Baqiyatallah University of Medical SciencesInternational Journal of Medical Reviews2345-525X13220260601The Impact of Renal Rehabilitation Programs on Clinical Outcomes in Hemodialysis Patients: A Systematic Review1098111024853610.30491/ijmr.2025.538271.1345ENBaharehMahmoudiShahid Beheshti University of Medical Sciences, Tehran, IranMarziehPazokianDepartment of Medical-Surgical Nursing, Shahid Beheshti University of Medical Sciences, Tehran, IranNazaninNazariShahid Beheshti University of Medical Sciences, Tehran, IranJournal Article20250731Introduction: Chronic kidney disease (CKD) is a global health challenge, with rising numbers of patients requiring hemodialysis. Optimizing dialysis adequacy, fluid control, and cognitive function is essential for improving quality of life. This systematic review evaluates the impact of renal rehabilitation programs on these outcomes.<br>Methods: We systematically searched PubMed, Scopus, Web of Science, and SID for studies (2015–2025) assessing nutritional counseling, physical exercise, or cognitive training in hemodialysis patients. Irrelevant papers and non-systematic reviews were excluded. Twenty-three eligible articles were analyzed.<br>Results: Out of 1,246 records initially retrieved, 23 studies met the inclusion criteria. Renal rehabilitation interventions consistently improved dialysis adequacy (Kt/V, urea reduction ratio), enhanced fluid control (reduced interdialytic weight ga in, improved blood pressure stability), and ameliorated cognitive function (measured by validated neuropsychological scales). Nutritional counseling was particularly effective in reducing fluid overload, while structured exercise programs demonstrated the most robust impact on overall physical performance and dialysis efficiency. Cognitive training showed promising but less consistent results due to limited sample sizes and methodological heterogeneity.<br>Conclusion: Multifaceted renal rehabilitation programs significantly improve clinical outcomes in hemodialysis patients, with physical activity providing the strongest evidence of benefit. In resource-constrained settings, prioritizing exercise-based interventions may yield the greatest clinical impact. Further large -scale, multicenter trials are required to optimize intervention protocols and confirm long-term benefits.https://www.ijmedrev.com/article_248536_08f63c6abd108e06aa8a8b3417ab3150.pdfBaqiyatallah University of Medical SciencesInternational Journal of Medical Reviews2345-525X13220260601Why Do We Grow Old: An Extensive Review1111112224853710.30491/ijmr.2026.565207.1360ENAbidNadeem NomaniClinical Research Unit (U), Goa, CCRUMBirjisFatmaDepartment of Niswan WA Qabalat, Ajmal Khan Tibbiya College, AMU, AligarhJamalAkhtarCentral Council for Research in Unani Medicine, New DelhiShahAlamRegional Research Institute of Unani Medicine, MumbaiNirmalaDevi MKRegional Research Institute of Unani Medicine, MumbaiN ZaheerAhmadCentral Council for Research in Unani Medicine, New DelhIiiJournal Article20251209Ageing is a ubiquitous and fundamental phenomenon that results from the progressive changes in the organ, which produces a decline in function. The concept of ageing is very old in the Unani system of medicine. Since the Hippocratic era (460 -370 BC), physicians have been interested in preserving the health of the elderly, extending life, and preventing age -related illnesses. Ageing is primarily influenced by lifestyle, environmental changes, dietary habits, occupation, chronic illness, psychosocial conditions. Small steps in eating — such as dividing a whole day’s diet into three to four meals — moderate exercise, and acquiring healthy habits, are a good, healthy start to a better quality of life for the elderly.