Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 35 3 2025 9 1 Bacterial extracellular vesicles in sepsis: from diagnosis to treatment 241 257 FA Elaheh Salmeh Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran - Faculty of Veterinary Medicine, Science and Research Branch, Islamic Azad University, Tehran, Iran N Erfan Soroush Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran - Faculty of Veterinary Medicine, Science and Research Branch, Islamic Azad University, Tehran, Iran Erfansorosh@yahoo.com N Masood Soltanipur Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran-Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Masood.noavaran@gmail.com N Hossein Yarmohammadi Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran-Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran hosseinyarmohammadi98@gmail.com N Mahdi Rezaei Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran-Health Research Center, Chamran Hospital, Tehran, Iran Dr.mrezaei98@gmail.com N Leila Hafazeh Department of Physiology, Tehran University of Medical Sciences, Tehran, Iran lhafazeh@gmail.com N Abolfazl Fateh Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran afateh2@gmail.com N Seyed Mohsen Mirhosseini Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohsenmirhosseini@yahoo.com N Seyed Davar Siadat Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran D.siadat@gmail.com Y 0000-0002-6892-5603 10.61882/iau.35.3.241 Sepsis is a systemic inflammatory reaction caused by infection. Severe sepsis can lead to multiple organ dysfunction, with high incidence and mortality. Nearly 500,000 cases of sepsis occur in the United States, causing 80,000 deaths annually. Septic shock is a subset of sepsis and is a fatal condition. Despite significant advances for treating this disorder, the mortality rate of sepsis remains high. Numerous studies have shown the important role of bacterial extracellular vesicles in cancers, neurodegenerative disorders, diabetes, viral infections, autoimmune and kidney diseases. Also, bacterial extracellular vesicles have recently received attention due to their effective help in the diagnosis and management of sepsis. In recent years, studies on the role of bacterial extracellular vesicles in inflammatory diseases have shown that they have a dual role in the imbalance of the inflammatory response in sepsis. Extracellular vesicles in sepsis can be beneficial or harmful, depending on their origin and content. These vesicles have also been considered mediators of cell death and inflammation during conditions such as sepsis. This review comprehensively reviews studies investigating the role of bacterial extracellular vesicles in the pathogenesis, management, and treatment of sepsis.   Bacterial extracellular vesicle, Sepsis, Inflammatory responses. http://tmuj.iautmu.ac.ir/article-1-2312-en.html http://tmuj.iautmu.ac.ir/article-1-2312-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 35 3 2025 9 1 A review of the mechanism of action of cyanobacteria to control diabetes and blood sugar 258 274 FA Sina Zaliani Master's student, Department of Biotechnology, Faculty of Converging Sciences and Technologies, Islamic Azad University, Science and Research Branch, Tehran, Iran sinazaliani2016@gmail.com N 0009-0001-2106-8835 Bahareh Nowruzi Associate Professor, Department of Biology, SR.C., Islamic Azad University, Tehran, Iran bahareh.nowruzi@srbiau.ac.ir Y 0000-0001-6656-777X 10.61882/iau.35.3.258 Bioactive compounds in cyanobacteria are full of various nutrients and chemical compounds, including proteins, carbohydrates, fats, vitamins, minerals, pigments, chlorophyll and enzymes. Spirulina, a genus of cyanobacteria, is full of active molecules and nutrients that have numerous pharmacological activities and applications, including antioxidants, anti-inflammatory, immunotherapy, immune booster, anti-cancer, antiviral activity, and neuroprotective properties. It is also used as a dietary supplement for weight loss and blood glucose levels in mouse models and type 2 diabetics. Various mechanisms, including anti-inflammatory activity, increased insulin sensitivity, gluconeogenesis inhibition, antioxidant activity, modulation of the composition of the intestinal microbiota, improvement of glucose homeostasis and activation of the insulin receptor, were attributed to this unique behavior of spirulina. In this review article, by studying the latest available articles, it provides all the essential information about the efficacy and possible side effects of identified bioactive compounds derived from cyanobacteria. However, further studies are still needed to fully explain its effects on human physiology and determine the optimal dose of treatment.   