Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 13 3 2025 08 01 Complementary Medicines in the Treatment of Breastfeeding Problems: An Overview 1 14 118602 10.30483/rijm.2025.254613.1396 EN Mohammad Hasan Mohammadi Department of pediatrics, Zabol University of Medical Sciences, Zabol, Iran Jamileh Ahmadi Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hossein Ali Kharazmi Endocrinology and Metabolism Research Center, Hormozgan University of Medical Science, Bandar Abbas, Iran Shahrzad Zolala Student research committee, school of nursing and midwifery, Shahid Beheshti University of Medical Science, Tehran, Iran Sahebeh Dadshahi Reproductive and Family Health Research Center, Kerman University of Medical Sciences, Kerman, Iran 0000-0002-0546-8628 Maryam Mirzaei Department of Obstetrics and Gynecology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran Masumeh Ghazarfanpour Reproductive and Family Health Research Center, Kerman University of Medical Sciences, Kerman, Iran 0000-0003-4639-3711 Narges Mirzadeh School of Nursing and Midwifery, Bam University of Medical Sciences, Bam, Iran Journal Article 2025 03 02 Background: Breastfeeding problems can lead to early cessation of breastfeeding. Given the importance of maintaining exclusive breastfeeding, this study was conducted to review complementary medicines for treating breastfeeding problems. Objectives: The goal of this research is to review complementary medicines on the treatment of breastfeeding problems such as nipple trauma, pain, mastitis, and breast engorgement. Methods: To identify clinical trials on the treatment of breast engorgement in postpartum women, domestic and international databases, including PubMed, ISI Web of Science, Embase, Cochrane, and Scopus, were systematically searched without time limits until September 10, 2024. The key search terms were (herbal OR complementary OR Acupressure OR Massage) AND (breastfeeding complications OR breastfeeding problems). Only articles published in the English language were included. Additionally, all clinical trials and systematic reviews are evaluating the effect of Complementary therapies on breastfeeding problems. The quality of articles was evaluated using the Jadad scale. Results: Four potentially relevant systematic reviews were identified, yielding 21 articles for this overview. Ginger (Commiphora mukul), Hollyhock leaf, Oketani, and warm compression, in the form of massage, were found to be effective. There is a significant difference between cold compression and hot fomentation in relieving breast engorgement among postnatal mothers. Two studies have shown that cabbage is more effective than routine care. The results of two other studies did not show any difference between the two groups. Overall, the findings on the effect of acupressure on breast engagement are controversial, and there is no consensus about the effect of hot or cold compresses. Herbal medications had a positive effect on the treatment and prevention of fissure and nipple pain. Peppermint water was more effective than breast milk, lanolin ointment, or placebo in preventing nipple cracks. Different types of breast massage were beneficial in relieving immediate pain and resolving symptoms, as well as lowering the rates of mastitis and three scores measuring the severity of inflammation (tension, erythema, and pain). Pain scores did not significantly change after 4 weeks of auricular acupressure. Conclusion: Massage, acupuncture, and herbal medicines can have beneficial effects on improving breastfeeding problems. Given the interest of patients in complementary medicine and the low cost of this treatment technique, it can be used as a valuable technique to improve engorgement. However, caution should be exercised in interpreting the findings due to the limited number of studies and their small sample size.

