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BACKGROUND Measuring hospital performance can be undertaken in different areas including efficiency, productivity, and quality. Many studies have been conducted using several indicators in this regard. AIM This study aimed at measuring efficiency of obstetrics and gynaecology, and paediatrics departments at the public hospitals affiliated with the Palestinian Ministry of Health in 2016, 2017 and 2018. METHOD This descriptive study includes 12 hospitals; four (A-D) and eight (E-L) providing obstetrics and gynaecology, and paediatrics services, respectively. Data were collected from health annual reports for the 3-year study period. Pabon Lasso charts were drawn using Microsoft Excel 2013. RESULTS AND CONCLUSION During the 3 years, hospitals B, D and C lied in zones 3, 1 and 2, respectively. Hospital A was in Zone 4 in 2016 and 2018, but in Zone 1 in 2017. In 2016, hospitals E, F and H were in Zone 3, while, hospitals I, J, K, and L were in Zone 1. In 2017, hospital G shifted from Zone 2 to Zone 3, and backed to Zone 2 in 2018. Hospital L has moved from Zone 1 to Zone 2 in 2018, whereas other hospitals have remained in the same zones. Inefficiency in hospitals provides an important opportunity for addressing the gaps in a quality and less costly manner. Emphasis antenatal care in primary healthcare is important. Further researches are required to cover other types of hospitals through employing frontier techniques of efficiency measurement.

Background Food Insecurity (FI) is a global health concern. For the first time, this study evaluated households’ food insecurity and factors related to it in Golestan province, North of Iran. Methods This cross-sectional study was conducted on 5129 randomly selected households in the Golestan Province in 2016. Sociodemographic characteristics, including age, ethnicity, household size, education level, and occupation status, were collected via interview. The prevalence and severity of food insecurity were identified by the Household Food Insecurity Access Scale (HFIAS), whose scores are between 0 and 27, with larger values indicating more severe food insecurity. The prevalence of food insecurity based on the geographical area was presented using GIS. Results Out of 5129 households, 2216 (43.21%) had food security, and 2913 (56.79%) households had food insecurity, with a Mean ± SD HFIAS score of 4.86 ± 5.95. Out of 2913 households with FI, 1526 (52.39%), 956 (32.82%), and 431 (14.79%) had mild, moderate, and severe food insecurity, respectively. Among 14 regions of the province, three regions had the most cases of food insecurity. Food insecurity (moderate or severe) was significantly associated with mothers as the household head (adjusted OR = 1.67, 95% CI: 1.03–2.70) and lower education level of the household head. Conclusion The prevalence of household food insecurity in the Golestan Province is higher than the national average. Factors such as literacy, employment status, and gender of the household head can be significantly associated with food insecurity.

BACKGROUND Hospitals have a paramount role in provision of health care services, which in turn significantly impacts the performance of any health system, especially in developing countries. AIM This study aimed to evaluate the performance of the Ministry of Health general hospitals in Gaza according to their surgical and internal medicine departments during a 3-year period (2016, 2017 and 2018) using Pabon Lasso model. METHOD This descriptive study includes the overall public general hospitals in Gaza Strip (7). Data have been collected from the officially disseminated reports, mainly about average length of stay, bed occupancy rate, and bed turnover ratio in the surgical and internal medicine departments for the study period. Pabon Lasso charts have been drawn using MS Excel 2013. RESULTS AND CONCLUSION For surgical departments, about 42.8% were efficient (zone 3) during the 3 years, while, 42.8% were inefficient (zone 1). Only one hospital was relatively efficient (zone 4) in 2017 and 2018. Regarding internal medicine departments, 28.6%-42.8% of hospitals were efficient during the study period, 14.3%-42.8% were inefficient, and 28.6%-42.8% were relatively efficient (zone 2 and 4). It is recommended to count on such type of analysis in decision-making and identify obstacles for best utilization of the available resources. Inefficiency in hospitals serves as a good opportunity for resources mobilization or innovation in demand-creating interventions, thereby, regular evaluation of resources' distribution. Further research is required by applying frontier techniques of efficiency measurement.