Cyanobacteria, Diabetes, Blood sugar control, Spirulina http://tmuj.iautmu.ac.ir/article-1-2301-en.html http://tmuj.iautmu.ac.ir/article-1-2301-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 35 3 2025 9 1 A review on high-performance liquid chromatography method design and development 275 285 FA Seyed Mohammad Alavi PhD student in Pharmacy, Faculty of Pharmacy, Faculty of Pharmacy, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran beactive90@gmail.com N 0009-0006-1762-3855 Amir Beheshti Maal PhD student in Pharmacy, Faculty of Pharmacy, Faculty of Pharmacy, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran amirbeheshtimaal@gmail.com N 0009-0001-4620-926X Hoda Jahandar Assistant Professor, Department of Medicinal Plants, Pharmaceutical Sciences Research Center, Faculty of Pharmacy, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran ho_jahandar@yahoo.com Y 0000-0002-9444-2736 10.61882/iau.35.3.275 High performance liquid chromatography is a suitable method for the separation, identification and measurement of components in samples. In the pharmaceutical industry, this method is very important for the analysis of impurities and active pharmaceutical ingredients in the quality control of pharmaceutical products, stability studies and evaluation of new formulations. With the daily emergence of new drugs and pharmaceutical formulations, the need to design and develop analysis methods with high-performance liquid chromatography has also increased. The purpose of this review article is to investigate how to develop an analysis method using high-performance liquid chromatography and related influencing factors. The databases including PubMed, Google Scholar, and Google were utilized with the keywords HPLC, HPLC Method Development, HPLC Method optimization, HPLC Method troubleshooting and HPLC Method validation to find articles related to method design and development. Additionally, the book “Principles of Instrumental Analysis” was used as a guide. Factors such as column type, mobile phase composition, HPLC Separation modes, detector, modes of elution and examination of the physicochemical properties of the drug are important parameters in the design and development of a HPLC method.   High-performance liquid chromatography, Method design and development, Drug analysis http://tmuj.iautmu.ac.ir/article-1-2261-en.html http://tmuj.iautmu.ac.ir/article-1-2261-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 35 3 2025 9 1 Antibacterial activity of Oliveria decumbens extract on Streptococcus mutans and Lactobacillus acidophylus 286 293 FA Yasamin Barkian Assistant Professor, Department of Oral and Maxillofacial Medicine, School of Dentistry, Qom University of Medical Sciences, Qom, Iran Dr.ybarakian@muq.ac.ir N 0000-0001-9860-9313 Roohollah Fateh Assistant Professor, Cellular and Molecular Research Center, Qom University of Medical Sciences, Qom, Iran rfareh59@gmail.com N 0000-0002-2073-5552 Hoda Abolhasani Assistant Professor of Pharmaceutical Chemistry, Department of Physiology and Pharmacology, School of Medicine, Cellular and Molecular Research Center, Qom University of Medical Sciences, Qom, Iran hodaabolhasani@gmail.com N 0000-0001-9174-5304 Ghazal Alavi Dentistry Student, School of Dentistry, Qom University of Medical Sciences, Qom, Iran alavighazal77@gmail.com Y 0009-0007-2547-5634 Azin Reiszadeh Dentist, School of Dentistry, Qom University of Medical Sciences, Qom, Iran a.raees196@gmail.com N 0009-0000-6509-3234 Zahra Amouzad Assistant Professor, Department of Oral and Maxillofacial Medicine, School of Dentistry, Qom University of Medical Sciences, Qom, Iran