Eurasian Journal of Chemical, Medicinal and Petroleum Research

Abstract Background: Heart failure (HF) is a chronic, progressive condition with high prevalence and mortality rates worldwide. Despite advances in medical management, patients with HF face significant challenges in self-care, leading to poor clinical outcomes and frequent hospital readmissions. Adherence to self-care behaviors is critical for reducing hospital readmissions, yet many patients struggle with maintaining these behaviors due to insufficient education and follow-up.

Objective: This study examined the impact of the Continuous Care Model (CCM) on self-efficacy and hospital readmission among patients hospitalized with HF.

Methods: This quasi-experimental study conducted on 70 patients with HF visiting two teaching hospitals in southeastern Iran in 2021. Patients were selected using convenience sampling and randomly assigned to two groups: control (n=35) receiving routine care and intervention (n=35) receiving CCM. The intervention consisted of six individual training sessions during hospitalization, six sessions post-discharge, and weekly telephone follow-up until the twelfth week. Data collected using a demographic form, readmission assessment, and Sullivan's Cardiac Self-Efficacy Scale. Analysis was performed using SPSS version 22 with chi-square, independent and paired samples t-tests, and ANCOVA at P < 0.05 significance level.

Results: ANCOVA revealed significantly higher self-efficacy scores in the intervention group after implementing CCM (P = 0.001). Independent t-test results showed that readmission frequencies in the control group (1.03 ± 1.01) were significantly higher than in the intervention group (0.34 ± 0.68) (P = 0.001).

Conclusion: The Continuous Care Model significantly improved self-efficacy and reduced hospital readmission frequency among patients with HF. Given its ease of implementation, applicability, and low cost, healthcare authorities recommended to develop policies for implementing CCM for HF patients.

Abstract Introduction: Lumpectomy is a standard breast-conserving procedure, yet acute postoperative complications may delay recovery and adjuvant treatment. Beyond clinical risk factors, tumor biology may influence wound healing and inflammatory responses. This study aimed to evaluate the association between progesterone receptor expression and the incidence of acute postoperative complications following lumpectomy.

Material and methods: This descriptive cross-sectional study was conducted at Tabriz University of Medical Sciences in 2025 on 54 women undergoing lumpectomy, with sample size estimated using the Cochran formula and participants enrolled by convenience sampling. Progesterone receptor expression was assessed by immunohistochemistry on surgical specimens, and its association with acute postoperative complications was analyzed alongside demographic, clinical, pathological, and perioperative variables using appropriate statistical tests.

Results: Results summary: Among 54 patients undergoing lumpectomy, PR-negative status was associated with poorer early postoperative outcomes. Compared with PR-positive patients, PR-negative patients had higher postoperative VAS scores (4.06 ± 1.43 vs. 3.14 ± 1.21; p = 0.017), more acute complications (50.00% vs. 22.22%; p = 0.037), and more unplanned visits (33.33% vs. 11.11%; p = 0.048). PR negativity independently predicted complications after adjustment (OR = 3.84; p = 0.039).

Conclusion: PR-negative status was associated with a higher risk of acute postoperative complications after lumpectomy. Despite broadly comparable operative variables, PR-negative patients experienced greater postoperative morbidity and more unplanned visits, suggesting that receptor status may help identify patients requiring closer early postoperative monitoring.

Abstract Introduction: Oral squamous cell carcinoma is a biologically aggressive malignancy in which molecular alterations may extend beyond visible tumor tissue into surgical margins. Long non-coding RNAs, particularly LNC-NORAD, may influence genomic stability, stress responses, and tumor progression. This study aimed to assess LNC-NORAD expression changes in tumor and surgical margin samples of OSCC.

Material and methods: This descriptive cross-sectional study was conducted at Tabriz University of Medical Sciences in 2024. Using convenience sampling, 100 specimens comprising 50 oral squamous cell carcinoma tissues and 50 matched healthy surgical margins were collected from 50 patients. LNC-NORAD expression was quantified by real-time PCR and evaluated alongside age, sex, smoking status, tumor site and size, histological grade, invasion characteristics, TNM stage, lymph node involvement, and margin status.