Background and objectives: Iran was reported in the high-risk group of World Food Security Map in 2008 .Identifying food insecurity is first step for executing interventions. Measuring household food security is its cornerstone. SAMAT System was designed to provide a variety of GIS-based reports to policy makers and managers in the field of food security. Methods and Materials: SAMAT system was developed by a team working with various specialties. The system was analyzed using Rational Unified Process methodology and after optimization and normalization process, centralized database was formed. SQL Server 2014 software was used for its implementation. SharpMap open source engine was used to render spatial data and display maps on the web, and many parts of the engine were coded specifically to meet different organizational needs. The system was designed using the WEB GIS engine. Results: SAMAT system was executed in nine provinces of the country in different periods. SAMAT dashboard provides a variety of information for executive managers. Based on demographic data, the state of food insecurity can be identified at different levels from city to village, in a variety of graphs. A spectrum from the urban distribution to the local distribution of food insecurity can be identified on the GIS map. Zooming in on different areas can help to identify more food insecure neighborhoods within the village or town, thus giving managers the priority of food insecurity interventions at the neighborhood or village level. One can view household characteristics and the results of questionnaire information . Conclusion: SAMAT system can be useful for managing food security at the national, provincial, city and even rural or urban levels. we recommend periodically prioritizing points, Identifying the provinces and re-evaluating the effectiveness of interventions through the SAMAT-based system after comprehensive implementation of food insecurity reduction

Background Cancer-related causes of death (cancer CoD) are the main etiologies of death in cancer patients. Recent increase in survival rates of cancer patients resulted in higher risk of dying from causes other than cancer, called competing causes of death (competing CoD). We aim to characterize competing CoD among cancer patients in Golestan province, Northern Iran. Methods Data on cancer incidence was obtained from the Golestan population-based cancer registry (GPCR) dataset. Data on causes of death was obtained from the Golestan death registry (GDR) dataset. Using a linkage method between the GPCR and GDR dataset, we prepared the study dataset including data on vital status and causes of death in our cancer patients. The proportions of cancer CoD and competing CoD were calculated. Multivariate logistic regression analysis was considered to assess the relationship between competing CoD and other variables. Results Overall, 4,184 cancer patients died in the study population, including 2,488 men (59.9%). Cause of death in 3,455 cases was cancer and 729 cases (17.4%) died due to competing CoD. Ischemic heart disease (40.7%) was the most common competing CoD in our population. Higher survival rate was the strongest variable related to the competing CoD (adjusted OR=1.91; 95%CI: 1.61-2.26). Residence area, age group and year of death were other indicators of competing CoD in our population. Conclusion Our results suggest high rates of competing CoD in our cancer patients. Competing CoD should be mentioned in cancer control planning both in clinical practice as well as in public health policy making. .

Sustainable Development Goals (SDGs) provide a global inclusive indicator framework for improving the population’s health, adapted to each country’s socio-political context. This study aimed to propose a national indicator framework for Iran as a reference list toward SDGs realisation in health and health-related. SDGs and three additional complementary frameworks (WHO Core Health Indicators, Action on Social Determinants of Health Core Indicators and Iranian National Health Equity Indicators) were selected to provide the theoretical base for the National Indicator Framework and to identify, compare, and select the potential indicators based on the country’s contextual needs and capacities. WHO’s “result chain pattern for heath core indicators classification” was used as a conceptual basis to facilitate identifying indicators and to link those to underlying country data systems and data gathering methods. After identifying the initial list of 181 indicators, senior informants from the Ministry of Health and Medical Education-related departments and other health-related organisations were consulted to reduce and verify the initial list. A National Indicator Framework for health monitoring in Iran has been developed to contain 101 indicators (including 12 input/ process indicators, 13 output indicators, 44 outcome indicators, and 32 impact indicators) organised within four domains of “health status”, “risk factors”, “service coverage” and “the health system”. This framework addresses the health core indicators gap identified in paragraph No. 3 under article NO.7 of the Law on Permanent Provisions of Country Development Programs. It will be used to notify policies and programs to improve the health system and population health status at the national level.