Zahra_amuzad_kh@yahoo.com N 0000-0003-0858-5544 10.61882/iau.35.3.286 Background: This study investigated the antimicrobial effects of aqueous and ethanolic extracts of Oliveria decumbens on Streptococcus mutans and Lactobacillus acidophilus, which are key contributors to dental caries. Considering the relative resistance of these bacteria to antibiotics and the traditional use of medicinal plants, this study was conducted to evaluate these effects. Materials and methods: The plant extracts were prepared using the maceration method and serial dilutions. Standard bacterial strains were obtained from reliable sources and cultured in appropriate media. Aqueous and ethanolic extracts were added to bacterial suspensions in microplate wells and incubated anaerobically at 37°C for 48 hours. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined through visual observation. Results: The aqueous extract inhibited the growth of both bacterial species at concentrations of 2048, 1024, and 512 µg/ml, with an MIC of 512 µg/ml. Additionally, the aqueous extract exhibited bactericidal activity at concentrations of 2048 and 1024 µg/ml, with an MBC of 1024 µg/ml. On the other hand, the ethanolic extract showed no antimicrobial activity at any concentration. Conclusion: This study demonstrates that the aqueous extract of the plant has moderate antimicrobial effects, whereas the ethanolic extract exhibited no activity.   Oliveria decumbens, Lactobacillus acidophilus, Streptococcus mutans http://tmuj.iautmu.ac.ir/article-1-2280-en.html http://tmuj.iautmu.ac.ir/article-1-2280-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 35 3 2025 9 1 Growth and differentiation of mesenchymal cell-derived cardiomyocytes on biologically active nanofibers: an experimental study 294 305 FA Zakiye Mokhames Biology Department, Medical Biotechnology Research Center, Ashkezar Branch, Islamic Azad University, Ashkezar, Yazd, Iran N 0000-0001-7555-353X Mahmood Dehghani Ashkezari Biology Department, Medical Biotechnology Research Center, Ashkezar Branch, Islamic Azad University, Ashkezar, Yazd, Iran mdashkezary@yahoo.com Y 0000-0002-5208-7502 Ehsan Seyedjafari Department of Biotechnology, College of Science, University of Tehran, Tehran, Iran N 0000-0003-3773-2830 Seyed Morteza Seifati Biology Department, Medical Biotechnology Research Center, Ashkezar Branch, Islamic Azad University, Ashkezar, Yazd, Iran N 0000-0002-8505-5267 10.61882/iau.35.3.294 Background: Dysfunction of the heart cells is one of the main causes of heart failure or lack of properly heart function. In the present study, human placenta extract (PE) along with poly lactic co-glycolic acid (PLGA) and poly hydroxyl butyrate (PHB) were used to make bioactive scaffolds using electrospinning method. Materials and methods: Electrospinning method was used to make PLGA-PHB and PLGA-PHB-PE nanofibers. Morphological evaluation of PLGA-PHB and PLGA-PHB-PE nanofibers was done using electron microscope. Degradability rate, water absorption capacity, protein and adhesion strength of the scaffolds were investigated. Mesenchymal cells were extracted from adipose tissue. In order to confirm stem cells, CD34, CD45, CD90 and CD105 markers were performed by flow cytometry. Also, the expression of MyoD and Troponin T genes was performed by RT-PCR. Results: The degradability of PLGA-PHB-PE scaffold was higher compared to PLGA-PHB in different days. Also, water absorption, protein and adhesive strength were higher in PLGA-PHB-PE scaffold compared to PLGA-PHB (p<0.05). Gene expression of MyoD and Troponin T genes was higher in cells grown on PLGA-PHB-PE scaffold compared to PLGA-PHB (p<0.05). Conclusion: According to the results, it can be concluded that the PLGA-PHB-PE scaffold has a high potential to promote the cardiac differentiation of MSCs and can be used in cardiac tissue engineering for heart muscle repair.   