2023 Impact Factor: 1.3
2023 CiteScore: 2.2
pISSN: 2251-6085
eISSN: 2251-6093
Chairman & Editor-in-Chief:
Dariush D. Farhud, MD, Ph.D., MG.
This journal is a member of, and subscribes to the principles of, the Committee on Publication Ethics (COPE). 
Vol 42 No 6 (2013)
Articles
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Information about Chronic obstructive pulmonary diseases (COPD)-related health resources allocation in China is very limited. The aim of the study was to explore the distribution of COPD-related health resources allocation among different levels public hospitals (PHs) in Hunan Province of central south China.We randomly collected data from 57 Public Hospitals (PHs) at 3 different levels in Hunan province as well as 893 pulmonary physicians (PPs) who worked there in 2009. Questionnaires based on the recommendations of COPD guideline were designed, including availability of spirometers, inhaled agents for COPD and COPD-related health education for local residents, as well as PPs' educational levels.Spirometers equipped ratio in 3(rd) level PHs was much higher than 1(st), 2(nd) PHs. The disparity varied vastly form 0% to 100%. The inhaled agents equipped ratio was 5.56%, 70.85% and 100% respectively for the 1(st), 2(nd) and 3(rd) levels PHs. No 1(st) level PHs launched COPD-related healthcare education for local residents, only 10 of 24 for the 2(nd) level PHs and 10 of 15 for the 3(rd) level PHs. PPs of high educational levels concentrate in 3(rd) levels PHs, however, PPs working in 1(st) levels PHs and 2(nd) levels PHs were mainly low and median educational levels PPs' knowledge of COPD of 3(rd) levels PHs was much better than of 1(st) levels PHs and 2(nd) levels PHs.The extreme imbalance and disparity existed in COPD-related health resources allocation at three levels PHs in central south China. Inequity and insufficient in COPD-related health resources in 1(st) and 2(nd) levels PHs should be improved.
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The present study was designed in quasi-experiment to assess adoption of the essential clauses of particular clinical laboratory quality management requirements based on international organization for standardization (ISO 15189) in hospital laboratories and to evaluate the cost effectiveness of compliance to ISO 15189.The quality management intervention based on ISO 15189 was conceded through three phases; pre - intervention phase, Intervention phase and Post-intervention phase.In pre-intervention phase the compliance to ISO 15189 was 49% for study group vs. 47% for control group with P value 0.48, while the post intervention results displayed 54% vs. 79% for study group and control group respectively in compliance to ISO 15189 and statistically significant difference (P value 0.00) with effect size (Cohen's d) of (0.00) in pre-intervention phase and (0.99) in post - intervention phase. The annual average cost per-test for the study group and control group was 1.80 ± 0.25 vs. 1.97 ± 0.39, respectively with P value 0.39 whereas the post-intervention results showed that the annual average total costs per-test for study group and control group was 1.57 ± 0.23 vs 2.08 ± 0.38, P value 0.019 respectively, with cost-effectiveness ratio of (0.88) in pre -intervention phase and (0.52) in post-intervention phase.The planned adoption of quality management requirements (QMS) in clinical laboratories had great effect to increase the compliance percent with quality management system requirement, raise the average total cost effectiveness, and improve the analytical process capability of the testing procedure.
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The most common geriatric psychiatric disorder is depression, known to be a multi factorial disorder. However, the influence of common preventable factors is yet to be discovered. This study was designed to evaluate the prevalence of depression and some possible risk factors in elderly residents of nursing homes in Iran.Data on demographic characteristics, nutritional and health status of 244 residents aged 60 years or older were collected from seventeen nursing homes in Tehran, Iran, during 2010 to 2012. Depression was assessed and classified according to the 15-item GDS. Univariate and then multivariate complex sample survey ordinal regression analysis was performed to investigate the association between depression and the risk factors.The average age of the 244 cases studied was 75.8 (±8.7) years, 53.3% were female (of whom 74.2% were housewives), 43.4% illiterate, and 32.0% were divorced or were living separately. The percentages of non-depressed, mild, moderate and severe depression were 9.8%, 50.0%, 29.5% and 10.7%, respectively. Multivariate analysis showed that dissatisfaction with personnel of nursing homes and food quality had odds ratios of 2.91 (1.33-6.36) and 2.64 (1.44-4.87), corresponding to greater odds of having a higher grade depression. Moreover, those who rested or walked had significantly higher risk of a more severe depression in comparison with those who did not (OR of 2.25 (1.50-3.38) and 1.98 (1.24-3.18), respectively), however, studying had a protective odds ratio of 0.17 (0.13-0.22).Depression was very common in our sample and their lifestyle influenced its prevalence.
