Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 44 850 2026 03 21 The relationship between exposure to a number of allergens and pathogens during pregnancy with anthropometric indicators of infants in Yazd The relationship between exposure to a number of allergens and pathogens during pregnancy with anthropometric indicators of infants in Yazd 75 82 33338 10.48305/jims.v44.i850.0075 FA Zahra Mohebi Dehnavi Assistant Professor of Reproductive Health, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-1640-7978 Razieh Sadat Tabatabaei Department of Obstetrics and Gynecology, AND, Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 0000-0003-1230-8064 Leila Asadi PhD in Reproductive Health Research Center for Nursing and Midwifery Care, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 0000-0001-6896-519X Ali Dadbinpour Assistant Professor, Department of Genetics, Research Center for Genetics and Environmental Hazards, School of Paramedical Sciences, Abarkuh, AND,Assistant Professor, Department of Social Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 0000-0003-3627-9472 Mahmood Vakili Ghasemabad Assistant Professor, Department of Social Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 0000-0002-0113-7100 Journal Article 2025 02 27 Backgroud :Pregnant women are exposed daily to various allergens and pathogens that may influence infant growth indices. This study aimed to investigate the association between exposure to selected allergens and pathogens during pregnancy and anthropometric indices at birth. Methods: This prospective cohort study was conducted in four referral obstetrics and gynecology hospitals in Yazd, Iran. The study population included all eligible pregnant women (n=1,623) who visited these referral centers from 2014 to 2019, selected through a census method. Data collection tools included a demographic characteristics form, infant anthropometric indices, and maternal exposure history to allergens and pathogens during pregnancy. Data were analyzed using SPSS version 22. Findings: A significant association was found between exposure to mobile phone towers and high-voltage power lines and infant height (p≤0.05). Increased exposure to mobile phone towers was associated with decreased infant height, while exposure to high-voltage power lines was linked to increased infant height. No significant associations were observed between exposure to other allergens or pathogens and anthropometric indices (p>0.05). Conclusion: The findings indicate a significant relationship between electromagnetic wave exposure and infant height. However, factors such as the intensity, duration, and distance of exposure to electromagnetic waves warrant further investigation. Backgroud :Pregnant women are exposed daily to various allergens and pathogens that may influence infant growth indices. This study aimed to investigate the association between exposure to selected allergens and pathogens during pregnancy and anthropometric indices at birth. Methods: This prospective cohort study was conducted in four referral obstetrics and gynecology hospitals in Yazd, Iran. The study population included all eligible pregnant women (n=1,623) who visited these referral centers from 2014 to 2019, selected through a census method. Data collection tools included a demographic characteristics form, infant anthropometric indices, and maternal exposure history to allergens and pathogens during pregnancy. Data were analyzed using SPSS version 22. Findings: A significant association was found between exposure to mobile phone towers and high-voltage power lines and infant height (p≤0.05). Increased exposure to mobile phone towers was associated with decreased infant height, while exposure to high-voltage power lines was linked to increased infant height. No significant associations were observed between exposure to other allergens or pathogens and anthropometric indices (p>0.05). Conclusion: The findings indicate a significant relationship between electromagnetic wave exposure and infant height. However, factors such as the intensity, duration, and distance of exposure to electromagnetic waves warrant further investigation.