Nanofibers, Stem cells, Tissue engineering, Mesenchymal cells, Poly lactic-co-glycolic acid, Poly hydroxyl butyrate http://tmuj.iautmu.ac.ir/article-1-2283-en.html http://tmuj.iautmu.ac.ir/article-1-2283-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 35 3 2025 9 1 Evaluation of cooperative protective effect of sinomenine combined with gastrodin on carbon tetrachloride-induced hepatic injury in male mouse 306 313 FA Aref Nooraei Assistant Professor of Comparative Anatomy and Embryology, Department of Histology, Faculty of Veterinary Sciences, Ilam University, Ilam, Iran a.nooraei@ilam.ac.ir N 0009-0006-3710-7671 Marzieh Darvishi Associate Professor of Anatomical Sciences, Department of Basic Sciences, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran marzidarvish@yahoo.com N 0000-0001-7656-0854 javad Cheraghi Associate Professor of Physiology, Department of Laboratory Sciences, Faculty of Veterinary Sciences, Ilam University, Ilam, Iran j.cheraghi@ilam.ac.ir Y 0000-0003-2918-2891 Marzieh Havasi PhD Candidate in Biochemistry, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran havasiii1270@gmail.com N 0000-0003-0290-2254 salman soltani Assistant Professor of Comparative Histology, Department of Histology, Faculty of Veterinary Sciences, Ilam University, Ilam, Iran sa.soltani@ilam.ac.ir N 0000-0001-3938-7708 10.61882/iau.35.3.306 Background: As one of the most important organs of the body, the liver is responsible for detoxifying the body, and any liver failure caused by hepatotoxicity leads to acute liver damage, cirrhosis, and inflammation and destruction of hepatocytes. Therefore, this study was done to investigate the supportive effect of sinomenin with gastrodin among cases of liver damage caused by carbon tetrachloride. Materials and methods: In this study, 48 male mice were used in the weight range of 23 to 30 grams. Then the mice were randomly divided into 8 groups (n= 6 each), including healthy group, healthy group receiving gastrodin, healthy group receiving sinomenin, the healthy group receiving sinomenin and gastrodin, the damage group receiving gastrodin, the damage group receiving sinomenin, the damage group receiving gastrodin and sinomenin, and the acute liver damage group. After the end of the experiment, the animals were killed by enzyme assay and liver histological study.   Results: The toxicity induced by carbon tetrachloride leads to increase in liver enzymes, as well as destruction of hepatocytes, accumulation of fatty tissue in the liver, and inflammation of the liver. Taking sinomenin and gastrodin improved liver enzymes and liver inflammation. Conclusion: The use of herbal medicines can be a suitable alternative to synthetic medicines that have many side effects, in which the use of sinomenin and gastrodin can replace anti-inflammatory drugs for the liver and the entire digestive system.   Carbon tetrachloride, Hepatotoxicity, Gastrodin, Sinomenin http://tmuj.iautmu.ac.ir/article-1-2295-en.html http://tmuj.iautmu.ac.ir/article-1-2295-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 35 3 2025 9 1 Evaluation of prevalence of colistin and fosfomycin resistance genes in the clinical Acinetobacter baumannii isolates producing carbapenemase and ESBL 314 322 FA Maryam Nikbakht Department of Microbiology, TeMS.C, Islamic Azad University, Tehran, Iran maryam95nikbakht@gmail.com N 0000-0002-0758-0170 Mohammad Karim Rahimi Department of Microbiology, TeMS.C, Islamic Azad University, Tehran, Iran mohammadkrahimi@yahoo.com N 0000-0002-7430-1565 Samin Taghizadeh Marand Department of Microbiology, TeMS.C, Islamic Azad University, Tehran, Iran N 0009-0008-3239-2420 Seyyed Khalil Shokouhi Mostafavi Department of Microbiology, TeMS.C, Islamic Azad University, Tehran, Iran Shokouhi@iautmu.ac.ir Y 0000-0002-6227-3376 10.61882/iau.35.3.314 Background: There are many reports of antibiotic resistance in ESBL (Extended Spectrum Beta-Lactamase) producing strains of Acinetobacter baumannii including cephalosporins from all over the word. This research aimed to determine the frequency of colistin-resistant genes (mcr-2, mcr-1) and fosfomycin-resistant genes (fos A3) in ESBL-producing and carbapenem-resistant A. baumannii strains. Materials and methods: Acinetobacter baumannii isolates collected from selected hospitals in Tehran were confirmed by detecting the bla OXA-51-lik gene using PCR. Antibiograms were performed using the disk diffusion method, and the combined disk method was used