Hospital Practices and Research

Abstract I would like to draw attention to the emerging challenges in treating dermatophytosis, particularly the increasing resistance posed by new fungal strains, such as Trichophyton indotineae. Dermatophytosis is the most common superficial fungal infection affecting the skin, hair, and nails. Although it is not considered life-threatening, its high prevalence and negative impact on patients' quality of life make it one of the most widespread infectious diseases in various populations...

Abstract Background: Surgical site infections (SSIs) are the most frequent healthcare-associated infections worldwide. Identifying risk factors is a key priority to focus prevention efforts, reduce their incidence, and improve patient safety.
Objectives: We aim to identify the risk factors for SSI in patients from various nationalities cared for in Qatar.
Methods: A nested case-control study was conducted at a community hospital in Dukhan, Qatar.
Results: One hundred and twenty-six patients from 45 nationalities were included in the study, with 42 SSI cases. The risk of SSI was 3.48 times greater when non-compliance with the timing of antibiotic prophylaxis was documented, 9.69 times for improper antibiotic selection, and the risk decreased by 63% for each postoperative consultation.
Conclusion: The study has identified key risk factors for SSI and areas for prevention and research in patients who underwent cesarean section.

Abstract Background: Parents of children with bipolar II disorder often experience a substantial caregiver burden, encompassing emotional, psychological, and practical challenges. This burden can negatively affect both the parents' well-being and the overall family functioning.
Objectives: This study investigated the effectiveness of family-focused therapy in reducing caregiver burden among parents of children with bipolar II disorder.
Methods: This quasi-experimental pre-test-post-test control group study investigated the effects of family-focused therapy on caregiver burden. Thirty parents of children with bipolar II disorder, recruited from counseling services in Isfahan, Iran in 2023, were randomly assigned to either a family-focused therapy group (n = 15) receiving nine 120-minute sessions or a waiting-list control group (n = 15). All participants completed the Caregiver Burden Inventory at pre-test, post-test, and follow-up. Data were analyzed using descriptive and inferential statistics, including repeated measures ANOVA in SPSS v.26.
Results: In the family-focused therapy group, the mean caregiver burden scores showed a significant reduction from the pre-test (81.78 ± 8.63) to the post-test (54.50 ± 7.52), with partial maintenance of this reduction observed at the three-month follow-up (58.36 ± 6.63). Family-focused therapy had a statistically significant impact on caregiver burden (P <0.01), specifically on the time-related, developmental, and social burden subscales, as well as the total caregiver burden score at both post-test and follow-up assessments.
Conclusion: This study found that family-focused therapy effectively reduced caregiver burden in parents of children with bipolar II disorder. These results suggest that family-focused therapy is a valuable tool for enhancing the quality of life for caregivers.

Abstract Background: Recent advancements in medical technology have significantly influenced social life through the advancement of scientific research.
Objectives: This study examined the Generic Structure Potential (GSP) of medical diagnostic reports in Iran, specifically focusing on Radiology Case Reports (RCRs), Magnetic Resonance Imaging (MRI) reports, and Computed Tomography-Scan (CT-scan) reports.
Methods: This descriptive corpus-based study analyzed a corpus of 300 diagnostic medical reports collected from Tabriz Medical Science University over a three-month period during the autumn of 2024. The research employed Hasan's (1989) Generic Structure Potential (GSP) model, integrated with Halliday's Systemic Functional Linguistics (SFL) framework, to investigate both the macro-structural elements (obligatory, optional, and recursive) and the micro-structural features (field, tenor, and mode) of these reports.
Results: The analysis revealed that the obligatory elements dominated medical diagnostic imaging reports (94.3%), with "Findings" being the most frequent (59.1%), underscoring their central diagnostic role. Normal structures appeared less frequent (23.4%), highlighting the emphasis on pathological findings over normal observations. Optional elements (5.7%) like impressions and recommendations were rare, while recursive elements were entirely absent. The study found no significant presence of recursive elements, indicating a preference for a clear and concise reporting style.
Conclusion: The findings of the present study suggest that this structured approach enhances the utility of diagnostic medical reports in supporting accurate diagnosis and patient care within the Iranian healthcare context. These findings have significant implications for researchers, emphasizing the crucial role of understanding and embracing the generic structure of medical reports as a fundamental aspect of scholarly writing within their respective domains.