https://jims.mui.ac.ir/article_33338_c8d9450ad0f783748512ced1c72c5da3.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 44 850 2026 03 21 The Effect of Two Doses of Sublingual Melatonin On Sedation and Pain Control in Cataract Surgery Under Sedation and Local Anesthesia The Effect of Two Doses of Sublingual Melatonin On Sedation and Pain Control in Cataract Surgery Under Sedation and Local Anesthesia 83 90 33324 10.48305/jims.v44.i850.0083 FA Behzad Nazemroaya Associate Professor, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-6208-9053 Milad Masaeli Assistant Professor, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-5620-0955 Seyed Taghi Hashemi Associate Professor, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0003-2626-8868 Kheirmohammad Noorzehi Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0009-0004-1190-028X Journal Article 2025 03 12 Cataract surgery is performed in elderly patients, the use of melatonin as a premedication for this procedure has been considered. The present study aimed to determine the effect of two doses of melatonin on sedation and pain control in cataract surgery under sedation and local anesthesia. The present study was a randomized, double-blind clinical trial that 90 patients . The patients were divided into three groups of 30 and were administered melatonin in doses of 3 and 5 mg in two groups and placebo in the third group. The data were collected using standard scales and analyzed in SPSS version 26 software at a significance level of less than 0.05. According to the results; Melatonin, at both doses of 3 and 5 mg, can significantly reduce and improve the behavioral scale of pain and sedation from one minute after anesthesia until the time of leaving the recovery room compared to the placebo group (P<0.05). In addition, it had no significant effect on heart rate, mean arterial blood pressure, and arterial oxygen saturation (P>0.05), as they remained within the normal range from before the operation until the end. Based on the results, it can be stated that the present study is one of the studies that confirms the effects of reducing the behavioral pain scale and sedation one minute after sublingual melatonin administration at both 3 and 5 mg doses, until the time of leaving recovery. Cataract surgery is performed in elderly patients, the use of melatonin as a premedication for this procedure has been considered. The present study aimed to determine the effect of two doses of melatonin on sedation and pain control in cataract surgery under sedation and local anesthesia. The present study was a randomized, double-blind clinical trial that 90 patients . The patients were divided into three groups of 30 and were administered melatonin in doses of 3 and 5 mg in two groups and placebo in the third group. The data were collected using standard scales and analyzed in SPSS version 26 software at a significance level of less than 0.05. According to the results; Melatonin, at both doses of 3 and 5 mg, can significantly reduce and improve the behavioral scale of pain and sedation from one minute after anesthesia until the time of leaving the recovery room compared to the placebo group (P<0.05). In addition, it had no significant effect on heart rate, mean arterial blood pressure, and arterial oxygen saturation (P>0.05), as they remained within the normal range from before the operation until the end. Based on the results, it can be stated that the present study is one of the studies that confirms the effects of reducing the behavioral pain scale and sedation one minute after sublingual melatonin administration at both 3 and 5 mg doses, until the time of leaving recovery.

https://jims.mui.ac.ir/article_33324_42e48dffac7c80798ae435772756f026.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 44 850 2026 03 21 Challenges of Implementing the International Patients Department (IPD) Regulations in University Hospitals Challenges of Implementing the International Patients Department (IPD) Regulations in University Hospitals 91 99 33337 10.48305/jims.v44.i850.0091 FA Tahereh Sadeghi MSc Student, Isfahan Endocrine & Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 0009-0000-4521-8714 Marzieh Hadian Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran 0000-0002-5682-1188 Alireza Jabbari - Associate Professor, Department of Health Services Management, School of Management and Medical, Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-5964-4116 Journal Article 2025 05 05 Background: Medical tourism represents one of the most rapidly expanding segments within the global tourism industry, characterized by accelerated market growth and increased international patient mobility. In light of the application of regulations for establishing International Patient departments (IPD), in Iran and the strategic role of hospitals as primary service delivery nodes, this study seeks to systematically identify and analyze the operational and managerial challenges encountered by university hospitals in the effective implementation of these regulations. Methods: This qualitative, cross-sectional study was conducted in 2024 (year 1403 in the Iranian calendar). Semi-structured interviews were held with 18 managers and experts involved in health tourism at university hospitals in Isfahan. Written informed consent was obtained from the interviewees. The data were analyzed using thematic analysis supported by MAXQDA, version24 Findings: The challenges reported by participants were organized into 13 main categories: ethical issues, financial issues, marketing strategies, monitoring and supervision, equipment and supplies, medication management, physical infrastructure, information and communication technology, process management, legal matters, customer orientation, advocacy, and human resource management. These categories included 79 detailed sub-themes. Conclusion: Given the variety of challenges identified, the study offers recommendations to improve the implementation, review, and clarification of the regulations to support better management of medical tourism services in hospitals. Background: Medical tourism represents one of the most rapidly expanding segments within the global tourism industry, characterized by accelerated market growth and increased international patient mobility. In light of the application of regulations for establishing International Patient departments (IPD), in Iran and the strategic role of hospitals as primary service delivery nodes, this study seeks to systematically identify and analyze the operational and managerial challenges encountered by university hospitals in the effective implementation of these regulations. Methods: This qualitative, cross-sectional study was conducted in 2024 (year 1403 in the Iranian calendar). Semi-structured interviews were held with 18 managers and experts involved in health tourism at university hospitals in Isfahan. Written informed consent was obtained from the interviewees. The data were analyzed using thematic analysis supported by MAXQDA, version24 Findings: The challenges reported by participants were organized into 13 main categories: ethical issues, financial issues, marketing strategies, monitoring and supervision, equipment and supplies, medication management, physical infrastructure, information and communication technology, process management, legal matters, customer orientation, advocacy, and human resource management. These categories included 79 detailed sub-themes. Conclusion: Given the variety of challenges identified, the study offers recommendations to improve the implementation, review, and clarification of the regulations to support better management of medical tourism services in hospitals.