to identify ESBL-producing isolates. The minimum inhibitory concentration (MIC) for colistin was obtained using the E-test. The presence of colistin (mcr-1, mcr-2) and fosfomycin (fosA3) resistance genes was evaluated using PCR. Results: Of 219 clinical isolates of A. baumannii, 71 isolates with ESBL and carbapenem resistance were detected. The 100% of A. baumannii isolates were resistant to cephalosporins and piperacillin. The antibiotic resistance to ciprofloxacin, amikacin, gentamicin was evaluated at 87.3%, 71.8%, and 67.6%, respectively. The ESBL-producing and carbapenem-resistant isolates were 100% sensitive to colistin, fosfomycin and tigecycline. In these strains, fosA3, mcr-1, and mcr-2 genes were not detected. Conclusion: In the present study, common genes that cause resistance to the antibiotics fosfomycin and colistin were not observed among ESBL-producing and carbapenem-resistant A.baumannii isolates. Therefore, prescribing these antibiotics is still effective and their excessive use should be avoided.   Acinetobacter baumannii, ESBL, Carbapenem resistant. http://tmuj.iautmu.ac.ir/article-1-2302-en.html http://tmuj.iautmu.ac.ir/article-1-2302-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 35 3 2025 9 1 Comparison of the effectiveness of compassion-focused therapy with short-term solution-focused therapy on self-esteem and aggression in male adolescents with self- injurious behaviors 323 333 FA Mohammad Sadegi BS of General Psychology, Payam-e Noor University, Ahar, Iran mohammadsadeghi1376varzeghan@gmail.com N 0009-0009-6742-3984 Masoumeh Ghavvasi Heris 2MA in General Psychology, University College of Nabi AKram, Tabriz, Iran N Hadi Smkhani Akbarinejhad Department of Psychology, University College of Nabi Akram, Tabriz, Iran hadiakbarinejhad@yahoo.com Y 0000-0001-5667-1790 10.61882/iau.35.3.323 Background: The aim of the present study was to compare the effectiveness of compassion-focused therapy (CFT) with short-term solution- focused therapy (STSFT) on cognitive self-esteem and aggression in male adolescents with self-injurious behaviors. Materials and methods: The study was semi-experimental with pre-test, post-test and follow-up with the control group design. The statistical population of this study included all male students with self-injurious behaviors in the second level of middle school in Tabriz City who were studying in the academic year of 1402-1403. In total, 45 male students with self-injurious behaviors were selected by targeted non-random sampling method and randomly divided into three groups (15 people in each group). The members of the CFT group and the STSFT received their specific intervention in 8 and 6 sessions of 1.5 hours, respectively, but the control group did not receive any treatment. Three groups answered the 58-question self-esteem Cooper Smith and 29-question aggression Buss and Perry questionnaires before, after and 4 months after the intervention. The collected data were analyzed using analysis of repeated measures analysis of variance and Bonferroni's post-hoc test. Results: Compassion-focused therapy with short-term solution- focused therapy leads to increased self-esteem and reduced aggression in male adolescents with self-injurious behaviors in the post-test, compared to the control group (P<0.001). The effect of both treatments on self-esteem and aggression was lasting in the follow-up phase. In addition, the effect of both treatments on self-esteem and aggression in post-test and follow-up was not significant. Conclusion: According to the findings of the present study, it is possible to use CFT and STSFT to increase self-esteem and reduce aggression in adolescent boys with self-injurious behaviors.   