the courses in this field are clinical, full mastery of the material can significantly improve practical learning. To date, no study has investigated the impact of MLM on neurosurgery education. Mastery learning is a teaching method in which students must achieve a predetermined level of mastery in each unit before progressing to the next. The present study aimed to assess and compare the effects of MLM and the traditional learning model (TLM) on the development of neurosurgical knowledge and related practical skills in ST students in Hamadan, Iran.Methods: This semi-experimental study employed a pre-test– post-test two-group design. The study population consisted of 32 operating room students from Hamadan University of Medical Sciences, recruited through census sampling. A pre-designed questionnaire (for assessing neurosurgical knowledge) and a checklist (for evaluating practical skills) were validated using CVR and CVI indices. Data were analyzed using SPSS v.16, employing the paired t-test, the Kolmogorov–Smirnov test for normality, the Wilcoxon test, and the Mann–Whitney test.Results: The mean scores of neurosurgical practical skills increased significantly (P<0.05) in post-test ST students (26.44±5.01) compared to the pre-test (18.91±3.85). Similarly, neurosurgical knowledge scores increased significantly (P<0.05) in the post-test (48.38±5.21) compared to the pre-test (34.69±8.85).Conclusion: Both neurosurgical knowledge and practical skills in ST students can be substantially improved through the use of MLM. This model is recommended as an effective alternative to TLM for neurosurgery education.
Original Article
Roghayeh Mohseni; Leila Bazrafkan; Nasrin Shokrpour
Abstract
Background: The number of asylum seekers is increasing annually due to social, economic, and political challenges. Limited access to quality health services for asylum seekers poses serious risks not only to their own health but also to thepublic health of host communities. Given the importance of this ...
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Background: The number of asylum seekers is increasing annually due to social, economic, and political challenges. Limited access to quality health services for asylum seekers poses serious risks not only to their own health but also to thepublic health of host communities. Given the importance of this issue, the present study aimed to evaluate healthcare services for residents of the Commissariat Camp Sarvestan (UHNR) using the responsive evaluation model.Methods: This quantitative cross-sectional study was conducted in 2023. The study population consisted of Afghans aged 18 years or older residing in the UHNR camp (Shahid Beheshti Hospital, Sarvestan, Fars Province). Due to the limited population size, a census sampling method was employed, resulting in a total sample of 270 participants. Data were collected using a questionnaire designed based on the responsive evaluation model, assessing fourkey components of health services: healthcare delivery, physicianpatient relationships, therapeutic collaboration, and access to services. Data analysis was performed using SPSS version 21.Results: Among the evaluated components, physician-patient relationships received the highest mean score (17.88±6.91), while therapeutic collaboration received the lowest mean score (14.58±5.80). Overall, 75–90% of participants rated the four dimensions as relatively good to moderate, reflecting general satisfaction with the services, whereas 10–25% reported poor or relatively poor ratings. Quantitative analysis revealed a statistically significant relationship between the total healthcare service score and both age and gender.Conclusion: Over 75% of participants reported high satisfaction across all components, highlighting the efforts, coordination, and planning of the responsible authorities in delivering healthcare services at the camp.
Original Article
Fatemeh Taghipour; Mehdi Norouzi; Ali Taghipour; Mohammad Hossein Madahali; Zahra Amiri; Ehsan Mosa Farkhani
Abstract
Background: Identifying risk factors for severe COVID-19 outcomes is essential for shaping effective public health strategies. This study analyzed demographic, clinical, and comorbidity-related factors associated with hospitalization, ICU admission, mechanical ventilation, and mortality in a large Iranian ...