Background: We aimed to present the temporal and geographical trends in the incidence of stomach cancer in the Golestan province, a high-risk area in Northern Iran. Methods: This study was conducted on stomach cancer cases registered in the Golestan Population-based Cancer Registry (GPCR) during 2004-2016. Age-standardized incidence rates (ASRs) per 100000 person-years were calculated. The Joinpoint regression analysis was used to calculate the average annual percent changes (AAPC). We also calculated the contribution of population aging, population size and risk to the overall changes in incidence rates. Results: Overall, 2964 stomach cancer patients were registered. The ASR of stomach cancer was significantly higher in men (26.9) than women (12.2) (PP=0.02). We found a higher ASR of stomach cancer in the rural (21.4) than urban (18.1) (P=0.04) population, as well as a significant decreasing trend in its rates (AAPC=-2.14, 95% CI: -3.10to-1.17; PConclusion: We found high incidence rates as well as temporal and geographical diversities in ASR of stomach cancer in Golestan, Iran. Our results showed an increase in the number of new cases, mainly due to population size and aging. Further studies are warranted to determine the risk factors of this cancer in this high-risk population.

We aimed to present the time trends and geographical distribution of lung cancer in Golestan province, a high-risk area for pulmonary tuberculosis (TB) in Northern Iran (2004-2016).Data on incident primary lung cancers were obtained from the Golestan population-based cancer registry. The data were analyzed by CanReg-5 software to calculate the age-standardized incidence rates (ASRs). We used Joinpoint software for time trend analysis. Average annual percent changes were calculated. The contribution of population aging, population growth and risk to the overall changes in incidence of lung cancer were determined using partitioning analysis.Overall, 1829 cases of lung cancer were registered by the GPCR during 2004-2016, of which 1274 (69.7%, ASR in 2016 = 21.3) were men and 555 (30.3%, ASR in 2016 = 11.4) were women. The results of Joinpoint regression suggested a significant increasing trend in incidence of lung cancer in Golestan province during 2004 and 2016 (AAPC = 3.74; p-value = 0.01) with more prominent increasing in rural population (AAPC = 4.93; p-value0.01). The number of new cases of lung cancer increased by 131.6% (from 98 in 2004 to 227 in 2016), of which 34.1%, 22.3% and 75.3% were due to population size, population aging and risk, respectively. Hot points of lung cancer were found in western parts of the Golestan.With high incidence rates and increasing trends of lung cancer, further studies are warranted to clarify the role of TB and other risk factors on its burden in this population.

There is currently little known about the epidemiology of lymphomas in Iran. The aim of this paper is to describe the geographic and time variations in incidence rates of lymphomas in the Golestan province between 2004 and 2013.The Golestan Population-based Cancer Registry (GPCR) routinely registers primary cancer patients from all sources (e.g. pathology centers, hospitals, etc.) throughout the Golestan province. We obtained data on newly-diagnosed lymphomas in Golestan during 2004-2013 from the GPCR dataset. Crude rates and age standardized incidence (ASR) rates (per 100000) of lymphomas were estimated, joinpoint regression was used to quantify incidence trends and average annual percent changes (AAPCs) were calculated.In total, 898 new cases of lymphoma were registered in the GPCR during 2004-2013. The ASR of Hodgkin lymphoma (HL) was 1.5 and 1.1 in males and females, respectively, while corresponding non-Hodgkin lymphoma (NHL) rates were greater, at 6.5 and 3.4 in males and females, respectively. Our results indicated a significant difference in the trends of HL between males (AAPC = -3.2) and females (AAPC = 3.6, P value = 0.001). The incidence rates of lymphoma were considerably higher in the urban population (ASR = 7.3) compared to those residing in rural areas (ASR = 5.3, P value = 0.054). We also found higher incidence rates for both HL and NHL in the western parts of the Golestan province.The incidence rates of lymphoma in the Golestan province are relatively high and vary geographically, with a higher incidence observed in the western area. Such differences may reflect unknown lifestyle and environmental determinants linked to ethnic susceptibility differing between the two areas.