Results: LNC-NORAD expression was significantly higher in OSCC tumor tissues than in matched healthy surgical margins (3.18 ± 1.07 vs. 1.24 ± 0.43; P<0.001). Increased tumoral expression was associated with smoking, larger tumor size, poorer histological differentiation, deeper invasion, perineural invasion, advanced TNM stage, and lymph node metastasis. By contrast, no significant associations were observed with sex, anatomical tumor site, or lymphovascular invasion.

Conclusion: LNC-NORAD is markedly upregulated in OSCC tissues compared with matched surgical margins and is closely associated with several indicators of tumor aggressiveness. These findings suggest that this long non-coding RNA may serve as a useful molecular marker for identifying biologically advanced and clinically high-risk oral squamous cell carcinoma.

Abstract Introduction: Femoral implant surgery is frequently complicated by early inflammatory reactions that may be difficult to distinguish from normal postoperative responses. Because C-reactive protein reflects systemic inflammatory activity, preoperative measurement may help identify patients at greater risk of acute pathologic inflammation after surgery. The aim of this study was to evaluate the diagnostic value of preoperative CRP in predicting acute inflammation following femoral implant placement.

Material and methods: This descriptive cross-sectional study was conducted at Shahid Madani Hospital in Tabriz, Iran. Using Cochran’s formula, the sample size was estimated at 73 patients, who were enrolled through convenience sampling. Data were extracted from medical records on demographic characteristics, comorbidities, preoperative CRP and other laboratory findings, operative details, and early postoperative inflammatory outcomes to assess the diagnostic value of preoperative CRP.

Results: Among 73 patients, acute postoperative inflammation occurred in 21.9%. Affected patients had higher preoperative CRP (24.18 vs 12.32 mg/L, P < 0.001), ESR (34.50 vs 25.98 mm/h, P = 0.009), and WBC (9.96 vs 8.40 x10³/muL, P = 0.015), but lower hemoglobin (11.28 vs 12.34 g/dL, P = 0.021) and albumin (3.29 vs 3.70 g/dL, P = 0.003). CRP showed good diagnostic performance (AUC = 0.812, sensitivity 78.9%, specificity 73.6%, NPV 95.1%).

Conclusion: Preoperative CRP appears to be a clinically useful marker for identifying patients at risk of acute inflammation after femoral implant placement. Its strong discriminatory capacity and high negative predictive value suggest particular value in perioperative risk stratification, especially when interpreted alongside comorbidity burden, nutritional status, and operative complexity.

Abstract Introduction: Early infection after femoral implant placement is a serious complication influenced by host immunity, wound healing capacity, and nutritional-inflammatory status. Preoperative serum albumin is a practical biomarker that may reflect vulnerability to postoperative infection, but its predictive accuracy remains uncertain in femoral implant surgery. This study aimed to evaluate the sensitivity and specificity of preoperative serum albumin in predicting early infection after femoral implant placement.

Material and methods: This retrospective descriptive cross-sectional study was conducted at Shahid Madani Hospital, Tabriz, on 125 patients selected by convenience sampling. The sample size was estimated using Cochran’s formula. Data were extracted from medical records to evaluate preoperative serum albumin, demographic and clinical variables, operative characteristics, and early postoperative infection after femoral implant placement, with the aim of assessing the diagnostic performance of albumin in predicting early infection.

Results: Among 125 patients, early postoperative infection occurred in 15.2% (19/125). Infected patients had lower preoperative albumin (3.12 ± 0.46 vs 3.66 ± 0.51 g/dL; P < 0.001), a higher rate of hypoalbuminemia (63.2% vs 27.4%; P = 0.002), lower hemoglobin (P = 0.011), and higher inflammatory markers (WBC, P = 0.018; CRP, P = 0.006). Serum albumin predicted infection with good accuracy (cutoff 3.35 g/dL; sensitivity 78.9%, specificity 73.6%, AUC 0.812, P < 0.001).

Conclusion: Preoperative serum albumin appears to be a clinically useful marker for identifying patients at increased risk of early infection after femoral implant placement. Lower albumin levels were consistently associated with infection and showed acceptable diagnostic performance. These findings support incorporating serum albumin into routine preoperative assessment to improve risk stratification and guide perioperative optimization in this surgical population.

