Hamedan University of Medical Sciences

Preeclampsia is a hypertensive disorder of pregnancy associated with significant maternal and perinatal morbidity. Emerging evidence suggests that deficiencies in micronutrients such as magnesium and zinc may contribute to its pathogenesis. This study aimed to compare serum magnesium and zinc levels between pregnant women with preeclampsia and healthy controls and to evaluate their association with preeclampsia risk. In this case-control study conducted at Fatemieh Hospital, Hamadan, Iran (2023-2024), 89 pregnant women diagnosed with preeclampsia and 81 matched healthy pregnant controls were enrolled. Serum magnesium and zinc concentrations were measured using commercial kits and biochemical analyzers. Comprehensive demographic, obstetric, and laboratory data were gathered, and statistical analyses were performed using independent t-tests and multivariate logistic regression. Serum magnesium (1.08 ± 0.23 mg/dL vs. 1.21 ± 0.32 mg/dL, p < 0.001) and zinc levels (68.5 ± 7.8 µg/dL vs. 91.5 ± 10.9 µg/dL, p < 0.001) were significantly lower in the preeclampsia group compared to controls. Multivariate analysis indicated that each unit increase in serum magnesium and zinc was associated with decreased odds of preeclampsia (OR = 0.024; 95% CI: 0.002-0.277 and OR = 0.720; 95% CI: 0.625-0.829, respectively). Blood group and proteinuria also independently predicted preeclampsia risk. No significant correlations were found between micronutrient levels and demographic or other laboratory variables (p > 0.05). The findings suggest that lower maternal serum magnesium and zinc concentrations are significantly associated with increased risk of preeclampsia. Routine monitoring and appropriate supplementation of these micronutrients during pregnancy may help identify at-risk women and reduce adverse outcomes.

Early prediction of hospital-acquired pressure injuries (HAPIs) is crucial for delivering prompt therapeutic interventions and personalised preventive measures to hospitalised patients. However, existing pressure injury (PI) assessment tools often lack transparency, objectivity, comprehensiveness and reliability. This study protocol aims to identify risk factors, develop a screening tool (Pressure Injury after Hospital Admission - PIAHA), and conduct a two-step validation for the early prediction of PI after hospital admission. This multiphase, multicentre, sequential research design comprises five phases. The first phase involves an umbrella review to synthesise comprehensive information on PI risk factors in hospitalised patients from published review studies. The second phase will use conventional content analysis and qualitative interviews with national and international experts to identify context-specific predictors of HAPIs. The third phase will employ a three-round E-Delphi method to integrate findings and establish a structured list of potential predictors. In the fourth phase, a cross-sectional study will evaluate the predictive value of identified risk factors for HAPI development among hospitalised patients, contributing to the development of the PIAHA screening tool. The final phase consists of a two-step validation: (1) a cross-sectional comparison of the PIAHA tool against the gold standard and (2) a cluster randomised controlled trial to compare the effectiveness and cost-effectiveness of the novel 'IDEAL SKIIN CARES' prevention bundle, administered by trained wound specialist nurses, vs routine standard care. Ethical approval was granted by Baqiyatallah University of Medical Sciences (IR.BMSU.REC.1402.059) covering all study phases. Written informed consent will be obtained from participants or their legal representatives. The study follows the Declaration of Helsinki. Results will be disseminated via peer-reviewed publications, conferences, webinars, policy briefs and public engagement through social media, educational videos and podcasts. The PIAHA tool promises to enhance early detection of HAPI risk, facilitating individualised prevention and optimising clinical resource allocation. Implementation of the IDEAL SKIIN CARES bundle may improve patient outcomes and reduce healthcare costs by standardising evidence-based preventive care. CRD42024532133. NCT06369688.