Introduction In recent years, platelet rich plasma (PRP) has been receiving increasing attention for the treatment of soft tissue injuries. These numerous applications have raised a great deal of questions and debate about the effectiveness of this method. This study aimed to determine the efficacy of PRP in improving sports injuries and subsequently throw some light on these controversies. Methods A systematic review of the literature and meta-analysis of results were undertaken. All related databases, such as PubMed, Cochrane Database of Systematic Reviews, DARE, and EMBASE, were searched on the use of PRP on athletes and in sports medicine. The search was conducted from June 2013 to February 2014. Results Our search retrieved 905 studies, of which 13 randomized control trials (RCT) met our inclusion criteria for systematic review and meta-analysis. All articles were appraised by Critical Appraisal Skills Program (CASP) checklist for RCT studies. The analysis of the results of pain scores and physical activity/functions did not show any superiority for PRP as opposed to the other options. Conclusions The meta-analysis showed no more effectiveness for PRP application in sports-related injuries in terms of physical function improvement and pain relief. Therefore, the extensive use of PRP for such injuries should be limited. Well-designed RCTs are needed to support the findings.

Introduction The Golestan population-based cancer registry (GPCR) was established in Golestan province, Northern Iran, within the Asian belt with predominance of upper-gastrointestinal cancers. We aimed to present the experiences of the registry in a resource–limited setting over the 10 years since its inception (2004–2013). Methods The GPCR was established as a research project to enable sustainable funding. A clear plan was developed for use of the GPCR data. New primary cancers were registered based on international standards, indices of data quality were routinely assessed and age-standardized incidence rates (ASR) per 100,000 person-years calculated using IARC’s CanReg-5 software. Results Overall, 19807 new cancer cases were registered during the study period, an average of 1981 cases per annum, with overall ASR of 175.0 and 142.4 in males and females, respectively. The GPCR data suggested gastrointestinal and breast cancers as the most common malignancies in Golestan province. We observed increasing incidence rates of breast and colorectal cancers but declining trends of esophageal cancer. Overall, indices of data quality were within acceptable ranges. Conclusions The GPCR data have been included in IARC’s Cancer Incidence in Five Continents series, were used in 21 research projects, and published as 30 research papers. The key ingredients for the successful establishment and maintenance of the GPCR included sustainable sources of funding, a clear action plan for the use of data as well as stakeholder cooperation across all areas of the registration. The GPCR may be considered as a model for planning population-based cancer registries in lesser-resourced settings.

Over 100 endophytic bacterial isolates were isolated from surface-sterilised roots of the Fabaceae family in East Azerbaijan farms. These isolates were screened for their in vitro biocontrol activity against Colletotrichum lindemuthianum by dual culture technique using potato dextrose agar (PDA) medium. Eight bacterial isolates (Bacillus subtilis subsp. subtilis, Bacillus atrophaeus, B. tequilensis, B. subtilis subsp. spizizenii, Streptomyces cyaneofuscatus, S. flavofuscus, S. parvus, S. acrimycini) showed promising inhibition on mycelial growth of C. lindemuthianum , and thus, these isolates were selected for greenhouse experiments. The disease control rate using these selected endophytic bacteria was varied from 40 to 76.80% in greenhouse without any negative effects on different growth performance, suggesting that these selected endophytic bacteria are potential to be developed as biocontrol agents.

Endophytic bacteria live inside plant tissues without causing disease and not only promote plant growth but can also protect plants against plant pathogens. During 2010–2011 crop years, some endophytic bacteria were collected and are then biochemically and molecularly identified (16srRNA) from bean farms of East Azarbaijan, Iran. Among these bacteria isolates, four isolates from Bacillus genera and four isolates from Streptomyces genera were selected for evaluation of their ability for biocontrol of Sclerotium rolfsii in laboratory and glasshouse conditions. Except one isolate named Streptomyces parvus, the rest of isolates could significantly inhibit mycelial growth in dual culture on PDA medium. All seven selected isolates showed significant inhibition in disease treatments in glasshouse experiments. Biological traits, such as length, wet and dry weight of roots and stems in endophytic bacterial treatment showed no differences with healthy control.