https://journal.razavihospital.ir/article_118602_5175dd28b8996f068c34d78a8bc4261a.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 13 3 2025 08 01 Patterns of Online Health Information Seeking Among Gen Z Nigerians: A Behavioral Analysis 16 26 118593 10.30483/rijm.2025.254600.1385 EN Akinade Adebowale Adewojo PhD Nigerian Stored Products Research Institute Information and Documentation (Library)Ilorin, Nigeria 0000-0002-2921-8500 Oluwasegun Moses Olatunji BSc Nigerian Stored Products Research Institute Information and Documentation (Library)Ilorin, Nigeria 0009-0002-0125-1218 Adebola Adewojo Ms National Open University, Lagos State, Nigeria Precious Monjolaoluwa Olalere Doctoral student, University of Illinois, United States Journal Article 2024 08 13 Background: The increasing accessibility of smartphones, internet connectivity, and social media platforms has revolutionized how health information is sought globally. In Nigeria, where infrastructural challenges often constrain access to traditional healthcare services, Generation Z (Gen Z) has turned to online platforms as their primary source of health-related information. This shift reflects the demographic's digital nativity and preference for convenience, anonymity, and engaging, interactive content. Objectives: This study explores the behavioral patterns, motivations, and challenges of seeking online health information among Gen Z Nigerians. It focuses on the platforms and sources used, perceptions of trustworthiness, and the influence of socio-cultural and digital literacy factors. Methods: A qualitative research design was employed, involving semi-structured interviews with 30 participants aged 18–24 years from urban and rural areas of Nigeria. The data were analyzed thematically using the Self-Efficacy Model and the Uses and Gratifications Theory. Results: The findings reveal six key themes. Social media platforms, including Instagram, YouTube, and TikTok, dominate as primary sources for health information due to their accessibility and engaging formats. However, trust in online health information varies, with many participants relying on peer recommendations or influencers rather than verified medical sources. Peer and influencer-driven content significantly shapes health decisions concerning fitness, mental health, and nutrition. Cultural stigmas surrounding sensitive topics, such as sexual and mental health, push many young Nigerians to seek information anonymously online. Challenges include the prevalence of misinformation, overwhelming and contradictory content, and limited internet access in rural areas. Conclusion: Online health information influences positive health changes, such as improved diets or fitness routines, and adverse outcomes, such as reliance on unverified remedies. The findings note critical gaps in digital health literacy.

https://journal.razavihospital.ir/article_118593_ccafaab35b02775189ec0f5c5ded4688.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 13 3 2025 08 01 Effects of Mindfulness Training on Alexithymia and Resilience of Psychosomatic Patients 27 37 118571 10.30483/rijm.2025.254507.1311 EN Majid Shiri Department of clinical Psychology, Islamic Azad University, Garmsar Branch, Garmsar, Iran 0009-0005-6551-4728 Journal Article 2024 02 12 Background: A psychosomatic illness is a mental disorder that manifests physical symptoms without any clear physiological cause. Objectives: The main objective of this research was to investigate the effects of mindfulness training on the levels of alexithymia and resilience in individuals suffering from psychosomatic disorders. Methods: This study was conducted using a quasi-experimental pretest-posttest control group design. It specifically examined women who were diagnosed with psychosomatic disorders and sought treatment in Tehran in 2019. A total of 30 women were selected via convenience sampling and randomly assigned to experimental and control groups. The experimental group took part in eight 150-minute sessions of mindfulness intervention. The tools used for assessment during the pre-test and post-test phases were the Toronto Alexithymia Scale and the Conner-Davidson Resilience Scale. The data were analyzed in SPSS software (version 19) using analysis of covariance. Results: The multivariate analysis of covariance demonstrated a significant difference between the two groups in dependent variables (P<0.05). The results of the univariate analysis of covariance for the variables of alexithymia and resilience revealed that mindfulness training had a significant impact on alexithymia and resilience in psychosomatic women during the post-test phase, as compared to the control group (P<0.05). Conclusion: As evidenced by the results of this study, mindfulness training had a significant effect on decreasing alexithymia and boosting resilience in women with psychosomatic symptoms.