Abstract Introduction: Femoral fracture surgery in elderly patients is frequently followed by substantial acute postoperative pain, which may be influenced not only by surgical trauma but also by systemic inflammatory and immune responses. Because the Systemic Immune-Inflammation Index may reflect this biological susceptibility, the present study aimed to pathologically assess its association with the severity of acute postoperative pain after femoral fracture surgery.

Material and methods: This descriptive cross-sectional study was conducted at Shahid Madani Hospital, Tabriz, on 93 elderly patients selected by convenience sampling, with sample size estimated using Cochran’s formula. Demographic, clinical, laboratory, surgical, and postoperative pain data were collected. The Systemic Immune-Inflammation Index was calculated from preoperative platelet, neutrophil, and lymphocyte counts, and its association with acute postoperative pain severity was statistically evaluated.

Results: Patients with severe postoperative pain had markedly higher preoperative SII than those with moderate or mild pain (1801.2±789.6 vs 1280.5±542.7 and 850.2±386.4; P<0.001), along with higher inflammatory markers, lower hemoglobin and albumin, longer operations, greater blood loss, more opioid use, delayed mobilization, and longer hospitalization (all P<0.05). SII correlated with pain intensity (highest 24-hour NRS: r=0.574, P<0.001) and independently predicted severe pain (OR=2.86, 95% CI 1.54-5.31), with good accuracy (AUC=0.812).

Conclusion: Preoperative SII appears to be a clinically useful biomarker for identifying patients at increased risk of severe acute postoperative pain. Its independent association with pain severity and acceptable diagnostic performance suggest that SII may support early perioperative risk stratification and help guide individualized analgesic planning, particularly in patients with an elevated inflammatory burden before surgery.

Abstract Introduction: Pregnancy-related hormonal and vascular changes may increase nasal mucosal congestion, particularly during the third trimester, when sleep disturbance is also common. Nasal obstruction can promote mouth breathing, nocturnal discomfort, and fragmented sleep. This study aimed to evaluate the effect of NOSE score on sleep quality in primigravid women during the third trimester of pregnancy.

Material and methods: This descriptive cross-sectional study will be conducted at Tabriz University of Medical Sciences in 2026 on 66 primigravid women in the third trimester of pregnancy, selected by convenience sampling. The main variables will include demographic and obstetric characteristics, NOSE score, sleep quality indices, and pregnancy-related sleep disruptors such as nocturia, reflux, back pain, fetal movement-related awakening, and nocturnal breathing discomfort.

Results: Among 66 primigravid women, poor sleep quality was associated with significantly higher NOSE scores than good sleep quality (56.84 ± 18.27 vs. 31.46 ± 14.92, p < 0.001), with severe nasal obstruction occurring more often in poor sleepers (39.47% vs. 10.71%, p = 0.012). NOSE score correlated with worse sleep quality (r = 0.58, p < 0.001) and remained an independent predictor in adjusted analysis (B = 0.07, p = 0.001).

Conclusion: Poor sleep quality in third-trimester primigravid women was significantly associated with greater nasal obstruction severity. Higher NOSE scores independently predicted worse sleep quality, suggesting that nasal symptoms may represent an important and potentially modifiable contributor to sleep disturbance during late pregnancy.

Abstract Introduction: Nasal bone fracture is a common facial injury with potential early postoperative consequences, including pain, bleeding, edema, airway symptoms, and residual deformity. Fracture severity may influence these outcomes by reflecting the extent of structural and soft-tissue damage. This study aimed to determine short-term postoperative complications according to nasal bone fracture severity.

Material and methods: This descriptive cross-sectional study of 75 patients at Tabriz University of Medical Sciences in 2024 investigated the association between nasal bone fracture severity and early outcomes. Measured variables included demographics, fracture characteristics, surgical parameters, and short-term complications, including VAS pain score, epistaxis, edema, ecchymosis, and septal hematoma. Data were analyzed using normality testing, t-tests, Mann-Whitney U, and chi-square tests.