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Background: Identifying risk factors for severe COVID-19 outcomes is essential for shaping effective public health strategies. This study analyzed demographic, clinical, and comorbidity-related factors associated with hospitalization, ICU admission, mechanical ventilation, and mortality in a large Iranian population.Methods: We conducted a population-based cross-sectional study of 405,397 individuals registered under the Mashhad University of Medical Sciences, combining primary care records with hospital monitoring data. Variables included age, sex, geographic region, diabetes, hypertension, cardiovascular disease, hyperlipidemia, pregnancy, obesity, and vaccination status. Logistic regression models were applied to examine associations with each outcome.Results: Among 405,397 individuals (mean age 40.21±16 years; 46.30% female), 4.29% were hospitalized, 0.17% admitted to ICU, 0.42% required mechanical ventilation, and 0.67% died. Advanced age (≥80 years) was the strongest predictor across all outcomes, with adjusted odds ratios (AORs) ranging from 17.21 (95% CI, 15.37–19.28) for hospitalization to 283.31 (95% CI, 155.57–515.93) for mortality. Cardiovascular disease, diabetes, obesity, and pregnancy were also significant risk factors. In contrast, female sex (AOR for mortality: 0.63; 95% CI, 0.58– 0.69), hypertension, and hyperlipidemia were associated with reduced risks. Vaccination demonstrated a strong dose-dependent protective effect, with three doses reducing the odds of mortality by 93% (AOR: 0.07; 95% CI, 0.05–0.12).Conclusion: Advanced age, cardiovascular disease, diabetes, obesity, and pregnancy emerged as major risk factors for severe COVID-19 outcomes. The apparent protective associations of female sex, hypertension, and hyperlipidemia warrant further exploration. Most critically, the profound protective effect of vaccination highlights the urgent need to sustain and expand comprehensive immunization programs.
Original Article
Rezheen Abdullah Ismael; Dindar Sharif Qurtas; Abdulrahman Omer Abdulrahman
Abstract
Background: Dermatological diseases are among the most common health problems observed in infertile women. Thisstudy, conducted from April to September 2023, aimed to determine the prevalence of dermatological disorders amonginfertile women in Duhok City, Iraq.Methods: A descriptive cross-sectional study ...
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Background: Dermatological diseases are among the most common health problems observed in infertile women. Thisstudy, conducted from April to September 2023, aimed to determine the prevalence of dermatological disorders amonginfertile women in Duhok City, Iraq.Methods: A descriptive cross-sectional study was carried out among 100 infertile women in Kurdistan, northern Iraq, usinga convenience sampling method. Data were collected through a structured and validated questionnaire. Clinical assessment focused on hirsutism, acne, androgenetic alopecia (AGA), acanthosis nigricans, and other dermatological manifestations, with an evaluation of their duration, distribution, and severity. Standard dermatological clinical guidelines were applied.Results: The most common dermatological finding was seborrhea, observed in 71 (71%) women. Acne was present in 43 (43%) women, with acne grading as follows: 26 (26%) with grade 1, 13 (13%) with grade 2, and 4 (4%) with grade 3. Hirsutism was observed in 37 (37%) women. AGA was detected in 35 (35%) women, with severity scores distributed as follows: 18 (18%) with a score of 1, 14 (14%) with a score of 2, 1 (1%) with a score of 3, and 2 (2%) with a score of 4. Other dermatological findings included hidradenitis suppurativa in 2 (2%), skin tags in 10 (10%), warts in 2 (2%), and linea nigrain 4 (4%) women. Additionally, 40 (40%) had hypertrichosis, 39 (39%) had hyperhidrosis, 16 (16%) had eczema, 9 (9%) haddermatophytosis, and 27 (27%) had melasma or facial melanosis.Conclusion: This study demonstrated a high prevalence of dermatological disorders among infertile women. Health careproviders should consider the interplay between infertility and skin conditions during evaluation and management. Anintegrated approach may aid in identifying underlying causes of infertility and associated dermatological manifestations, thereby improving both clinical outcomes and quality of life.
Original Article
Reza Noubakht; Ahmad Dorahaki
Abstract
Background: Fertility rates in Iran have undergone significant changes in recent decades, raising concerns about population dynamics and the country’s future demographic structure. This study investigates the spatial distribution of fertility across Iranian counties and examines the impact of socioeconomic ...
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Background: Fertility rates in Iran have undergone significant changes in recent decades, raising concerns about population dynamics and the country’s future demographic structure. This study investigates the spatial distribution of fertility across Iranian counties and examines the impact of socioeconomic and demographic variables on fertility patterns.Methods: This study employs a secondary data analysis approach. The dataset comprised 429 counties in Iran from 2011 to 2016, derived from national census data. Descriptive statistics, ordinary least squares (OLS) regression, and geographically weighted regression (GWR) were employed to investigate the spatially varying relationships between socioeconomic and demographic factors and fertility rates.Results: T he fi ndings i ndicate t hat c entral c ounties e xhibit favorable economic and social conditions, including higher levels of female education. Fertility rates were highest in southeastern and eastern counties, which shared similar socioeconomic contexts. GWR results showed that female education had the strongest influence on fertility in Western, Northern, and Northeastern counties, while its effect was lowest in Sistan and Baluchestan.Conclusion: Although all examined variables significantly contribute to explaining fertility variation, their relative influencediffers across geographical regions. Spatial analysis methods, which emphasize the role of location and place, reveal that the effects of determinants vary locally, providing a more precise understanding of county-level fertility patterns and their spatial interconnections.
