Background and Objective: Health includes various dimensions, one of the most important of which is spiritual health. Although this aspect of health has a long history, it has attracted the attention of doctors and psychologists in the last few decades. One of the effective factors in spiritual health is rationality, which has always been one of the most controversial topics in the history of human thought. This study was done to explain the relationship between health and spirituality.

Methods: This research is of analytical-descriptive type, which was carried out using the library method and using verses, narrations and interpretive sources.

Results: Rationality is not only incompatible with spirituality but also strengthens it. The religion of Islam, which was descended for the development and growth of spiritual health, has always invited people to rationality and has condemned those who do not use reason and thought.

Conclusion: This study shows that rationality has a direct relationship with spirituality and causes the spiritual health of a person.

Background and Objective: Considering hypertension as the most prevalent comorbidity among patients diagnosed with COVID-19, this study intended to investigate clinical characteristics and in-hospital mortality risk factors among COVID-19 patients with hypertension history.
Methods: This descriptive-analytical study was conducted on 527 hypertensive patients (277 male and 250 female) a mean age of 64.73±13.13 years infected with COVID-19 and hospitalized at Sayyad Shirazi Hospital, Gorgan Iran from February to September 2020. The patients’ data were extracted from the hospital information system and completed by patients’ medical records and telephone calls. The association between the risk factors and in-hospital mortality was identified by employing the logistic regression analysis in three various models, including model 1 (demographic data and patients’ history), model 2 (model 1 plus vital signs and pulse oximetry measurement at hospital admission) model 3 (model 2 plus laboratory findings at hospital admission). Each model individually described the odds ratios (ORs) with 95% confidence intervals (95% CIs) for every risk factor. Furthermore, a corrected area under the receiver-operating characteristics curve (AUC) was estimated to evaluate the model’s discriminatory power.
Results: Among 527 hospitalized patients, 88 patients (16.6 %) died during 6.48 days of hospitalization, of which 47 patients were men. In model 1, opium consumption (CI95%=1.16-3.85, OR=2.11) and cognitive impairment at admission (CI95%=0.98-5.40, OR=2.30) were significantly associated with higher mortality (AUC=0.65). In model 2, after adding vital signs and oxygen saturation, cognitive impairment association lost its association, and only opium consumption (CI95%=1.09-3.19, OR=1.87) and oxygen saturation (CI95%=0.90-0.95, OR=0.93) were associated with in-hospital mortality. (AUC=0.73). In model 3, after incorporating laboratory findings, with an AUC of 0.79 (CI95%=0.70-0.90), each percent higher oxygen saturation at admission was associated with a 7% decrease in in-hospital mortality (CI95%=0.88-1.00, OR=0.93). Although opium consumption and higher creatinine level lead to higher mortality, the associations were not significant.
Conclusion: Regarding the association of oxygen saturation at admission with in-hospital mortality among hypertensive patients diagnosed with COVID-19, the pulse oximetry measurement data upon admission would be crucial in evaluating these patients.

Background and Objective: Thyroid masses are one of the most common reasons for patients to visit endocrinology clinics. Fine needle aspiration (FNA) is used to reduce thyroid surgery for benign lesions. This study was done to determine the diagnostic accuracy of FNA of thyroid mass(s) compared with histological results in Medical Centers, Gorgan, Iran.
Methods: In this descriptive-analytical study, 102 patients (12 males and 90 females) were diagnosed with a thyroid mass and referred for surgery to Medical Centers, Gorgan, Iran during 2020-21. FNA was performed, and the samples were sent to the pathology department for examination. The result of cytology was recorded in the checklist. According to cytology results, some patients were referred for surgery. Then, the surgical pathology results were compared with the cytology findings. In addition, the sensitivity and specificity of the results of the cytology of thyroid masses were calculated compared to the results of pathology.
Results: FNA, mass size, and the patient’s main complaint had a significant relationship with histological results (P<0.05). According to FNA findings compared to pathology, sensitivity was 74%, specificity was 88.1%, positive predictive value was 88.1%, negative predictive value was 74%, false positive rate was 12%, false negative rate was 26%, and accuracy was 80.4%.
Conclusion: FNA remains a key tool in evaluating thyroid nodule(s). Improving FNA techniques is necessary to increase the accuracy of FNA.