Compassion-focused therapy, Short-term solution-focused therapy, Self-esteem, aggression, Self- injurious behaviors. http://tmuj.iautmu.ac.ir/article-1-2276-en.html http://tmuj.iautmu.ac.ir/article-1-2276-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 35 3 2025 9 1 The effectiveness of group acceptance and commitment therapy training for mothers on reducing externalizing disorder symptoms in their children 334 345 FA Hadi Pordel PhD Student in Clinical Psychology, Shahed University, Tehran, Iran H.PORDEL2@YAHOO.COM N 0009-0002-2031-9142 Mohammad Ebrahim Maddahi Assistant Professor, Department of Psychology, Shahed University, Tehran, Iran MEMADAHI@YAHOO.COM Y 0000-0002-6692-0833 Leila Heydari Nasab Associate Professor, Department of Psychology, Shahed University, Tehran, Iran lhn1psy@gmail.com N 0000-0002-1051-1475 Ruhollah Abbasi Assistant Professor, Department of Psychology, Shahed University, Tehran, Iran abba1si.ro@gmail.com N : 0000-0002-4673-4646 10.61882/iau.35.3.334 Background: Externalizing disorders in children are common issues that can lead to serious problems in their social and academic relationships. Acceptance and commitment therapy (ACT), as a modern psychotherapeutic approach, can help reduce behavioral problems in children. The aim of this study was to examine the effectiveness of group ACT training for mothers in reducing externalizing disorders in their children. Materials and methods: This study was conducted using a semi-experimental design with a pre-test-post-test control group and a one-month follow-up period. The statistical population included all mothers of children with externalizing behavioral disorders in the elementary schools of Qom City during the academic year 2023-2024. From this population, 30 mothers were selected using purposive sampling and randomly assigned to experimental and control groups (15 in each group). The experimental group participated in 8 sessions of group acceptance and commitment therapy training. Assessments were conducted using the child behavior checklist (CBCL) parent version, before and after the intervention and at the follow-up stage. Data were analyzed using descriptive statistics (mean and standard deviation) and repeated measures analysis of variance with SPSS22 software. Results: The results indicated that group ACT training for mothers had a significant impact on reducing externalizing disorders in their children (P<0.01). Conclusion: These findings suggest that group ACT training can be introduced and implemented as an effective approach in parent education.   Training, Acceptance and commitment therapy, Mothers, Externalizing disorders, Children. http://tmuj.iautmu.ac.ir/article-1-2332-en.html http://tmuj.iautmu.ac.ir/article-1-2332-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 35 3 2025 9 1 Investigating factors related to converting laparoscopic cholecystectomy to open surgery 346 352 FA Seyede Sajedeh Noshahi General Practitioner, Innovative Medical Research Center, MMS.C., Islamic Azad University, Mashhad, Iran Sajedeh1996@outlook.com N 0000-0002-1100-4782 Tooraj Zandbaf Assistant Professor of General Surgery, Department of General Surgery, MMS.C., Islamic Azad University, Mashhad, Iran tooraj.zandbaf@gmail.com N 0000-0002-4882-5058 Mohammad Barhemmat Assistant Professor of General Surgery, Department of General Surgery, MMS.C., Islamic Azad University, Mashhad, Iran dr.m.barhemmat@gmail.com  N 0000-0003-4161-6592 Mohammad Barhemmat Assistant Professor of General Surgery, Department of General Surgery, MMS.C., Islamic Azad University, Mashhad, Iran Ghamarimj@yahoo.com N 0000-0002-0351-6219 Narges Mesbah Medical Student, Student Research Committee, MMS.C., Islamic Azad University, Mashhad, Iran nargesmesbah1380@gmail.com N Ali Mirsadeghi Assistant Professor of General Surgery, Department of General Surgery, MMS.C., Islamic Azad University, Mashhad, Iran mirsadeghi1355@gmail.com Y 0000-0002-5864-5376 10.61882/iau.35.3.346 Background: In some cases, laparoscopic cholecystectomy may need to be converted to open surgery, because of several factors. This study aimed to identify factors. Materials and methods: In this cross-sectional study, 30 patients who underwent cholecystectomy were included. Among these patients, 15 underwent fully laparoscopic surgery, while the other 15 underwent laparoscopic surgery that was later converted to open surgery. The study compared demographic information, opium use, history of diabetes, history of abdominal surgery, duration of operation, type of surgery, increase in the thickness of the gallbladder wall, previous ERCP, and laboratory findings between