Roozbeh Hospital

ABSTRACTIntroductionPatient Classification Systems (PCS) are essential for managing resources and staffing in hospitals. However, existing systems are predominantly nursing‐centric and fail to capture the interdisciplinary nature and complexity of care in rehabilitation settings, leading to inaccuracies in workload assessment and resource allocation. This study aims to develop and validate a novel, context‐specific PCS for rehabilitation hospitals through a participatory approach that actively engages patients and stakeholders.MethodsThis mixed‐methods study protocol comprises three sequential stages. First, a systematic scoping review following Arksey and O'Malley's framework will identify key PCS components from existing evidence. Second, structured expert panel sessions employing a modified Delphi technique will develop a consensus‐based preliminary framework. Third, the developed PCS will undergo rigorous validation through pilot implementation, assessing inter‐rater reliability using Cohen's Kappa and criterion validity against established tools, including the Functional Independence Measure (FIM) and Barthel Index, with explicit sample size calculation and reliability criteria.ConclusionThe study will generate a validated PCS specifically designed for rehabilitation hospital settings through systematic integration of evidence and stakeholder insights. The resulting tool is expected to enhance workload measurement accuracy, promote equitable resource distribution, and ultimately improve both care quality and operational efficiency in rehabilitation contexts.Patient or Public ContributionStakeholders, including patients, their families, administrators, and multidisciplinary clinical staff, have been engaged from the initial conception of the study. They contributed to defining the research objectives, formulating the scoping review questions, and are integral participants in the co‐design and validation stages, ensuring the resulting system is relevant and applicable to real‐world practice.

Alzheimer’s disease (AD) is a neurodegenerative condition characterized by cognitive decline and associated metabolic disturbances, including altered amino acid profiles. This study investigated the effects of probiotic supplementation with Lactobacillus rhamnosus HA-114 and Bifidobacterium longum R0175 on serum amino acid levels in adults with mild to moderate AD. In a 12-week, randomized, double-blind, placebo-controlled trial, 60 participants (aged 50–90 years) were assigned to three groups: L. rhamnosus (n = 20), B. longum (n = 20), or placebo (n = 20). Serum amino acids were analyzed using High-Performance Liquid Chromatography (LC). Changes in total amino acids, Branched Chain Amino Acids (BCAAs), and aromatic amino acids (AAAs) were assessed as the primary outcomes. A significant interaction effect was found between time and group for serum amino acids. Compared to placebo, the B. longum group showed a significant increase in total amino acids (difference: 2132.67 µmol/L, 95% CI: 464.06–3801.28; p = 0.01), BCAAs (difference: 255.15 µmol/L, 95% CI: 53.01–457.30; p = 0.01), and AAAs (difference: 374.34 ng/ml, 95% CI: 57.45–691.23; p = 0.02). The L. rhamnosus group also showed a significant increase in BCAAs compared to placebo (difference: 206.08 µmol/L, 95% CI: 3.94–408.23; p = 0.04). The greatest improvements were consistently observed in the B. longum group across all primary outcome measures. Probiotic supplementation, particularly with B. longum, significantly improved serum amino acid profiles in patients with mild to moderate Alzheimer’s disease. These findings support the potential of specific probiotic strains to address metabolic imbalances in AD through gut-brain axis modulation. Trial Registration: IRCT number: 20210513051277N1 (2021-05-27).

ObjectiveThis study aims to evaluate the effectiveness of RehaCom cognitive rehabilitation in improving neurocognitive functions in patients with temporal lobe epilepsy (TLE) following anterior temporal lobectomy (ATL), a common surgical intervention for medically refractory epilepsy.MethodA total of 12 patients who had undergone ATL participated in a 10-session RehaCom rehabilitation program. Cognitive assessments were conducted pre- and post-intervention, measuring verbal memory, figural memory, attention, and executive function. Cognitive improvements were analyzed using repeated measures ANOVA and non-parametric tests to evaluate changes in performance and the effect of the surgery side on outcomes.ResultsSignificant improvements were observed in verbal memory, working memory, and learning ability, especially in patients who underwent left anterior temporal lobectomy. Overall, cognitive improvements were evident across both groups, though specific patterns of recovery differed depending on the side of the surgery.ConclusionsRehaCom cognitive rehabilitation significantly improves cognitive functions, particularly in memory, attention, and executive function, following ATL. The side of surgery plays a role in determining specific outcomes, with left ATL patients benefiting more in verbal memory. These findings support the use of RehaCom as a multi-domain, adaptive rehabilitation tool for enhancing cognitive recovery in TLE patients post-ATL.