Background and Objective: Micro-ribonucleic acids (microRNAs) have introduced a new field in the molecular diagnosis of cancer. However, the role of circulating microRNAs in the plasma/serum of colorectal cancer patients is still unclear. This study was conducted to determine the expression of let-7d microRNA in patients with colorectal cancer.
Methods: This case-control study was conducted on 40 patients with colorectal cancer and 40 healthy people. In this study, 7 mL blood samples were collected from patients with colorectal cancer (both before and after tumor resection) and healthy individuals (only once). The serum samples were isolated and stored at - 80°C until molecular analysis. MicroRNAs were extracted from serum samples, and cDNA was synthesized. Let-7d expression was examined using the RT-qPCR method. Data were analyzed using GraphPad Prism v. 9 software. The receiver operating characteristic (ROC) curve analysis, sensitivity, and specificity were also calculated for the let-7d microRNA data to introduce a diagnostic biomarker between the preoperative patient group and the control group.
Results: In the preoperative samples of the patients, the expression of let-7d microRNA was significantly lower than that of the control group (P˂0.05). The expression of let-7d microRNA significantly increased after tumor resection compared to before. The ROC analysis for let-7d microRNA in the preoperative patient group with the control group showed that the sensitivity was 33.3%, specificity was 92.3%, and the area under the curve (AUC) was 0.622.
Conclusion: Let-7d microRNA could potentially serve as a new noninvasive diagnostic biomarker for the early detection of colorectal cancer. However, further studies are required on this subject.

Background and Objective: Lidocaine is the most effective anesthetic and a valuable drug for nerve pain control and management. Dexamethasone is commonly used to prevent postoperative nausea and vomiting. Dexamethasone, together with a local anesthetic, enhances the peripheral nerve block. Therefore, this study was conducted to compare the duration of anesthesia and analgesia effects after surgery in 2 anesthesia methods.
Methods: This descriptive-analytical study was conducted on 50 patients aged 18 to 70 years who were candidates for orthopedic surgery and visited the 5th Azar Medical Training Center, Gorgan, Iran during 2021. The sample was selected via convenience sampling and by checking the inclusion criteria. In group 1, 10 ml of Lidocaine 1%, and in group 2, 8 ml of 1% Lidocaine and 2 ml of dexamethasone were used as infiltration in the operation site. The average onset of analgesia and the duration of analgesia as well as postoperative pain between both anesthesia methods were determined and compared with the visual analog scale.
Results: The average duration of anesthetic effect was significantly higher in group 2 (P<0.05). In addition, the average pain duration of the patients of group 2 had a downward trend from the time of entry to when they exited the recovery room (P<0.05).
Conclusion: The combination of dexamethasone and Lidocaine increased the duration of finger nerve block effect and analgesia after surgery.

Background and Objective: Sinus extension is a physiological process that occurs in the growth cells of the paranasal sinuses and leads to increasing their volume over time, causing challenges in the dental implant process. This study was conducted to evaluate maxillary sinus morphometrics by cone-beam computed tomography (CBCT).
Methods: This descriptive-analytical study was conducted on the CBCT images of 100 people (52 male and 48 female) with a mean age of 45.32 ± 17.41 and the age range of 27 to 63 years referring to an oral and maxillofacial specialized radiology clinic in Babol, Iran during 2019. The amount of maxillary sinus extension in the panoramic-like view was recorded based on the amount of its extension in terms of the first anterior tooth and the last posterior tooth. In the new net technologies (NNT) software, in the section related to creating panoramic-like views, first, in the axial sections, the starting point of the maxillary sinus was specified from the occlusal side, and the mediolateral dimensions were measured at distances of 3 mm above and 3 mm below.
Results: The highest amount of maxillary sinus progress in the right anterior side was related to the mesial of tooth 5 (15%), and the highest amount of sinus progress in the left anterior side was related to the distal of tooth 3 (15%) and the mesial of tooth 4 (15%), which had no statistically significant differences. The most progress in the anterior area was related to the distal of the canine tooth and the mesial of the first premolar. The mean mediolateral sinus progress at 3 mm above the right nasal floor was higher in females than in males (P<0.05). Gender and age had no statistically significant relationship with maxillary sinus progress.
Conclusion: The maxillary sinus progress was almost equal in the left and right sides and also in males and females.