Abstract Background: Cutaneous leishmaniasis (CL) is one of the most significant parasitic diseases in Iran and other endemic regions. Existing standard treatments face challenges, including drug toxicity, difficulty in administration, and parasite resistance.
Objectives: In this study, nano chitosan based on dendrimers (NChi), which has antibacterial and antiparasitic effects, was used to target Leishmania major in vitro.
Methods: NChi was synthesized first. Fourier transform infrared spectroscopy (FTIR) and dynamic light scattering (DLS) were used to confirm the synthesis and measure the size, while scanning electron microscopy (SEM) was employed to examine the nanostructure's morphology. After assessing the cytotoxicity of the NChi on the macrophage cell line, the antileishmanial effects of NChi were evaluated after 24 and 48 hours. Finally, the data were statistically analyzed using the ANOVA test in SPSS software.
Results: The results demonstrated that NChi, with a size of 128.5 nm, is suitable for drug delivery. FTIR analysis confirmed the successful synthesis of the nanostructure by indicating the attachment of chitosan to the dendrimer. The MTT assay on macrophage cells showed no cytotoxicity of the synthesized nanocomposite at the applied concentration. Moreover, after 48 hours, the NChi exhibited significant antileishmanial activity, achieving 100% growth inhibition at a concentration of 40 µg/ml.
Conclusion: This study highlights NChi as a more effective alternative to conventional chitosan for leishmaniasis due to its optimal size, stability, and potent anti-promastigote activity, positioning it as a promising substitute for chemical drugs like glucantime.

Abstract Background: Iatrogenic dural tear is a relatively common complication in lumbar spine surgery; however, little information exists about the frequency of this condition and its complications in our country.
Objectives: This study aimed to assess the frequency of dural tear and its complications in lumbar spine surgery.
Methods: This cross-sectional descriptive study was conducted on 884 patients who underwent lumbar spine surgery and were referred to Kashani and Alzahra hospitals from 2020 to 2021. Information including age, gender, type of surgery, duration of surgery, duration of hospitalization, number of hospitalizations, need for a second surgery, number of previous surgeries, complications of surgery, involved vertebrae, and underlying diseases were extracted from the checklist.
Results: Among 884 patients who underwent lumbar spine surgery, iatrogenic dural tear was observed in 62 patients (7%). Fever, headache, and wound site complications were observed in 8 (12.9%), 22 (35.5%), and 4 patients (6.5%), respectively. Moreover, the duration of surgery in the total group and the dural tear group was 195 ± 76.2 and 204.13 ± 71.69 minutes, respectively. The duration of hospitalization in the total group and the dural tear group was 3.10 ± 1.3 and 4.08 ± 2.68 days, respectively. Laminectomy was performed in 24.09% and 24.2% of patients in these two groups, respectively.
Conclusion: According to the findings of this study, the frequency of dural tear was 7%, which may be affected by several factors, including age, duration of surgery and hospitalization, underlying disease, smoking, and history of previous surgery.

Abstract Background: The COVID-19 pandemic has impacted the socioeconomic situation worldwide, but another issue is the impact of socioeconomic status on the rate of coronavirus infections.
Objectives: This study aims to examine the socioeconomic status of individuals infected with COVID-19.
Methods: This case-control study was conducted on 768 hospitalized patients at 7 hospitals in Tehran, Iran from 2020 to 2021. The study included two groups: a case group of 384 hospitalized COVID-19 patients and a control group of 384 individuals hospitalized. A socioeconomic status questionnaire was used for data collection. The data were analyzed using SPSS v.26 software, descriptive statistical tests, and logistic regression. A significance level of less than 0.05 was considered.
Results: The findings indicated a significant relationship between age (OR = 1.017), marital status (OR = 0.316), and education level (OR = 0.348) with the rate of infection. Individuals over 60 years old, married, and those with higher education had a greater chance of infection. The regression results for two components of economic class and housing status, categorized by housing prices and purchasing ability, were not significant (P >0.05). However, there was a significant relationship between income level (P <0.05, OR = 0.497) and the rate of infections; individuals with lower income had a lower chance of infection.
Conclusion: The researchers concluded that the Hygiene Hypothesis may influence the rate of COVID-19 infection among individuals; however, further research in this area is needed.