Original Article
Jwan Jellal Rasheed Shwana; Burhan Tahir Saeed; Fattah Hama Rahim Fattah
Abstract
Background: Androgenetic alopecia (AGA) is a common form of hair loss that significantly affects individuals’ self-esteem,psychological well-being, and quality of life. This study aimed to investigate the prevalence, epidemiology, pathophysiology, and clinical implications of AGA among adults in ...
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Background: Androgenetic alopecia (AGA) is a common form of hair loss that significantly affects individuals’ self-esteem,psychological well-being, and quality of life. This study aimed to investigate the prevalence, epidemiology, pathophysiology, and clinical implications of AGA among adults in Sulaimani Governorate, Iraq.Methods: A cross-sectional study was conducted in Sulaimani Governorate from September 2022 to December 2023. A stratified sampling method was used to select 1,438 participants aged 18 years and older. Data were collected through a researcherdesigned questionnaire and clinical examinations using the Ludwig and Norwood-Hamilton scales. Descriptive statistics, logistic regression, and Pearson’s chi-square test were used fordata analysis.Results: The study population consisted of 49.7% males (n=715) and 50.3% females (n=723), with mean ages of 32.23±10.04 and 31.46±11.19 years, respectively. Females exhibited a higher incidence of sudden hair loss (27.5%) compared to males (18.3%). Significant risk factors included a family history of hair loss (OR=1.29, 95% CI: 1.23–1.35, P=0.001) and recent general operations (OR=1.07, 95% CI: 1.01–1.15, P=0.023). Additionally, the use of flat irons/curling irons (OR=1.09, 95% CI: 1.10–1.18, P=0.001) and frequent use (>3 times/week) (OR=1.04, 95% CI: 1.02–1.35, P=0.002) were associated with increased hair loss.Conclusion: This study provides important insights into the epidemiology and risk factors of AGA in Sulaimani Governorate, Iraq. The findings underscore the need for targeted prevention and treatment strategies that consider the distinct characteristics of the local population. Further research is warranted to investigate the genetic and environmental factors that contribute to AGA in this region.
Original Article
Fereshteh Aliasghari; Seyede Mahsa Taghavipour; Nadia Mohammadi; Fatemeh Rahimian; Anahita Fakherpour; Mohammad Fararouei; Esmaeel Soleimani
Abstract
Background: Previous studies on the relationship between benzene exposure and hematotoxicity have reported inconclusive findings, particularly at low exposure levels. This study aimed to investigate the potential relationship between low-level benzene exposure and changes in hematological parameters ...
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Background: Previous studies on the relationship between benzene exposure and hematotoxicity have reported inconclusive findings, particularly at low exposure levels. This study aimed to investigate the potential relationship between low-level benzene exposure and changes in hematological parameters among petrochemical workers.Methods: In this cross-sectional study, 495 benzene-exposed workers and 217 sex-matched non-exposed controls were assessed. Demographic, occupational, and medical data were collected. Air monitoring was conducted to determine benzene exposure, and the time-weighted average (TWA) was calculated. Blood samples were analyzed for hematological parameters. Data were analyzed using SPSS version 22.0. All exposures were within the OSHA permissible exposure limit (PEL). The mean TWA benzene exposure among the exposed group was 0.07±0.37 ppm.Results: After adjustment for confounders, statistically significant associations were observed for red blood cell (RBC) count and mean corpuscular volume (MCV). No significant associations were found for other hematological parameters.Conclusion: RBC count and i ts i ndices, particularly MCV, appear to be more sensitive to low-level benzene exposure thanother blood parameters. These findings suggest that benzene may exert hematotoxic effects even at concentrations below the current OSHA PEL-TWA.
Letter to Editor
Nematullah Shomoossi; Mohammadreza Shegarf Nakhaie Shegarf Nakhaie; Nasrin Shokrpour
Abstract
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