https://jims.mui.ac.ir/article_33337_ecf398e72d98e8060502ac6b98f1ccd4.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 44 850 2026 03 21 Microbial resistance pattern and antibiogram results in children with urinary tract infections in Shahrekord 2025; a cross-sectional descriptive-analytical study Microbial resistance pattern and antibiogram results in children with urinary tract infections in Shahrekord 2025; a cross-sectional descriptive-analytical study 100 107 33331 10.48305/jims.v44.i850.0100 FA Elham Emami Assistant Professor, Department of Paediatrics, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran 0000-0002-7573-6800 Atrin Oroojeni Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. 0000-0003-4874-9558 Panteha Oroojeni Department of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 0009-0000-3656-3145 Journal Article 2026 01 28 Background: The increasing antimicrobial resistance in pediatric urinary tract infections (UTIs) has complicated empirical treatment of these infections. This study aimed to determine the antibiotic resistance pattern and to evaluate antibiogram results in children with UTIs presenting to Hajar Hospital (Shahrekord) and Imam Ali Clinic during 2024–2025. Methods : In this cross-sectional (descriptive-analytical) study, children under 15 years of age with positive urine cultures who presented to the above centers were enrolled by census. Demographic data and antibiogram results were collected and analyzed using SPSS version 21. Chi-square and independent t-tests were used to examine associations between variables, and a p-value < 0.05 was considered statistically significant. Findings: The results showed that the prevalence of UTIs was significantly higher in females than in males. Escherichia coli was identified as the most frequent microbial agent, followed by Klebsiella species and other pathogens. The antibiotic resistance profile indicated high resistance of the pathogens to cotrimoxazole (63.3%) and ciprofloxacin (39%). Relatively high resistance was also observed to cefotaxime (64%) and ceftriaxone (36.8%). In contrast, the highest antibiotic susceptibilities were seen for imipenem (3.6% resistance), nitrofurantoin (1.9% resistance), and amikacin (0% resistance). A statistically significant association was also found between constipation and the occurrence of UTIs. Conclusion : The findings underscore the need to revise empirical treatment protocols for pediatric UTIs, to continuously monitor microbial resistance, and to consider clinical risk factors such as sex and constipation. Background: The increasing antimicrobial resistance in pediatric urinary tract infections (UTIs) has complicated empirical treatment of these infections. This study aimed to determine the antibiotic resistance pattern and to evaluate antibiogram results in children with UTIs presenting to Hajar Hospital (Shahrekord) and Imam Ali Clinic during 2024–2025. Methods : In this cross-sectional (descriptive-analytical) study, children under 15 years of age with positive urine cultures who presented to the above centers were enrolled by census. Demographic data and antibiogram results were collected and analyzed using SPSS version 21. Chi-square and independent t-tests were used to examine associations between variables, and a p-value < 0.05 was considered statistically significant. Findings: The results showed that the prevalence of UTIs was significantly higher in females than in males. Escherichia coli was identified as the most frequent microbial agent, followed by Klebsiella species and other pathogens. The antibiotic resistance profile indicated high resistance of the pathogens to cotrimoxazole (63.3%) and ciprofloxacin (39%). Relatively high resistance was also observed to cefotaxime (64%) and ceftriaxone (36.8%). In contrast, the highest antibiotic susceptibilities were seen for imipenem (3.6% resistance), nitrofurantoin (1.9% resistance), and amikacin (0% resistance). A statistically significant association was also found between constipation and the occurrence of UTIs. Conclusion : The findings underscore the need to revise empirical treatment protocols for pediatric UTIs, to continuously monitor microbial resistance, and to consider clinical risk factors such as sex and constipation.