Results: Among 75 patients, severe/complex nasal fractures (n = 34) were associated with worse short-term postoperative outcomes than mild/moderate injuries (n = 41). Severe fracture patients experienced longer operations (41.53 ± 11.47 vs. 28.64 ± 8.12 minutes, p < 0.001), higher 24-hour VAS pain (4.85 ± 1.56 vs. 3.42 ± 1.18, p < 0.001), increased moderate/severe edema (61.76% vs. 26.83%, p = 0.002), and more unplanned visits (26.47% vs. 7.32%, p = 0.027). Severe fracture independently predicted early complications (adjusted OR = 3.86, p = 0.020).

Conclusion: Severe nasal bone fractures are independently associated with an increased risk of short-term postoperative complications. Patients with complex fracture patterns experience higher pain levels, more pronounced soft-tissue edema, and greater rates of early residual deformity, leading to more frequent unplanned clinical evaluations. Preoperative severity stratification can identify high-risk cases requiring closer early postoperative surveillance.

Abstract Introduction: Liver transplantation is a life-saving treatment for end-stage liver disease, but its success depends heavily on accurate pathologic assessment before, during, and after surgery. Pathology helps define native liver disease, assess donor organ quality, and identify causes of graft dysfunction. The aim of this study was to evaluate the pathologic findings in patients undergoing liver transplantation.

Material and methods: This retrospective descriptive cross-sectional study was conducted at Imam Reza Hospital, Tabriz, on 73 liver transplant patients selected by convenience sampling based on the Cochran formula. Data were extracted from archived medical records and pathology reports, and included demographic characteristics, transplant indications, explant pathology, and available post-transplant histopathologic findings to evaluate the spectrum of pathologic changes in this patient population.

Results: Among 73 liver transplant recipients, cirrhosis was the leading transplant indication (32.9%) and the dominant explant finding (71.2%), while advanced fibrosis/cirrhosis was present in 75.3%. Steatosis was identified in 31.5%, cholestasis in 23.3%, and hepatocellular carcinoma in 19.2%. Hepatocellular carcinoma was significantly associated with older age (P = 0.041), viral hepatitis (P = 0.018), pre-transplant cirrhosis (P = 0.047), dysplasia (P = 0.006), vascular abnormalities (P = 0.039), and microvascular invasion (P < 0.001).

Conclusion: These findings indicate that end-stage cirrhotic liver disease constitutes the principal pathologic burden in liver transplant recipients, while hepatocellular carcinoma represents a clinically important subset linked to adverse pathologic features. Careful explant pathologic evaluation is therefore essential not only for confirming the underlying disease spectrum but also for identifying malignant and high-risk microscopic characteristics with prognostic relevance.

Abstract Introduction: Breast cancer remains a major global health burden, and lymph node involvement is a key pathologic indicator of tumor spread, prognosis, and postoperative treatment planning in patients undergoing mastectomy. Accurate nodal assessment also improves disease staging and therapeutic decision-making. This study aims to evaluate the pathologic status of lymph node involvement in patients undergoing mastectomy.

Material and methods: This retrospective descriptive cross-sectional study was conducted at Shahid Madani Hospital in Tabriz on 250 patients selected by convenience sampling, with sample size estimated using Cochran’s formula. Data were extracted from archived medical and pathology records, and clinicopathologic variables, particularly lymph node status and related breast tumor characteristics, were systematically collected and analyzed to evaluate the pattern of nodal involvement in mastectomy patients.

Results: Among 250 mastectomy patients, invasive ductal carcinoma was the predominant subtype (79.2%), most tumors were grade II (57.2%), and mean tumor size was 3.41 ± 1.67 cm. Lymph node involvement was present in 58.4%, with macrometastasis in 51.2% and extranodal extension in 15.6%. Nodal positivity was significantly associated with larger tumor size (3.98 ± 1.78 vs. 2.61 ± 1.14 cm, P < 0.001), higher grade (P = 0.002), and lymphovascular invasion (60.3% vs. 23.1%, P < 0.001).