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This longitudinal study aims to examine the relationships between the perception of parental style, hope, self-esteem and Eysenck's psychoticism dimension throughout the span of four years.The sample was composed of 884 students from the Wollongong Youth Study, which commenced when students entered high school. During the course of the 4 years of the study, each participant completed the test booklets each time data was collected. Data was analyzed using one way ANOVA, Post-hoc test, Repeated Measurement, Pearson and Partial Correlation and General Linear Model in order to provide the aims of the study.The mean score of hope and self-esteem among adolescents from authoritative parents were higher from permissive and authoritarian families while the hope with a permissive perception were lower than those with authoritarian, and self-esteem was lower in the authoritarian group compared to the permissive group. Children with a permissive perception reported higher psychoticism compared to the two other. Significant correlations were found between authoritative perception and hope, self-esteem and psychoticism. Finally, hope, self-esteem and psychoticism showed a significant inter correlation in all of the parental styles.Adolescents with the perception of each kind of parental style showed significant between group differences in psychological well-being throughout the four years of the study.
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One of the methods used in the analysis of data related to diseases, and their underlying reasons is drawing geographical map. Mapping diseases is a valuable tool to determine the regions of high rate of infliction requiring therapeutic interventions. The objective of this study was to investigate obesity pattern in Iran by drawing geographical maps based on Bayesian spatial model to recognize the pattern of the understudy symptom more carefully.The data of this study consisted of the number of obese people in provinces of Iran in terms of sex based on the reports of non-contagious disease's risks in 30 provinces by the Iran MSRT disease center in 2007. The analysis of data was carried out by software R and Open BUGS. In addition, the data required for the adjacency matrix were produced by Geo bugs software.The greatest percentage of obese people in all age ranges (15-64) is 17.8 for men in Mazandaran and the lowest is 4.9 in Sistan and Baluchestan. For women the highest and lowest are 29.9 and 11.9 in Mazandaran and Hormozgan, respectively. Mazandaran was considered the province of the greatest odds ratio of obesity for men and women.Recognizing the geographical distribution and the regions of high risk of obesity is the prerequisite of decision making in management and planning for health system of the country. The results can be applied in allocating correct resources between different regions of Iran.
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The Ministry of Health, Treatment and Medical Education of Iran has recently announced an estimated figure of 200,000 injecting drug users (IDUs). The aim of this study was to pilot a national program using demographics, types of drug abuse and prevalence of blood-borne infections among IDUs.In order to elicit data on demographics, types of drug abuse and prevalence of blood-borne infections among IDUs, a questionnaire was designed in the Bureau of Mental-Social Health and Addiction in collaboration with Iran's Drug Control Headquarters of the Police Department. Therapeutical alliance of addiction in Shafagh Center was based on Methadone Maintenance Therapy (MMT).Among 402 reported IDUs most of them were male, single and in age range of 20 to 39 years old with 72.7% history of imprisonment. Most of them had elementary and high school education and a history of addiction treatment. The majority were current users of opioid, heroin and crack. The prevalence of blood-borne infections was 65.9% and 18.8% for HCV and HIV/AIDS infections, respectively.Prevention programs about harm reduction, treatment and counseling should include young IDUs as a core focus of their intervention structure.
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Ethical consideration is a basic requirement for design of randomized clinical trials. The purpose of this study was to assess whether reports of Iranian dental clinical trials complied with the requirements of the ethical principles of human research.In this retrospective observational study electronic search was performed to identify all dental clinical trials published between 2001 and 2011. Each trial report was assessed for inclusion of a statement that 17 items about research ethics.Totally 242 papers were identified, of which 15.3%, stated that ethical approval had been obtained and 50.4% of the trial reports indicated that informed consent had been obtained. The mean ethical score for the mentioned studies was 7/68 out of 17.Most Iranian dental clinical trial reports failed to consider important ethical principles. The reporting of the ethical issues associated with these trials could be improved further not only by the instructions to authors, but also by Journal editors refusing to publish trials that do not comply.
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This study was conducted to investigate the effects of Brewer's yeast supplementation on serum lipoproteins and blood pressure in patients with Type 2 diabetes mellitus.In a randomized double blind clinical trial, 90 adults with type 2 diabetes mellitus were recruited, and divided randomly into 2 groups, trial group received brewer's yeast (1800 mg/day) and control group received placebo for 12 weeks. Weight, BMI, food consumption (based on 24 hour food recall), fasting serum lipoproteins (Cholesterol, Triglyceride, LDL-c, HDL-c), systolic and diastolic blood pressures were measured before and after the intervention. Data analyses were performed by Statistical Package for Social Sciences ver. 18.0, and the statistical tests included Independent t-test, Paired t-test, Kolmogorov-Smirnov and analysis of covariance. This trial was registered in Iranian Registry of Clinical Trials (IRCT), No.IRCT138807062513N1.Eighty-four subjects (21 men and 63 women) aged 46.3±6.1 years completed the study. After 12 weeks supplementation, systolic and diastolic blood pressures were decreased in the group receiving brewer's yeast (4.1±1.5, P=0.007 and 5.7±0.6, P=0.001 respectively). No-significant changes in LDL-c, HDL-c, Triglyceride and Cholesterol were shown.Supplementation with Brewer's yeast besides the usual treatment of type 2 diabetes mellitus can reduce systolic and diastolic blood pressures in diabetic patients.