This study investigated preparation of nanocapsules (NCs) containing food-grade ingredients using two experimental designs: a one-factor-at-a-time method (OFATM) and an optimization method (OM). Response surface methodology (RSM) was used to optimize the process. The variables explored were concentration and type of polymer wall, using polycaprolactone (PCL) and polyethylene glycol–polybutylene adipate–polyethylene glycol (PEG–PBA–PEG) (1.0–4.0 mg) polyester triblock copolymer; food oil, using olive and avocado oil (0.5–2.0 mg); solvent, using acetone and ethyl acetate (6–12 ml); and surfactant concentration, using Tween 80 and Tween 60 (1–5 mg). The optimum conditions to obtain NCs were found to be 2.0 mg of PCL and 1.65 mg of PEG–PBA–PEG, olive oil (0.5 and 0.88 mg), acetone (6 and 10.25 ml), and Tween 60 (3.0 and 4.25 mg), with 90.9 and 71.9 nm for OFATM and OM, respectively. This research was conducted to investigate the use of NCs in the manufacture of fruits.

An experiment was conducted in the research field of the Islamic Azad University of Karaj in 2007 to study the relationship between weed seed bank at the start of the growing season and weed populations during the growing season, as well as to study the distribution pattern of the weeds. In this experiment, seed bank sampling was carried out at the beginning of the growing season (after planting the corn crop), and sampling of the populations of weed seedlings was performed at the four-leaf stage, at the 8 – 10 leaf stage, and at tussle formation, in 96 places using the networking method. Then, on the basis of the abundance of weed seeds in the soil and the seedlings germinated at different sampling stages, the relationship between seed bank and seedling populations was investigated; and it was found that there is a significant relationship between seed bank at the start of the growing season and the population of weed seedlings during the growing season. The greatest correlation (r=0.83) was that between Flora 1 and the seed bank, indicating that weed density at this stage (the four-leaf stage of corn) was at its maximum, and that it was the best time for weed control. Next, the field was mapped with the help of the GS+ (GS plus) software, and the isotropic and anisotropic diagrams of each of the species were plotted with the help of semi-variogarms. Results obtained showed that the distribution pattern of weed species in the field was patchy, with different species having different patch diameters. Finding the correlation between seeds and floras makes it possible to determine the best time for weed sampling and weed control.

In order to compare sampling methods for estimating the populations of the seed bank and the populations of weed seedlings during the growing season in the field, an experiment was conducted in the research field of the Agriculture college of Karaj in the cropping year of 2007. In this experiment, sampling of the seed bank was carried out first at the start of the growing season. Then, during the growing season, the weed populations were sampled in 96 points using the networking method, and their means were considered as the base and the real means of the populations of the weeds. Next, to compare other methods with the networking method, sampling was carried out using the systematic, the diagonal, and the random methods, and then the variance of error of each method was calculated and compared with that of the networking method in the format of factorial using a completely randomized design. The first factor studied, the species of weeds, included the three species of grasses, Amaranthus, and Portulaca. The zigzag, the diagonal, and the random sampling methods constituted the second factor. Results relating to the seed bank and those concerning the populations of the weeds were different from each other. The results obtained showed that the suitable method for each species differed according to the different distribution patterns of the weed species in the field. In the seed bank, there were no significant differences among sampling methods for any of the species, but the random method for grasses and Portulaca showed the least error in predicting weed populations. Altogether, among the sampling methods used for Amaranthus, there were no differences in accuracy. Concerning the populations of weed seedlings, the random method for broadleaf weeds (Amaranthus and Portulaca), and the zigzag method for grasses, were the best. As for the seed bank, the variance of error of all the methods decreased with an increase in the number of samples taken; and when more than 15 samples were taken, this trend of decrease in the variance of error stabilized and no more reduction in error was observed. Regarding the populations of the weeds, no trend was found between the number of samples taken and the variance of error.