https://jims.mui.ac.ir/article_33331_1975727c448e45ab391dcef95c06b788.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 44 850 2026 03 21 Effect of DNS Exercises on the Electromyographic Amplitude of Lumbo-Pelvic-Hip Complex Muscles in Athletes with Lumbopelvic Movement Dysfunction Syndrome and Foot Pronation During Stair Task Effect of DNS Exercises on the Electromyographic Amplitude of Lumbo-Pelvic-Hip Complex Muscles in Athletes with Lumbopelvic Movement Dysfunction Syndrome and Foot Pronation During Stair Task 108 117 33270 10.48305/jims.v44.i850.0108 FA Shirin Aali Assistant Professor, Department of Physical Education, Farhangian University, Tehran 0000-0002-8148-1883 Farhad Rezazadadeh Assistant Professor, Department of Sports Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran 0009-0003-4190-935X Hamed Sheikhalizadeh PhD in Sports Biomechanics, Department of Sports Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran 0000-0002-5788-4447 Nastaran Moradzade PhD student, Department of Sports Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran 0009-0005-6483-0024 Marjan Zariian PhD in Information Science and Epistemology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-7353-6418 Parsa Forghani Kinesiology Student, York University, Toronto, Ontario, Canada 0009-0006-0522-2755 Journal Article 2026 02 01 Background: The stair task is a common daily motor activity that can have positive or negative effects on low back pain. The presence of lumbopelvic movement dysfunction syndrome combined with foot pronation may alter the electrical activity pattern of lower limb muscles. This study aimed to determine the effect of a dynamic neuromuscular stability training program on changes in the electromyographic activity amplitude of selected lower limb muscles in athletes with lumbopelvic movement dysfunction syndrome and foot pronation during the stair task. Methods: In this randomized controlled trial, 28 athletes with a mean age of 24.26±1.37 years suffering from lumbopelvic movement dysfunction syndrome with foot pronation participated. Participants were divided into two groups of 14: an intervention group and a control group. Surface electromyographic activity of eight selected muscles (Tibialis Anterior, Gastrocnemius, Vastus Medialis, Vastus Lateralis, Rectus Femoris, Semitendinosus, Biceps Femoris, and Gluteus Medius) was recorded and calculated during stair ascent and descent. Findings: Significant differences were found between groups for time effects on Gastrocnemius (P=0.032) and Gluteus Medius (P=0.009) during stair ascent, and on Rectus Femoris (P=0.001) during descent. Group effects were significant for Rectus Femoris (P=0.009) during descent, and time×group interaction was significant for Semitendinosus (P=0.001) during ascent. Conclusion: Dynamic neuromuscular stability exercises may improve the activation pattern of some key lower limb muscles in athletes with lumbopelvic movement dysfunction syndrome and foot pronation during functional activities such as stair ascent and descent. Background: The stair task is a common daily motor activity that can have positive or negative effects on low back pain. The presence of lumbopelvic movement dysfunction syndrome combined with foot pronation may alter the electrical activity pattern of lower limb muscles. This study aimed to determine the effect of a dynamic neuromuscular stability training program on changes in the electromyographic activity amplitude of selected lower limb muscles in athletes with lumbopelvic movement dysfunction syndrome and foot pronation during the stair task. Methods: In this randomized controlled trial, 28 athletes with a mean age of 24.26±1.37 years suffering from lumbopelvic movement dysfunction syndrome with foot pronation participated. Participants were divided into two groups of 14: an intervention group and a control group. Surface electromyographic activity of eight selected muscles (Tibialis Anterior, Gastrocnemius, Vastus Medialis, Vastus Lateralis, Rectus Femoris, Semitendinosus, Biceps Femoris, and Gluteus Medius) was recorded and calculated during stair ascent and descent. Findings: Significant differences were found between groups for time effects on Gastrocnemius (P=0.032) and Gluteus Medius (P=0.009) during stair ascent, and on Rectus Femoris (P=0.001) during descent. Group effects were significant for Rectus Femoris (P=0.009) during descent, and time×group interaction was significant for Semitendinosus (P=0.001) during ascent. Conclusion: Dynamic neuromuscular stability exercises may improve the activation pattern of some key lower limb muscles in athletes with lumbopelvic movement dysfunction syndrome and foot pronation during functional activities such as stair ascent and descent.