<br>Ageing is a biological process that affects people at varying speeds. Aging has been defined as a general deterioration in physiological processes that leads to failure to adjust to environmental demands (for example, adaptability to stress) and eventually death.https://www.ijmedrev.com/article_248537_a9d79bdc96c7afe7c8cf7199ddb1568e.pdfBaqiyatallah University of Medical SciencesInternational Journal of Medical Reviews2345-525X13220260601The Impact of Organizational Culture and Technological Integration on Healthcare Organization Performance1123114924855810.30491/ijmr.2026.562284.1359ENMohamedHamdy ElnagarProductivity and Quality Inistitute, Arab Academy for Science, Technology and Maritime Transport – Cairo Branch, Egypt0009-0006-6558-9313ٍSamirMarzoukProductivity and Quality Institute (PQI), Arab Academy for Science, Technology and Maritime Transport (AASTMT), EgyptِAlyElshekh SeoudProductivity and Quality Institute (PQI), Arab Academy for Science, Technology and Maritime Transport (AASTMT), Egyp0000-0002-4857-2660Journal Article20251126Organizational culture and technological integration are widely recognized as critical drivers of healthcare organizational performance, particularly in the context of accelerating digital transformation. This review examines how alignment between organizational culture and technological initiatives influences performance outcomes in healthcare organizations. Drawing on empirical studies and healthcare case evidence, the review identifies four recurring barriers to effective digital transforma tion: resistance to change, financial and infrastructural constraints, interoperability challenges, and limited digital competencies among healthcare professionals. The findings indicate that healthcare organizations characterized by strong leadership engagement, adaptive cultures, and structured change-management practices achieve higher levels of technology adoption, improved operational efficiency, enhanced patient safety, and better quality of care . Importantly, the review demonstrates that technology alone does not lead to sustainable performance improvement; its effectiveness is largely shaped by organizational culture, leadership alignment, and continuous workforce development. Based on these findings, the review recommends strengthening leadership commitment, embedding formal change-management frameworks, investing in continuous staff training, and promoting cross-sector collaboration to support sustainable digital transformation. Overall, integrating cultural transformation with technological innovation is essential for building resilient, efficient, and high -performing healthcare organizations.https://www.ijmedrev.com/article_248558_9b8486d4fa9d522205fd92f82e818b2f.pdfBaqiyatallah University of Medical SciencesInternational Journal of Medical Reviews2345-525X13220260601Olivocochlear System Neurobiology and Pathophysiology in Relation to Psychiatric Disorders: A Perspective1150116124856010.30491/ijmr.2025.544342.1348ENNarmeenTourmanDepartment of Audiology and Speech Pathology, An-Najah National University, Nablus, Palestine0009-0003-0617-1919Journal Article20250831Recent research indicates an association between auditory efferent abnormalities and the core symptoms of several psychiatric disorders. Neurobiological and electroacoustic studies further implicate CNTNAP2 gene mutations in these efferent anomalies. The medial olivocochlear bundle (MOCB), originating from the periolivary region surrounding the medial superior olive, regulates outer hair cell activity and modulates basilar membrane motion, thereby influencing cochlear input transmission. Impaired neurotransmission along the MOCB or structural alterations of the medial superior olive may lead to efferent auditory dysfunctions that remain undetected by standard audiological assessments. This review explores these mechanisms in relation to auditory hallucinations, selective mutism, tinnitus, and autism spectrum disorder .https://www.ijmedrev.com/article_248560_c8560eb5ce1fbe8be30e72cd4f7e9231.pdfBaqiyatallah University of Medical SciencesInternational Journal of Medical Reviews2345-525X13220260601Screening for Down Syndrome in Pregnant Women in Anar County Using Serum Markers: Alpha-Fetoprotein, Pregnancy-Associated Plasma Protein A, and hCG1162117024856110.30491/ijmr.2026.565556.1361ENMohaddesehSoleymaniShahid Bahonar University of Kerman Master of Science in Cell and Molecular Biology Specialization: GeneticsKamranVosooDepartment of science, Faculty of biology, Payame Noor University, Qeshm, Iran0000-0001-9285-4086Journal Article20251211Introduction: Down syndrome (DS), caused by trisomy 21, is a common chromosomal abnormality associated with intellectual disability, developmental delays, and characteristic physical features. Prenatal screening enables early risk assessment and informed decision-making. Advanced maternal age is a major risk factor, highlighting the need to consider maternal age alongside biochemical and ultrasound markers. This study investigated the association between maternal age and key prenatal markers—including Pregnancy-Associated Plasma Protein A (PAPP-A), β-human Chorionic Gonadotropin (β-hCG), AlphaFetoprotein (AFP), Inhibin A, unconjugated Estriol (uE3), and Nuchal Translucency (NT)—and evaluated their contribution to Down syndrome risk stratification across maternal age groups.