the two groups. The results were analyzed using SPSS software version 20. Results: In the laparoscopic surgery group, 80% of the cases were females, while in the conversion to open surgery group, 53% were males. The laparoscopic surgery group had a significantly lower mean age of 46.40 ± 15.05 years compared to the open surgery group, which had an average age of 60.27 ± 11.66 years. Several factors were identified that were associated with a higher likelihood of conversion to open surgery, including advanced age, thicker gallbladder walls as seen on ultrasound, gallbladder wall fibrosis during surgery, gallbladder adhesion, and elevated levels of total bilirubin. Conclusion: Surgeons performing laparoscopic cholecystectomy may sometimes need to switch to an open surgery approach depending on various factors. Identifying these factors can help improve surgeons' understanding of how to choose the most appropriate surgical technique and better predict the post-operative condition of their patients.   Cholecystectomy, Laparoscopy, Conversion http://tmuj.iautmu.ac.ir/article-1-2294-en.html http://tmuj.iautmu.ac.ir/article-1-2294-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 35 3 2025 9 1 Investigating the relationship of perceived social support, quality of life and sleep quality on suicidal behaviors in elderly and middle-aged patients hospitalized in psychiatric wards 353 366 FA Pegah Abdoli MD Student, Kermanshah University of Medical Sciences, Kermanshah, Iran sayehmm12345@gmail.com N 0009-0005-2511-1801 Omran Davarinejad Associate Professor, Department of Psychiatry, Kermanshah University of Medical Sciences, Kermanshah, Iran odavarinejad@gmail.com Y 0000-0002-4267-7867 Nasrin Abdoli Assistant Professor, Drug Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran N 0000-0001-7161-848x 10.61882/iau.35.3.353 Background: Suicide is one of the most important issues in old age and middle age, and knowing its underlying factors is necessary to provide preventive and therapeutic solutions. Therefore, the present study aimed to investigate the effect of perceived social support, quality of life and quality of sleep on suicidal behaviors in elderly and middle-aged patients hospitalized in psychiatric wards. Materials and methods: In this cross-sectional-analytic study, the statistical population of the study included all elderly and middle-aged patients with psychiatric disorders who were hospitalized and treated at Farabi Hospital in Kermanshah during the years 2019-2021 according to the diagnosis of a psychiatrist. Chi-square test, Pearson correlation, logistic regression with stepwise backward entry method was used to analyze the data using SPSS-20 software. Results: There was a significant relationship between suicidal behaviors and quality of life with psychiatric disorders in patients. Also, there was a significant negative correlation between suicidal behaviors with perceived social support and patients' quality of life, and a significant positive correlation between suicidal behaviors and patients' poor sleep quality. Among the predictor variables, only quality of life and perceived social support could explain the variable changes of suicidal behaviors in patients. Conclusion: it is suggested to take a step towards increasing the mental health of elderly and middle-aged patients by considering programs and approaches aimed at improving perceived social support, quality of life and quality of sleep, and reducing suicidal behaviors based on concepts, meaning and purpose.   Perceived social support, Quality of life, Quality of sleep, Suicidal behaviors, Elderly and middle-aged. http://tmuj.iautmu.ac.ir/article-1-2290-en.html http://tmuj.iautmu.ac.ir/article-1-2290-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 35 3 2025 9 1 Determining the relationship between systems thinking and patient safety culture in selected hospitals of Kermanshah University of Medical Sciences 367 376 FA Sahel Pashaei Department of Health Services Management, School of Public Health, TeMs.C., Islamic Azad University, Tehran, Iran pashaee.hit@gmail.com N Mahboobeh Safavi Department of Health Services Management, School of