Introduction: Opioid use disorder (OUD) is a significant public health concern, and different treatment approaches, such as maintenance therapy or group therapy, have been proposed.The effectiveness of these therapies in improving the psychological and mental state of the patients has drawn the focus of research and evaluation.This study aimed to compare the dimensions of quality of life (QoL), depression, anxiety, stress, and substance control-related factors in OUD subjects and those who have entered methadone maintenance treatment or narcotics anonymous (NA) group therapy compared to control subjects who had never used opioids. Methods:The participants (n=80) in this cross-sectional study were all male subjects and divided into 4 groups (n=20 in each group), OUD subjects, NA members with a history of OUD, methadonemaintenance therapy (MMT) individuals previously involved with OUD and a healthy control group.The first three groups were recruited from substance use disorder treatment centers and community groups in Tehran City, Iran.All participants completed the validated Farsi version of questionnaires, the World Health Organization QoL-BREF (WHOQoL-BREF), the depression anxiety stress scale (DASS-21), and the desire for drug questionnaire (DDQ).Multivariate analysis of variance followed by the least significant difference was used to assess the differences between groups.Results: Data showed that for the DASS-21 scale, the differences between OUD subjects and the other three groups for all scale variables were statistically significant, except for the difference between OUD and MMT subjects for the stress variable, which was not significant.For the DDQ and WHOQoL-BREF scales, the differences between the OUD group and NA or control subjects for all variables of the scales were significant.However, no significant differences were observed between OUD and MMT groups regarding these variables. Conclusion:The results of our study suggest that entering NA programs may be a more effective treatment option than consuming methadone for individuals with OUD in terms of improvement in the mental and psychological state of the patient, which may need to be further evaluated in the future.

Current treatments for schizophrenia encounter resistance, limited efficacy, and limiting complications, necessitating novel approaches. The effects of saffron on negative symptoms were investigated as it has shown neuroprotective and antipsychotic properties. Fifty-six clinically stable chronic schizophrenic outpatients were equally assigned to saffron 15 mg q12hr or placebo groups while continuing risperidone. The Positive and Negative Syndrome Scale (PANSS) was used to assess schizophrenia-related symptoms in weeks 4 and 8. Also, the patients were assessed for the Hamilton depression rating scale (HDRS) and adverse effects. The baseline characteristics of the groups were comparable ( P s > 0.05). There were significant time-treatment interaction effects on negative ( = 0.137), general psychopathology ( = 0.193), and total ( = 0.113) PANSS scores. Affirmatively, their reductions were significantly greater in the saffron group until weeks 4 (Cohen's d s = 0.922, 0.898, and 0.759, respectively) and 8 (Cohen's d s = 0.850, 1.047, and 0.705, respectively). Regarding the negative symptoms, a better 25% response rate was obtained in the saffron group until the endpoint ( P = 0.003). The HDRS scores, extrapyramidal symptom rating scale scores, and side effect frequencies were comparable between the groups ( P s > 0.05). Saffron was beneficial for primary negative symptoms of chronic schizophrenia in a safe and tolerable manner. It also outperformed placebo in improving general psychopathology and total symptoms.

Background: Obsessive-compulsive disorder (OCD) is characterized by alterations in brain connectivity, particularly within the default mode network (DMN) and the salience network (SN). Investigating these connectivity differences can provide a deeper understanding of the neural mechanisms underlying OCD. Methods: This cross-sectional study involved 58 patients diagnosed with OCD and 38 healthy control subjects, totaling 96 participants. Resting-state functional MRI (fMRI) data were acquired and analyzed using the CONN toolbox to examine functional connectivity within intrinsic resting-state networks. Graph theory metrics were applied to evaluate node connections and the overall network topology. Clinical symptoms were assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and their correlations with connectivity patterns and graph-theory parameters were analyzed. Results: The OCD patients and healthy controls were matched in terms of age, gender, marital status, socioeconomic status, and handedness. However, OCD patients had significantly worse general health, quality of life, and higher levels of depression and anxiety. Network analyses revealed altered whole-brain connectivity in OCD patients, particularly within the DMN and the frontoparietal network. The most significant between-group connectivity differences were observed between the posterior parietal cortex (PPC) and the precuneus. Disruptions in the DMN, specifically altered connectivity between the medial prefrontal cortex and posterior cingulate cortex, and changes in the SN involving the anterior insula and anterior cingulate cortex, were significantly correlated with the severity of OCD symptoms. Conclusions: The findings suggest that OCD is associated with distinct alterations in DMN connectivity, which may play a critical role in the disorder's pathophysiology. These disruptions offer potential targets for therapeutic intervention. Further research is needed to explore these connectivity changes in larger cohorts and at various stages of OCD to better understand their clinical significance.

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