<br>Methods: A cross-sectional study was conducted on 138 pregnant women referred to a diagnostic laboratory in Anar County, Kerman Province. Serum markers were measured in first- and second-trimester screenings, alongside ultrasound assessment of NT. Statistical analyses, including one-way ANOVA, examined associations between maternal age, markers, NT, and estimated Down syndrome risk.<br>Results: Maternal age was significantly associated with estimated Down syndrome risk, highest among women aged 40–45 years and lowest in those aged 20–25 years. AFP and uE3 demonstrated the strongest predictive associations with risk, whereas PAPP-A, β-hCG, and NT contributed less prominently.<br>Conclusion: Combined prenatal screening using maternal serum markers and NT improves early identification of pregnancies at increased risk for Down syndrome. Integrating maternal age with biochemical screening optimizes risk stratification, especial ly in regional programs. Further multicenter studies are recommended to confirm and expand these findings .https://www.ijmedrev.com/article_248561_b1d535203b94b96ac8b7ee37a8347723.pdfBaqiyatallah University of Medical SciencesInternational Journal of Medical Reviews2345-525X13220260601Sutured Tape Pull-Through Technique in Arthroscopic Fixation of Neglected ACL Avulsion: A Technical Note1171117524856210.30491/ijmr.2025.514394.1323ENI KomangMahendra Laksana MendraOrthopaedic Surgeon Sport Consultant Wangaya Regional General Hospital, Denpasar, Bali, IndonesiaFebyanFebyanResident of Orthopaedic and Traumatology, Faculty of Medicine Udayana University, Prof. dr. I.G.N.G Ngoerah General Hospital, Denpasar, Bali, Indonesia0000-0001-9055-0361Journal Article20250329Introduction: Anterior cruciate ligament (ACL) avulsion fractures, although rare, can cause significant knee instability if untreated. High-energy trauma is the primary cause, often requiring surgical intervention for neglected cases. This case report presents a neglected ACL avulsion fracture treated with Arthroscopic Reduction Internal Fixation (ARIF) using suture tape pul lthrough.<br>Case Presentation: A 22-year-old female presented with right knee pain and instability for three months following a motorcycle accident five months earlier. Clinical examination revealed ACL instability. Plain radiographs and MRI confirmed avulsion of the tibial eminence, confirmed by plain radiographs and MRI showing avulsion of the tibial eminence with a partial tear of the posterolateral ACL bundle. The patient underwent ARIF using a suture tape pull-through technique. The avulsed fragment was anatomically reduced and fixed with a double stranded Ethibond suture and endobutton. Postoperative radiographs confirmed stable fixation. Six weeks following surgery, active range of motion was initiated, and by the end of seven weeks, the patient was gradually progressed to full weight bearing.<br>Discussion: Neglected ACL avulsion fractures pose challenges due to chronic instability. The arthroscopic approach minimizes soft tissue disruption and enhances joint visualization, which is crucial in complex cases. The suture tape pull -through technique ensures robust fixation, biomechanical stability, and preserves native alignment. This technique avoids common complications associated with traditional methods, such as implant migration or failure. Postoperative rehabilitation ensured progressive recovery, and the patient demonstrated marked improvement in stability and function.<br>Conclusion: ARIF using the suture tape pull-through technique is an effective, minimally invasive approach for managing neglected ACL avulsion fractures. This case underscores its utility in ensuring anatomical reduction, stable fixation, and early recovery, supporting its role as a preferred treatment option for delayed presentations .https://www.ijmedrev.com/article_248562_a4dc7b65d1a0f29b0f10b856cb621d8d.pdf