https://jims.mui.ac.ir/article_33270_1e63c54b315e95a1dc1d01d4dfc6e272.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 44 850 2026 03 21 Comparative Evaluation of the Efficacy of Injectable Dexamethasone and Oral Tamsulosin Versus Oral Tamsulosin Alone on Pain Reduction in Ureteral Stones Smaller Than 1 cm: A Double-Blind Randomized Controlled Trial Comparative Evaluation of the Efficacy of Injectable Dexamethasone and Oral Tamsulosin Versus Oral Tamsulosin Alone on Pain Reduction in Ureteral Stones Smaller Than 1 cm: A Double-Blind Randomized Controlled Trial 118 123 33336 10.48305/jims.v44.850.0118 FA Reza Kazemi Department of Urology, Alzahra Hospital, School of Medicine Isfahan University of Medical Sciences, Reproductive Sciences and Sexual Health Research Center, Isfahan, Iran 0000-0001-8993-6670 Nazanin Omidi Department of gynecology, Alzahra Hospital, School of Medicine Isfahan University of Medical Sciences, Isfahan, Iran Maede Amiryousefi Department of Urology, Alzahra Hospital, School of Medicine Isfahan University of Medical Sciences, Isfahan, Iran Narjes Saberi Assistant Professor, Department of Urology, Alzahra Hospital, School of Medicine Isfahan University of Medical Sciences, Isfahan, Iran 0000-0003-3697-6331 Journal Article 2026 02 09 Background: Distal ureteral stones <10 mm are a frequent cause of emergency urological visits. Medical expulsive therapy (MET) with alpha-blockers such as tamsulosin is commonly used, yet adjunctive anti-inflammatory agents may enhance efficacy. This study evaluated whether adding intramuscular dexamethasone to oral tamsulosin improves stone expulsion outcomes compared to tamsulosin monotherapy. Methods: In this double-blind, parallel-group randomized controlled trial, 110 adults with symptomatic distal ureteral stones ≤10 mm confirmed by non-contrast CT were randomized 1:1 to receive either oral tamsulosin 0.4 mg daily plus intramuscular dexamethasone 8 mg weekly (intervention group, n = 55) or oral tamsulosin plus intramuscular normal saline placebo (control group, n = 55). Treatment continued for up to 14 days or until stone passage. The primary outcome was stone expulsion rate by day 14 analgesic use (diclofenac suppositories). Findings: A total of 104 patients (52 per group) completed the trial. Mean time to expulsion was significantly shorter with dexamethasone (2.91 ± 1.56 vs 4.09 ± 1.58 days; P = 0.001). The intervention group required fewer diclofenac suppositories (2.38 ± 1.36 vs 3.42 ± 0.82; P < 0.001) and lost fewer work days (2.62 ± 2.05 vs 4.10 ± 2.15; P = 0.001). Conclusion: Weekly intramuscular dexamethasone combined with daily oral tamsulosin significantly improved stone expulsion rate, reduced analgesic use, and minimized work absence compared to tamsulosin alone, supporting its role as an enhanced MET strategy for distal ureteral stones <10 mm. Background: Distal ureteral stones <10 mm are a frequent cause of emergency urological visits. Medical expulsive therapy (MET) with alpha-blockers such as tamsulosin is commonly used, yet adjunctive anti-inflammatory agents may enhance efficacy. This study evaluated whether adding intramuscular dexamethasone to oral tamsulosin improves stone expulsion outcomes compared to tamsulosin monotherapy. Methods: In this double-blind, parallel-group randomized controlled trial, 110 adults with symptomatic distal ureteral stones ≤10 mm confirmed by non-contrast CT were randomized 1:1 to receive either oral tamsulosin 0.4 mg daily plus intramuscular dexamethasone 8 mg weekly (intervention group, n = 55) or oral tamsulosin plus intramuscular normal saline placebo (control group, n = 55). Treatment continued for up to 14 days or until stone passage. The primary outcome was stone expulsion rate by day 14 analgesic use (diclofenac suppositories). Findings: A total of 104 patients (52 per group) completed the trial. Mean time to expulsion was significantly shorter with dexamethasone (2.91 ± 1.56 vs 4.09 ± 1.58 days; P = 0.001). The intervention group required fewer diclofenac suppositories (2.38 ± 1.36 vs 3.42 ± 0.82; P < 0.001) and lost fewer work days (2.62 ± 2.05 vs 4.10 ± 2.15; P = 0.001). Conclusion: Weekly intramuscular dexamethasone combined with daily oral tamsulosin significantly improved stone expulsion rate, reduced analgesic use, and minimized work absence compared to tamsulosin alone, supporting its role as an enhanced MET strategy for distal ureteral stones <10 mm.