Background and Objective: The quality of life of mothers of children with autism spectrum disorder (ASD) is influenced by the problems of this disorder. Numerous interventions have been recommended for mothers with such children, including supportive interventions, cognitive-behavioral therapy (CBT), negative mood management training, parent-child interaction, and family-oriented interventions. One of these interventions is quality of life therapy. The present study was conducted aiming to determine the impact of training quality of life therapy on mothers with ASD children.
Methods: This clinical trial was conducted on 60 mothers of 6-13-year-old ASD children referring to the Ofogh Clinic in the city of Gonbad-e-Kavus, Golestan Province, during 2022-23. Mothers were selected by the convenience sampling method and were assigned to two 30-people control and intervention groups using the random number table. The psychotherapy training based on Frisch’s (2006) theory on the quality of life was implemented on mothers in the intervention group as a group in eight 90-minute sessions for two months. The World Health Organization Quality of Life Scale (WHOQOL-BREF) was used to measure the mothers’ quality of life.
Results: The mean and standard deviation of the total quality of life score of mothers in the intervention group (76.15±8.85) had a statistically significant increase in the post-test compared to the control group (64.82±10.15) (P<0.05). Also, the mean and standard deviation of the quality of life of mothers in the intervention group showed a statistically significant increase in the post-test in the dimensions of physical health (65.12±6.24), psychological health (69.55±7.52), environmental health (60.66±16.8), and general health (78.33±10.9) compared to the control group (P<0.05).
Conclusion: The quality of life of mothers with autistic children was improved by receiving quality of life-based therapy.

Background and Objective: Type 1 diabetes is considered one of the most common chronic diseases during childhood. Diagnosis and presence of chronic disease in the child create tension, worry, and problems for parents, particularly for the mother who is responsible for taking care of the child. The present study was conducted to determine the effectiveness of resilience training on the self-esteem of mothers of children with type 1 diabetes.
Methods: This clinical trial was carried out on 60 mothers of children with type 1 diabetes referring to diabetes clinics in the cities of Gonbad-e-Kavus and Gorgan, Golestan province, during 2022-23. Mothers were selected by the convenience sampling method and using a random number table and were assigned to two 30-people control and intervention groups. The resilience training program was implemented for the intervention group in 5-people groups for nine 90-minute sessions during 2 months. The data collection tool consisted of a demographic questionnaire and the Coopersmith Self-Esteem Inventory (SEI) filled out in two pre-test and post-test phases. Scoring of poor, moderate, and strong self-esteem was carried out by obtaining scores of 26 and below, 27-43, and over 44.
Results: The mean and standard deviation of the overall self-esteem (22.73±3.26), social (7.32±0.79), occupational/social (7±1.46), and general self-esteem (44.73±5.03) dimensions had a statistically significant increase in the post-test in mothers of the intervention group compared to those in the control group (P<0.05). The mean and standard deviation of the self-esteem scores of mothers in the intervention group were evaluated as moderate at the onset of the study and strong at the post-test (P<0.05).
Conclusion: Resilience training culminated in increasing the self-esteem of mothers of children with type 1 diabetes.