Conclusion: These findings indicate that lymph node metastasis is common in mastectomy specimens and is closely linked to adverse pathologic features. Larger tumors, higher histologic grade, and lymphovascular invasion appear to be the strongest correlates of nodal spread, underscoring the importance of careful pathologic lymph node assessment for accurate staging, prognostic stratification, and postoperative treatment planning in breast cancer patients.

Abstract Introduction: Scaphoid waist nonunion with avascular necrosis is a difficult reconstructive problem because impaired blood supply, instability, and deformity can compromise healing and function. Vascularized grafting has therefore emerged as a biologically appealing option to improve union in selected patients. The aim of this study was to evaluate the early outcomes of the Mathoulin technique in scaphoid waist nonunion with avascular necrosis.

Material and methods: This descriptive cross-sectional study was conducted at Shahid Madani Hospital, Tabriz, with a convenience sample of 50 eligible patients selected using the standard descriptive sample-size formula. Patients underwent evaluation and treatment with the Mathoulin technique, and demographic, clinical, radiographic, and early postoperative outcome variables were recorded to assess short-term surgical results.

Results: The cohort comprised 50 patients (mean age 34.8±9.6 years), predominantly men (64.0%), with avascular necrosis in all cases and a mean nonunion duration of 15.2±6.4 months. After the Mathoulin technique, pain, wrist motion, and grip strength improved significantly (VAS 6.9±1.2 to 2.1 1.0; flexion 41.3±8.7° to 55.6±7.9°; grip strength 19.4±5.3 to 28.7±6.1 kg; all P<0.001), and union was achieved in 88.0% of patients at 11.8±2.6 weeks. Smoking, prior surgery, longer nonunion, severe AVN, and humpback deformity were associated with poorer outcomes.

Conclusion: The Mathoulin technique provided encouraging early clinical and radiographic results for scaphoid waist nonunion with avascular necrosis, with high union rates and significant functional improvement. Outcomes were less favorable in patients with smoking, prior surgery, prolonged nonunion, severe AVN, or deformity, suggesting that careful patient selection remains important.

Abstract Introduction: Pediatric complete forearm fractures may redisplace after closed reduction, potentially causing functional impairment and requiring repeat intervention. Although long-arm and sugar-tong splints can restrict motion and accommodate swelling, the effectiveness of their combined use remains uncertain. This study aimed to evaluate the effect of combined sugar-tong and long-arm splinting on fracture displacement in children with complete forearm fractures.

Material and methods: This randomized clinical trial at Shohada Hospital, Tabriz, evaluated 50 children with complete forearm fractures requiring closed reduction (25 per group, calculated via the two-independent-means formula). Participants were randomly assigned to combined sugar-tong and long-arm splinting or standard long-arm splinting alone. Serial radiographs were obtained from post-reduction through early follow-up to evaluate changes in fracture angulation and translation between the two immobilization methods.

Results: The combined splint group maintained better alignment than the standard splint group, with lower AP angulation, lateral angulation, translation, and shortening at follow-up (week 1 and 2, all P≤0.001); it also had fewer losses of reduction (8.0% vs. 36.0%,P=0.014) and remanipulations (4.0% vs. 24.0%, P=0.037), while parental satisfaction was higher (8.6±1.1 vs. 6.8±1.5, P<0.001).

Conclusion: Combined sugar-tong and long-arm splinting was more effective than standard splinting in preserving reduction and preventing secondary displacement in children with complete forearm fractures, without increasing complications. This simple immobilization strategy may improve early fracture stability and reduce the need for repeat intervention.

Abstract Background: Performance anxiety is a significant challenge for anesthesia nursing students transitioning to clinical practice, potentially compromising patient safety and professional development. Virtual reality (VR)-based simulation offers immersive, repeatable practice opportunities in a safe environment.

Objective: This randomized controlled trial evaluated the effectiveness of VR-based simulation training compared to traditional simulation methods in reducing performance anxiety and enhancing clinical preparedness among anesthesia nursing students.

Methods: A total of 60 second-year anesthesia nursing students were randomly assigned to either an immersive VR simulation group (n=30) or a traditional task-trainer simulation group (n=30). Outcomes were measured at baseline, immediately post-intervention, and at two-week follow-up using the State-Trait Anxiety Inventory (STAI-S), a clinical performance checklist, and a self-efficacy scale.