https://jims.mui.ac.ir/article_33336_da32d205fc113251e52c40213cf9a78d.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 44 850 2026 03 21 Interventions and Effective Strategies in Managing Fatigue in Patients with Multiple Sclerosis: A Review Study Interventions and Effective Strategies in Managing Fatigue in Patients with Multiple Sclerosis: A Review Study 124 133 33329 10.48305/jims.v44.i850.0124 FA Alireza Hasan Zadeh Sureshjani Nursing Student, Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran 0009-0003-9913-6193 Alireza Seyfiardali MSc Student in Medical-Surgical Nursing, Student Research Committee, Najafabad Branch, Islamic Azad University, Najafabad, Iran 0009-0007-4301-6300 Reza Ahmadi Deh Kohneh Nursing Student, Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran 0009-0007-6016-8162 Amir Hossein Aghaei Medical Student, Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran 0009-0001-2450-3468 Alireza Hashemi Shahreki Nursing Student, Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran 0009-0002-8359-431X Fatemeh Aliakbari Associate Professor, Department of Nursing, Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran 0000-0002-4416-9786 Journal Article 2025 03 09 Background: Fatigue is one of the most disabling and common symptoms in patients with Multiple Sclerosis (MS). In the context of this narrative review, efforts have been directed to establish effective non-pharmacologic, pharmacologic, and nursing intervention in the management of MS fatigue Methods: A comprehensive search across various databases was conducted using customized strategies and keywords for each platform. Articles satisfying the inclusion criteria up to 2024 were included, and 58 appropriate articles were included in this narrative review. Findings: It was found that non-pharmacologic interventions included physiotherapy, regular exercise, psychological counseling, sleep management, and healthy nutrition,. Pharmacologic approaches such as use of stimulants and antidepressants were also found to be effective in minimizing fatigue. Conclusion: Fatigue has been defined legally as decreased capacity to do after effort or mental and is very prevalent among MS patients. Fatigue Severity Scale (FSS), Fatigue Impact Scale (FIS), and Unidimensional Fatigue Impact Scale (U-FIS) are the most frequently used fatigue rating scales. Amantadine, fampridine, aspirin, modafinil, and methylphenidate are usually prescribed by physicians to reduce fatigue in MS patients. The patient needs to be taught by the nurses regarding the potential side effects and needs to be watched carefully. Music therapy, meditation, yoga, sleep hygiene, subsequently followed strictly by diet by it, and depression and stress management are some of the non-pharmacologic measures that also diminish the fatigue. Intervention for fatigue and studies of the effect of nursing intervention on long-term MS patient alleviation of fatigue are definitely the cry of the day. Background: Fatigue is one of the most disabling and common symptoms in patients with Multiple Sclerosis (MS). In the context of this narrative review, efforts have been directed to establish effective non-pharmacologic, pharmacologic, and nursing intervention in the management of MS fatigue Methods: A comprehensive search across various databases was conducted using customized strategies and keywords for each platform. Articles satisfying the inclusion criteria up to 2024 were included, and 58 appropriate articles were included in this narrative review. Findings: It was found that non-pharmacologic interventions included physiotherapy, regular exercise, psychological counseling, sleep management, and healthy nutrition,. Pharmacologic approaches such as use of stimulants and antidepressants were also found to be effective in minimizing fatigue. Conclusion: Fatigue has been defined legally as decreased capacity to do after effort or mental and is very prevalent among MS patients. Fatigue Severity Scale (FSS), Fatigue Impact Scale (FIS), and Unidimensional Fatigue Impact Scale (U-FIS) are the most frequently used fatigue rating scales. Amantadine, fampridine, aspirin, modafinil, and methylphenidate are usually prescribed by physicians to reduce fatigue in MS patients. The patient needs to be taught by the nurses regarding the potential side effects and needs to be watched carefully. Music therapy, meditation, yoga, sleep hygiene, subsequently followed strictly by diet by it, and depression and stress management are some of the non-pharmacologic measures that also diminish the fatigue. Intervention for fatigue and studies of the effect of nursing intervention on long-term MS patient alleviation of fatigue are definitely the cry of the day.

https://jims.mui.ac.ir/article_33329_4a59a8ea539613e156495fe26f8e64cd.pdf