This systematic review aimed to evaluate the effects of various corrective exercises and supportive tools in individuals with genu valgum. To ensure a comprehensive review, a search for original research, review articles, and clinical trials in both Persian and English was conducted using databases such as WOS, SID, ISC, Magiran, Scopus, PubMed, and Google Scholar. The search covered publications during January 2008 to March 2023. A total of 76 relevant articles were selected based on strict inclusion and exclusion criteria, with 22 articles ultimately reviewed and analyzed regarding the effects of various corrective exercises and supportive tools on genu valgum. Findings from one study indicated that aerobic exercises had a significant impact on reducing body mass index (BMI) and the severity of genuvalgum. Other studies reported positive effects of resistance and corrective exercises on improving muscle electrical activity and knee stability. One study demonstrated that the use of orthotic insoles could significantly enhance knee joint support during stair descent. Six studies highlighted the positive effects of using orthoses, wedges, and braces in individuals with genu valgum. Conversely, one study pointed out the negative impact of these tools, citing the reduced limiting angle of the brace, increased applied forces, and, ultimately, greater injury risk. However, findings from three studies overwhelmingly supported the positive effects of using kinesiotape in individuals with genu valgum, providing optimism about the effectiveness of these interventions. In conclusion, our review underscores the promising potential of corrective exercises, particularly resistance exercises with TheraBand, and the combination of these with supportive tools such as insoles for arch support and kinesiotape. These interventions show significant promise in reducing the degree of knee valgus in individuals with genu valgum. This hopeful outlook can inspire healthcare professionals and individuals seeking evidence-based interventions for genu valgum, empowering them with the knowledge to make informed decisions about their care.
 

Background and Objective: Ensuring suitable access to hemodialysis, which provides high-quality dialysis over an extended period, is a significant challenge for patients with End-Stage Renal Disease (ESRD). One crucial aspect of this is maintaining the performance of hemodialysis catheters. Our study, which aimed to evaluate the one-year performance of long-term catheters in chronic hemodialysis patients in Golestan Province, is a critical step toward improving patient care in this population.
Methods: This descriptive-analytical study was conducted on 99 patients (34 men and 65 women) with ESRD who were candidates for starting or continuing dialysis with a catheter in the educational and therapeutic centers of Golestan Province, Iran during 2021-22. Transjugular catheters were placed for the patients, and after one year, variables such as age, gender, history of diabetes, history of hypertension, catheter placement site (right or left jugular), and antiplatelet medication use were evaluated concerning the performance of long-term catheters in providing adequate flow for hemodialysis.
Results: In 91 patients (91.9%), the one-year catheter performance was assessed as satisfactory. The age of 61.6% of the patients were over 60 years old. Sixty-nine patients (69.7%) had a history of hypertension, and 58 patients (58.6%) had a history of diabetes. Fifty-seven patients (57.6%) received antiplatelet medication. The catheters were placed on the right side in 82 patients (82.8%). Catheter performance in patients taking antiplatelet medication was non-significantly higher than in those not taking antiplatelet medicines.
Conclusion: The performance of long-term catheters in chronic hemodialysis patients with ESRD showed no significant correlation with age, gender, diabetes, hypertension, antiplatelet medication use, or the side of the jugular vein where the catheter was placed.

Background and Objective: Oral and dental health are crucial for nutrition intake, speech, and facial aesthetics. They also significantly influence individuals' physical, social, and psychological activities. This study aimed to determine the relationship between the Dental Caries Index (DMFT) and oral health-related quality of life.
Methods: This descriptive-analytical study was conducted on 61 patients (29 men and 32 women) aged 20-50 years who visited the Gorgan Dental School Clinic, Iran during 2019. The DMFT index, encompassing Decay (D), Missing (M), and Filled (F) teeth, was calculated. Quality of life was assessed using the 36-item DIDL (Dental Impact on Daily Living) questionnaire, which covers five domains: dental appearance and aesthetics, oral comfort, overall oral and dental function, eating limitations, and dental and jaw pain. Scores were categorized into three groups: dissatisfied (below 0), moderately satisfied (0 to 7), and satisfied (above 7).
Results: The mean score for oral health-related quality of life was 5.14±0.229, indicating a relative level of satisfaction. Pearson's correlation coefficient between DMFT and oral health-related quality of life was -0.358, suggesting a significant inverse relationship between DMFT and quality of life (P<0.05). The mean DMFT score ranged from 0 to 28, with a mean of 9.36, and the most frequent scores were 7, 11, and 13, each accounting for 11.5% of the sample. The mean decay (D) score was 3.44, the mean missing (M) score was 1.98, and the mean filled (F) score was 3.93, with ranges of 0-12, 0-19, and 0-13, respectively.
Conclusion: The results of this study indicate an inverse impact of the Dental Caries Index on patients' quality of life. Oral health-related quality of life is a multifaceted construct that affects various aspects such as appearance, oral comfort, and eating limitations, which are critical components of overall quality of life and satisfaction.