Results: The VR group demonstrated significantly greater reductions in state anxiety (mean difference: -8.4, p<0.001) and higher self-efficacy scores (p<0.001) compared to the control group. Clinical performance scores improved significantly in both groups, with the VR group showing superior non-technical skills including crisis management and communication (p=0.003).

Conclusion: VR-based simulation training effectively reduces performance anxiety and improves clinical preparedness in anesthesia nursing students, offering a scalable and accessible educational modality for healthcare training programs.

Abstract Cooling systems in thermal power plants play a decisive role in maintaining steam cycle efficiency, enhancing equipment reliability, and reducing maintenance costs. In the present study, the water chemistry and corrosion behaviour in the hybrid (dry-wet) cooling system of a sample thermal power plant were investigated. This plant, with a nominal capacity of 1000 MW, supplies the bulk of its water demand from treated municipal wastewater and employs a combination of dry and wet cooling towers to reduce water consumption. Sampling was conducted on demineralised water, recirculating water of the dry tower, inlet water to heat exchangers, wet tower water, and makeup water. General parameters including pH, electrical conductivity, TDS, temperature, and salinity were measured. Additionally, the concentrations of metallic elements were determined using ICP-MS. The results indicated that the demineralised water exhibits exceptionally high purity and is virtually devoid of metal ions, whereas in the dry cycle, a significant increase in aluminium concentration up to approximately 260 ppb was observed, indicative of active corrosion in the aluminium radiators of the dry tower. In contrast, in the wet tower, the concentrations of calcium, sodium, potassium, silica, copper, and zinc increased markedly, attributable to evaporation, concentration of dissolved solids, and the use of wastewater as make-up water. Comparison of the results with EPRI guidelines revealed that although iron and copper levels fall within acceptable ranges, the elevated aluminium concentration may be regarded as the primary indicator of heat transfer equipment degradation. Accordingly, the revision of the water chemistry control programme, continuous monitoring of dissolved aluminium, and reassessment of the dry tower operating conditions are proposed as the most critical management strategies. The findings of this research can serve as a basis for the development of intelligent corrosion monitoring programmes in power plants equipped with hybrid cooling systems.

Abstract Adverse drug reactions (ADRs) and adverse drug events (ADEs) remain major threats to patient safety in hospitals, particularly among older adults, patients with multimorbidity, individuals exposed to polypharmacy, and patients experiencing rapid changes in physiological status. Conventional pharmacovigilance and medication-monitoring approaches depend heavily on retrospective reporting and clinical recognition, which may delay identification of preventable harm. Artificial intelligence (AI), particularly machine learning (ML), natural language processing, and deep learning, offers opportunities to transform pharmacovigilance from a predominantly reactive process into a predictive and continuously updated safety system. This systematic evidence synthesis examined the performance and clinical implications of AI-based models for predicting ADRs and ADEs among hospitalized patients, with particular attention to nursing practice. Evidence published in major biomedical databases synthesized with emphasis on model performance, predictors, validation, explainability, and implications for medication administration and clinical surveillance. Recent systematic reviews indicate that random forest, gradient boosting, support vector machines, regularized regression, and deep-learning architectures frequently used, with pooled predictive performance generally demonstrating moderate discrimination. A 2025 systematic review specifically examining hospitalized patients reported pooled sensitivity and specificity of 78.1% and 70.6%, respectively, for development-only models, 81.5%, and 79.5% for models undergoing external validation. Contemporary evidence also demonstrates increasing use of longitudinal EHR representations, clinical narratives, nursing documentation, and foundation models. However, heterogeneous outcome definitions, missing-data procedures, limited external validation, class imbalance, alert fatigue, algorithmic bias, and insufficient explainability remain substantial barriers to implementation. AI therefore conceptualized as an augmentation technology rather than a replacement for nurses or other clinicians. Effective implementation requires interdisciplinary governance, transparent algorithms, prospective evaluation, workflow integration, education, and continuous monitoring. Properly implemented, AI-supported ADR prediction may strengthen nursing vigilance, prioritize high-risk patients, improve medication safety, and facilitate earlier clinical intervention.