https://journal.razavihospital.ir/article_118571_10caa7a7b480f6b3f231e5c5b2af27e7.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 13 3 2025 08 01 Using High-Dose Sufentanil Intrathecally For Painless Induction And Postoperative Pain Management In Gastrointestinal Cancer Surgeries 38 46 118589 10.30483/rijm.2025.254542.1340 EN Alireza Sharifian Attar Associate Professor, Department of Anesthesia, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 0000-0002-9259-4859 Alireza Bameshki Associate Professor, Department of Anesthesia, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Monavvar Afzalaghaee Associate Professor, Department of Epidemiology , School of Health, Mashhad University of Medical Sciences, Mashhad, Iran Naser Naderi Anesthesiologist, Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Journal Article 2024 05 27 Background: Intrathecal opioids have demonstrated efficacy in pain management during and after surgery, necessitating further exploration across various surgical procedures. This study examines the use of higher doses of intrathecal synthetic opioids (Sufentanil) for pain control in gastrointestinal cancer surgeries, highlighting the need for additional research to establish conclusive outcomes. Methods: A single-center clinical trial with a control group was conducted, involving adult non-addicted individuals eligible for gastrointestinal cancer surgeries. The intervention group (n=25) received intrathecal Sufentanil (0.2 mcg/kg) before anesthesia induction, while the control group (n=25) received intravenous Sufentanil (0.3 mcg/kg) at induction. The variables between the two groups were compared using chi-square tests, independent t-tests, and exact tests. Results: The average age in the intrathecal group was 55.1 years ± 9.3, and in the intravenous administration group was 54.2 years ± 13.2, showing no significant difference (p=0.4). A higher proportion of patients in the intrathecal group required three analgesic doses (52%) compared to the IV group, where 44% needed four doses during surgery, with no significant variance observed between groups (p=0.3). Postoperative pain scores were lower in the intrathecal group than in the intravenous administration group (0.8 ± 1.7 vs 0.66 ± 5.12, p<0.001). Conclusion: Based on our study findings, Intrathecal Sufentanil at a dose of 0.2 mcg/kg reduces postoperative pain by one-third compared to IV administration in gastrointestinal cancer surgeries.

https://journal.razavihospital.ir/article_118589_169c3beef5d1cfe69bb95f60a6889032.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 13 3 2025 08 01 The Diagnostic Value of Systemic Inflammatory Markers in Acute Appendicitis 47 54 118595 10.30483/rijm.2025.254604.1389 EN Mohammadreza Taheri Innovative Medical Research Center, MMS.C., Islamic Azad University, Mashhad, Iran 0000-0002-8682-3678 Amin Dalili Surgical Oncology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 0000-0001-6695-8551 Yalda Ravanshad Department of Community Medicine, MMS.C., Islamic Azad University, Mashhad, Iran Mojtaba Meshkat Department of Community Medicine, MMS.C., Islamic Azad University, Mashhad, Iran 0000-0003-0507-3295 Yeganeh Azadmanesh Department of Emergency Medicine, Razavi Hospital, Mashhad, Iran 0000-0003-1494-4718 Tooraj Zandbaf Department of General Surgery, MMS.C., Islamic Azad University, Mashhad, Iran 0000-0002-4882-5058 Journal Article 2025 01 15 Background: Early diagnosis of Acute Appendicitis (AA)can be challenging because it relies on the patient's signs and symptoms, which often mimic other abdominal pathologies. Objectives: The study aimed to assess the importance of systemic inflammatory response parameters in contrast with the Alvarado scoring system. Methods: This cross-sectional study was conducted on 300 patients diagnosed with AA who underwent an appendectomy. Demographic data, medical history, physical examination findings, Alvarado score, complete blood count (CBC), and pathology results of the appendix were documented. Results: In a study involving 300 patients, 53.7% were male. The mean age of the patients was 37.24 ± 14.79 years. The number of females with a negative appendectomy was 2.45 times higher than that of males. Most patients with appendicitis were male, while most with RLH (reactive lymphoid hyperplasia) and normal appendices were female. For diagnosing AA, the following thresholds were established: NLR (neutrophil-to-lymphocyte ratio) >2.93 with 90.08% sensitivity and 76.32% specificity, PLR (platelet-to-lymphocyte ratio) >117.8 with 70.61% sensitivity and 65.79% specificity. The sensitivity of the Alvarado scoring system was 79.8%, and its specificity was 81.6% at >6 cut-off value. Conclusion: NLR, PLR, CRP (C-reactive protein), SII (systemic immune inflammation index), and Alvarado scoring showed great potential in diagnosing appendicitis with acceptable sensitivity and specificity.