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European Foundation for Quality Management (EFQM) model is a widely used quality management system (QMS) worldwide, including Iran. Current study aims to verify the quality assessment results of Iranian National Program for Hospital Evaluation (INPHE) based on those of EFQM.This cross-sectional study was conducted in 2012 on a sample of emergency departments (EDs) affiliated with Tehran University of Medical Sciences (TUMS), Iran. The standard questionnaire of EFQM (V-2010) was used to gather appropriate data. The results were compared with those of INPHE. MS Excel was used to classify and display the findings.The average assessment score of the EDs based on the INPHE and EFQM model were largely different (i.e. 86.4% and 31%, respectively). In addition, the variation range among five EDs' scores according to each model was also considerable (22% for EFQM against 7% of INPHE), especially in the EDs with and without prior record of applying QMSs.The INPHE's assessment results were not confirmed by EFQM model. Moreover, the higher variation range among EDs' scores using EFQM model could allude to its more differentiation power in assessing the performance comparing with INPHE. Therefore, a need for improvement in the latter drawing on other QMSs' (such as EFQM) strengths, given the results emanated from its comparison with EFQM seems indispensable.
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Congenital toxoplasmosis is associated with variable complications including encephalitis, microcephaly, hydrocephaly, hepatitis, lymphadenopathy and even intrauterine death. Presence of Toxoplasma gondii in human placenta may induce congenital infection. The aim of this study was to determine the genotypes of Toxoplasma gondii infection in human spontaneous aborted fetuses in Shiraz, south of Iran.Five hundred and forty two paraffin-embedded blocks of aborted placenta were collected, from two university-affiliated hospitals in Shiraz. Occurrence of spontaneous abortion was confirmed by examine of the slides. After re-cutting of the blocks and dewaxing, semi-nested PCR assay was used to detect the fragments of T. gondii B1 gene in the samples. Also direct molecular genotyping was performed on positive samples with Restriction Fragment Length Polymorphism-PCR analysis on the SAG2 gene.Among the 542 tissue samples, the B1 gene was amplified from 78 (14.4%) of cases with the semi nested PCR and typed by RFLP. The genotype of Toxoplasma strains of 65 (out of 78) PCR-positive samples were evaluated and 54 out of 65 (83.1%) were found to be type II and 11 out of 65 (16.9%) were type I.Considering the high level of Toxoplasma infection in aborted fetuses in this study, Toxoplasma might largely contribute to spontaneous abortion in this area of Iran.
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Maternal nutritional is the most important environmental factor influencing pregnancy outcome. While studies showed association between maternal iron-micronutrient deficiencies with pregnancy outcome, data examining impact of micronutrient supplementation on growth rate beyond birth are sparse. Present study examined the relationship between iron and multivitamins supplementation on growth rate of babies up to age of 18 month.This study was a statistical analysis on data recorded through a routine procedure in health houses from 1994 to 2007. Subjects were selected by a two-stage randomization method and required data extracted from the records. Analyses were performed using STATA 10 software.Data was collected for 3835 pairs of mother-baby. Mothers received 61.7±5.4 and 115.6±53.8 multivitamins and iron tablets, respectively. Analyses showed significant relationship between children's weight and height at birth with iron supplementation and children's height at 6, 12 and 18 month with multivitamins supplementation.Mechanisms of these effects are unclear but it is safe to suggest supplementation during pregnancy is necessary.
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Iran's health system is expanding the disaster and emergency higher education programs over the country to enhance the capacity of human resources for effective and efficient disaster mitigation, preparedness, response and recovery. In this article we present an overview about the initiatives and progress of disaster and emergency health higher education in Iran. Following the Bam earthquake, in collaboration with the Ministry of Health & Medical Education and National Institute of Health Research, School of Public Health at the Tehran University of Medical Sciences, Iran took the initiative to develop a Master of Public Health (MPH) with disaster concentration in 2006, a PhD in disaster and emergency health in 2011, and a well constructed certificate course in 2008 entitled Disaster Health Management and Risk Reduction (DHMR). Iran, Kerman and Shahid Beheshti Universities of Medical Sciences and University of Social Welfare and Rehabilitation are other academia that joined this initiative. Regarding the importance of programs evaluation, we have planned for a comprehensive evaluation of MPH and DHMR programs in 2013-4 and the Accreditation and Evaluation Board of Disaster & Emergency Health, based in MOH&ME, is responsible for evaluation of the PhD program in 3-5 years from initiation.
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Melamine is a new risk of urinary stones. Gansu province is a heavily affected area and has large population and underdeveloped economy. We hypothesized that number of family members and family income may play significant roles in the formation of urinary stones. A case-control study was performed among 190 infants. Results showed that the case group had less numbers of family members than the control (4.4 vs. 5.6, respectively). The multivariate logistic regression analysis indicated that number of family members was an independent influencing factor associated with urinary stones (OR, 0.606; 95% CI, 0.411-0.893; P = 0.011). Family income, however, did not exhibit a significant difference. Observed results suggested that number of family members was a new and significant influencing factor to affect the risk of melamine-associated urinary stones.
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