Background and Objective: Individuals with a history of anterior cruciate ligament (ACL) injury are at a higher risk of re-injury compared to healthy individuals. ACL-injured patients exhibit weaker longitudinal arches and increased foot pronation compared to healthy individuals. This study aimed to determine the effect of short-term use of anti-pronation insoles on plantar pressure variables following ACL reconstruction (ACLR) with a pronated foot during gait.
Methods: This quasi-experimental study was conducted on 15 male participants who had undergone ACLR with a pronated foot (mean age= 23.2±4.5 years) and 15 healthy males (mean age= 22.7±4.3 years) in Ardabil, Iran during 2022. Plantar pressure values during gait with and without the use of anti-pronation insoles were recorded and compared using a foot scanner (sampling rate: 300 Hz).
Results: The effect of the group factor on the big toe plantar pressure variable was statistically significant (P<0.05). Pairwise comparison results demonstrated a significant increase in pressure in the ACLR group (154.63±41.71 N/cm²) compared to the healthy group (126.54±26.57 N/cm²) (P<0.05). Intragroup comparison results revealed a significant decrease in pressure on the second to fifth toes (215.73±60.74 N/cm²) and the first plantar (420.58±107.56 N/cm²) when using anti-pronation insoles compared to the non-insole condition (the second to fifth toes (201.57±76.21 N/cm²) and the first plantar (400.78±118.20 N/cm²) in the ACL reconstruction group (P<0.05).
Conclusion: The use of anti-pronation insoles can effectively reduce plantar pressure after ACLR in individuals with a pronated foot during gait.

Background and Objective: Breast cancer has a high prevalence and mortality rate in the world and also in Iran. Neoadjuvant chemotherapy (NAC) is one of the treatment methods to improve patient survival. This study aimed to determine the response rate to NAC in patients with locally advanced breast cancer based on common molecular receptors.
Methods: This descriptive-analytical study was conducted on 100 patients with breast cancer (mean age= 41.14±10.06 years) referring to the surgical clinic of the Fifth Azar Educational and Therapeutic Center in Gorgan, Iran during 2013-18. Patients without distant metastasis underwent NAC treatment regimen followed by surgery. Demographic characteristics, types of drugs, and molecular receptor characteristics, and their response to treatment were recorded in a checklist. Treatment response and overall patient survival were evaluated.
Results: The mean tumor size before NAC was 3.01±2.47 cm (range= 0-8, median= 2) and 16% were determined to be grade one, 52% were determined to be grade 2, and 32% were determined to be grade 3. Thirty-six percent of patients had a positive family history. Forty-six percent were estrogen receptor (ER) positive, 40% were PR positive, 22% were human epidermal growth factor receptor 2 (Her-2) positive, and 78% were Her-2 negative. Thirty-six percent had a Ki-67 index greater than 30%. Eighteen percent of patients had a complete pathological response, and 82% had a partial or negative response. In terms of family history of breast cancer, Her2, ER, progestrone receptor (PR), Ki-67 receptor status, histological grade, tumor size, and axillary lymph nodes, there was a significant statistical difference between the two groups with and without complete pathological response (P<0.05).
Conclusion: The rate of complete pathological response to NAC in patients with locally advanced breast cancer was 18%.