Public Health, TeMs.C., Islamic Azad University, Tehran, Iran Msafavi@iautmu.ir Y 0009-0000-6471-1870 Khalil Alimohammadzadeh Professor, Department of Health Services Management,NT.C., Islamics Azad University, Health Economics Policy Research Center, TeMs.C., Islamic Azad Univercity, Tehran, Iran Alimohamadzadeh@iautmu.ac.ir N 10.61882/iau.35.3.367 Background: System thinking is defined as "the ability to recognize, understand and synthesize system elements instead of individual components. Patient safety is one of the main components of quality of health services. One of the necessary factors to improve patient safety is the existence of safety culture. Since the development of systemic thinking can be used as a solution to strengthen the safety behaviors of employees, this study was done to determine the relationship between clinical staff's understanding of systemic thinking and patient safety culture in selected hospitals of Kermanshah University of Medical Sciences. Materials and methods: This study was applied and quantitative in terms of purpose and data type, descriptive and correlational in terms of data conversion into analytical information, and cross-sectional in terms of time. it was conducted among clinical staff (doctors and nurses) of 3 teaching hospitals of Kermanshah City in 2024. Available sampling method was used to select the sample. Systemic thinking and safety culture questionnaires were used to collect data. Results: In this study, the total score of understanding systems thinking was 99.71%. The percentage of positive scores of patient safety culture was 97.28. Therefore, at the 95% probability level, there was no significant relationship between systems thinking and patient safety culture (p=0.09). Conclusion: The results of study showed that clinical staff's understanding of systems thinking in selected hospitals was high, patient safety culture was at weak level, and a weak and inconsistent relationship was found between systems thinking and patient safety culture, but it was'nt significant.   Systemic thinking, Patient safety culture, Relationship http://tmuj.iautmu.ac.ir/article-1-2288-en.html http://tmuj.iautmu.ac.ir/article-1-2288-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 35 3 2025 9 1 A rare case of corneal ulcer caused by pythium insidiosum diagnosed with PCR screening and DNA sequencing: a case report 377 381 FA Mehran Zarei-Ghanavati Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran mehran_zarei@yahoo.com Y 0000-0002-0679-8055 Mehrnaz Atighehchian Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran mehrnaz.atighehchian@gmail.com N 0000-0002-6357-1033 Zakieh Vahedian Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran N 0000-0002-8100-0461 Fatemeh Bazvand Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran N 0000-0001-9720-2028 Seyed Mehdi Tabatabaei Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran N 0000-0002-2709-3257 Esmaeil Asadi Khameneh1 Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran N 0000-0003-0210-2783 10.61882/iau.35.3.377 This report discusses a case involving infectious corneal ulcers in a 32-year-old pregnant woman. The clinical presentation of keratitis did not align with the typical signs of fungal keratitis. Initial investigations, including corneal scraping for smear and culture samples, showed no evidence of fungal infection, leading to the start of topical antibacterial treatment. Despite this, there was still a concern about a fungal infection, which led to repeat sampling. Unfortunately, the patient's condition progressed, even after the application of topical antifungal medications. This progression resulted in an intraocular infection known as endophthalmitis. Due to the inability to manage the infection effectively, the affected eye was ultimately eviscerated. Further evaluation, including advanced diagnostic techniques like polymerase chain reaction, showed that the cause of the infection was a rare quasi-fungal organism called Pythium insidiosum Keratitis, Corneal ulcer, Polymerase chain reaction, Pythium insidiosum. http://tmuj.iautmu.ac.ir/article-1-2349-en.html http://tmuj.iautmu.ac.ir/article-1-2349-en.pdf