Background: Infertility presents significant emotional and psychological challenges for couples, often impacting marital satisfaction. This study investigates the efficacy of Gottman’s couple- oriented counseling in enhancing marital satisfaction among infertile couples. Methods: In a randomized controlled clinical trial conducted in 2020, 60 infertile couples were randomly assigned to either an intervention or a control group. The intervention group participated in eight sessions of couple-focused counseling based on the Gottman Method and GATHER principles, while the control group received standard psychological counseling. Both groups completed the ENRICH Marital Satisfaction Questionnaire and a demographic survey before the intervention and four weeks after the final session. Data were analyzed using ANCOVA for between-group comparisons, paired t-tests for within-group changes, and independent t-tests for between-group differences, with a significance threshold of p &lt; 0.05. Results: The intervention group exhibited significant improvements in marital satisfaction. Women’s mean scores increased from (150.18 ± 7.23) pre-intervention to (157.38 ± 7.23 )postintervention, (p = 0.001). Men’s mean scores also rose significantly, from (153.22 ± 8.07) to (158.51 ± 8.07), (p = 0.02). No significant changes were observed in the control group. Conclusion: Gottman’s couple-oriented counseling significantly enhanced marital satisfaction among infertile couples, with a more pronounced effect in women. This intervention fosters emotional connection and support, making it a valuable tool for improving relationship quality during infertility treatment. Trial Registration: IRCT20120215009014N368

Clonidine and melatonin are two medications that are used off-label in the management of sleep disorders in children. However, there is currently no well-established and effective treatment for sleep disturbances among pediatric patients with anxiety disorders. In this study, 72 children aged 6 to 12 years diagnosed with anxiety disorders and suffering from insomnia who attended the Farshchian Hospital Clinic in Hamadan between October 2022 and July 2023 were enrolled. Participants were randomly assigned, using simple randomization, into three groups of 24 each to receive clonidine, melatonin, or placebo. Sleep quality was assessed using the Children’s Sleep Habits Questionnaire (CSHQ) at baseline, week 4, and week 6. Both participants and investigators were blinded to the treatment allocation. This study registered with the Iranian Clinical Trials Registry (IRCT20220820055756N1, registered October 16, 2022). All 72 participants completed the study. Children receiving clonidine or melatonin showed significant improvement in sleep habits compared with the placebo group at the end of six weeks (P < 0.001). However, there was no significant difference between clonidine and melatonin in terms of sleep quality improvement at week six (P = 0.267). Notably, the incidence of adverse effects did not differ significantly among the three groups. The findings of the present study indicate that both clonidine and melatonin are effective treatments for sleep disturbances in children with anxiety disorders.

Thymoquinone (TQ), a bioactive compound derived from Nigella sativa herbal plant, exhibits antioxidative, anti-inflammatory, and antimicrobial effects against various bacteria, viruses, fungi, protozoa, and flatworms. A systematic search was conducted across Embase, PubMed, Scopus, and Web of Science until January 2025. All preclinical studies discussing the bactericidal, virucidal, fungicidal, and parasiticidal effects of nano-based formulations of N. sativa/TQ were included. Overall, 148 studies—comprising in vitro, in vivo, ex vivo, and in silico research—were identified involving 185 unique N. sativa/TQ-loaded nanocarriers with antimicrobial properties. The predominant nanoencapsulation methods included inorganic nanoparticles (27%), nanocomposites (23.2%), and nanofibers (13.5%). The essential oil (27.6%) and aqueous extract (20.5%) of the seeds, along with TQ (22.2%), were the most common natural cargos. 149 nanoformulations showed effectiveness against bacteria, 42 against fungi, 8 against viruses, and 7 against parasites. Additionally, 29 nanoformulations showed antibiofilm properties, and 41 showed efficacy against multidrug-resistant pathogens. Only 18 nanoformulations were not effective against at least one tested pathogen. 91.9% of the tested nanoformulations against Staphylococcus aureus showed effectiveness, while this percentage for Escherichia coli and Candida albicans was 88.5% and 96.9%, respectively. These three were the most widely examined pathogens in preclinical studies. The proposed clinical and practical applications were most prominent in wound healing (42 nanoformulations), followed by food preservation (33 nanoformulations) and water purification (9 nanoformulations). Integrating nano-based drug delivery systems with the antimicrobial benefits of TQ can address TQ’s limitations, including instability and low oral bioavailability. This review identifies knowledge gaps regarding TQ nanomedicines and emphasizes the need for regulatory frameworks for safety and clinical applicability, thereby facilitating their progression into human clinical trials.