https://journal.razavihospital.ir/article_118595_48b9ef5bcb5ede1575779d29b9eeffe7.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 13 3 2025 08 01 Incidence and Laboratory Predictors of Acute Ischemic Stroke in COVID-19: A Cross-Sectional Study 55 66 118598 10.30483/rijm.2025.254618.1399 EN Mehdi Torabi Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran Sara Azizi Shoul Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran Mina Ameri Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran Journal Article 2025 01 17 Background: The possibility of central nervous system (CNS) involvement following Coronavirus Disease 2019 (COVID-19) is rare. Laboratory tests may play a predictive role in the occurrence of stroke. Objective: The objectives of this study were twofold: first, to investigate the incidence of acute stroke, and second, to examine the role of laboratory tests in predicting the occurrence of these events following infection. Methods: This cross-sectional study was conducted over one year. The inclusion criteria were as follows: patients over 18 years of age with a positive multiple polymerase chain reaction (RT-PCR) test result or typical lung CT findings of confirmed cases of pneumonia due to COVID-19 and who had undergone a brain CT scan due to suspicion of brain damage. The patients were divided into two groups, with and without brain damage, and compared with each other. The chi-square test was employed to evaluate the correlation between the qualitative variables, while the Mann-Whitney U test and the Student's t-test were applied to analyze the quantitative variables. Subsequently, logistic regression analysis was conducted to examine the association between patient outcomes and the pertinent variables. A p-value of less than 0.05 was established as indicative of statistical significance. Data analysis was conducted using SPSS. Results: Among the 6604 patients, 98 underwent brain CT scans, of which 9.18% had stroke. Notably, 0.55% of all patients had acute ischemic stroke, a proportion that was significantly higher in women than in men. A statistically significant difference was observed in blood glucose (BG) and activated partial thromboplastin time (aPTT) levels among patients with ischemic stroke compared to those without stroke (p < 0.05). In both univariate and multivariate analyses with logistic regression, the three variables gender, blood glucose, and aPTT were significantly associated with the incidence of ischemic stroke. The Area Under the Curve (AUC) values for BG and aPTT were determined to be 0.66 and 0.67, respectively. Conclusion: The incidence of acute stroke following COVID-19 infection is not common. In female patients, decreased blood glucose and decreased aPTT were associated with an increased incidence of ischemic stroke following infection.

https://journal.razavihospital.ir/article_118598_e7a3aaed5551a9a613a266df82e46392.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 13 3 2025 08 01 Peripapillary Intrachoroidal Cavitation, A Rare Finding in Myopic Eye: A Case Report 67 70 118597 10.30483/rijm.2025.254607.1392 EN Saeed Karimi Department of Ophthalmology, Torfeh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-3231-8414 Mohsen Zare Department of Ophthalmology, Torfeh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0009-0008-4095-426X Omid Emadi Department of Ophthalmology, Torfeh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-9184-3139 Shima Azizi Department of Ophthalmology, Torfeh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0009-0001-6595-7378 Journal Article 2025 01 26 Background: To describe peripapillary intrathyroidal cavitation in a patient with pathologic myopia and to summarize the literature on its pathophysiology, clinical manifestations, and diagnostic imaging using optical coherence tomography. Case Presentation: We present an asymptomatic 65-year-old man with high myopia who was referred to our clinic with a suspected peripapillary choroidal tumor in the left eye. A comprehensive ophthalmologic examination was conducted. Anterior segment exam showed bilateral moderate crystalline lens opacity. A Fundus exam showed classic myopic fundus changes, including a tilted optic disc, posterior staphyloma, chorioretinal atrophy in both eyes, and a peripapillary yellow lesion raising suspicion for choroidal cavitation in the left eye. The diagnosis was confirmed with swept-source optical coherence tomography by demonstrating an intrachoroidal hyporeflective area beneath healthy RPE and scleral posterior bowing, compatible with choroidal cavitation. Conclusion: Peripapillary intrachoroidal cavitation should be considered a differential diagnosis of congenital disc malformations, peripapillary choroidal neovascularization, and choroidal tumors in myopic eyes.

https://journal.razavihospital.ir/article_118597_10302ba91626da00628bf0bfa928ea27.pdf