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Abstract Background Nursing students are faced with a variety of challenges that demand effective cognitive and emotional resources. The physical and psychological well-being of the students plays a key part in the public health of the community. Despite the special lifestyle of nursing students, few studies have addressed chronic pain in this population. Accordingly, the present study aims to identify the predictors of chronic pain among nursing students. Methods This cross-sectional study was conducted on 1,719 nursing students aged 18–42 years, between February and November 2019. Sampling was carried out in several stages. Data were collected using seven instruments, namely a demographics survey, the characteristics of chronic pain form, Spielberger State-Trait Anxiety Inventory (STAI), the Patient Health Questionnaire-9 (PHQ-9), the Bar-on Emotional Quotient Inventory, Academic Satisfaction Scale, and Procidano and Heller Social Support Scale. Descriptive statistics, multinomial logistic regression, and regression models were used to describe the characteristics of the pain and its predictive factors. Results The average age of the participants was 22.4 ± 2.96 years. The results of univariate analysis showed that gender (P = 0.506), mother’s education (P = 0.056, P = 0.278, P = 0.278), father’s education (P = 0.817, P = 0.597, P = 0.41), place of residence (P = 0.215), depression (P = 0.501), grade point average (P = 0.488), academic satisfaction (P = 0.183) and chronic pain weren’t significantly correlated with chronic pain in nursing students. The results of the multiple logistic regression models showed that chronic pain was positively correlated with age, social support, state anxiety, and trait anxiety (OR = 1.07, 95% CI: 1.02–1.12; OR = 0.95, 95% CI: 0.93–0.97; OR = 1.03, 95% CI: 1.02–1.05; and OR = 1.97, 95% CI: 0.95–1.99; respectively). Conclusion The prevalence of chronic pain was relatively high in these students. In addition, age, social support, and anxiety could be important factors in the development or persistence of chronic pain in nursing students. The results also provided basic and essential information about the contributing factors in this area. However, consideration of factors such as referral for treatment, home medications for pain relief, and outcomes of chronic pain are suggested in future longitudinal studies.

Introduction Due to the increasing incidence of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in the world, it is necessary to examine the level of knowledge among different parts of population, especially among students, in order to establish remedial preventive interventions. Therefore, the aim of this study was to determine the knowledge, attitude, and practice of dormitory students of Shahid Sadoughi University of Medical Sciences in Yazd towards HIV/AIDS. Material and methods This descriptive, cross-sectional study was performed among 658 dormitory students of Shahid Sadoughi University of Medical Sciences in 2019, who were recruited through multistage sampling. A valid and reliable questionnaire was used to collect students' data. SPSS version 22 was employed to analyze the data. Results In total, 59.9% of students had high knowledge level. There was a significant association between students' knowledge and gender, field of study, and grade point average of the last half year. Positive/neutral attitude was observed among 77.7% of the students. Age and sex had a significant association with attitude. A total of 32 students (4.9%) had experienced extra-marital sex, and 9.4% of them were condom ever users during sexual contacts. Conclusions The results revealed relatively high knowledge and neutral to positive attitude about HIV/AIDS among dormitory students. However, preventive measures among participants with high-risk behaviors were not properly employed.

Background: Patients’ adherence to the therapeutic regimen predicts the success of treatment and reduces the complications and severity of the disease. The purpose of this study was to determine the effectiveness of an educational intervention based on Teach-back method with adherence to treatment in patients with type 2 diabetes.Methods: We performed a quasi-experimental study on 90 patients with type 2 diabetes in the control and experimental groups. Data collection tools were a two-part questionnaire which consisted of the demographic information and the Mandaloo treatment adherence questionnaire with 40 questions. An educational intervention was performed for the members of the intervention group. One week and forty days after the intervention, the two groups filled out the treatment adherence questionnaire again. The gathered data were analyzed in SPSS software version 22 using statistical tests of Wilcoxon, Chisquare, Makhli, Ben Foroni, the repeated-measures variance of analysis, and independent t-test. The significance level in this study was considered less than 0.05.Results: The mean scores of adherence to treatment in the training group before the intervention, one week, and forty days after the intervention were 120.52±11.49, 157.60±17.96, and 140.65±18.80, respectively; also, in the control group, the mean scores were 113.38±16.89, 150.67±18.58, and 145.02±18. 47, respectively. There was no difference in terms of adherence to treatment between the control and experiment groups (P=0.164).Conclusion: The findings also showed that adherence to treatment in both groups in all three measurement times was at the fitness level.

Background: Epidural hematoma (EDH) and subdural hematoma (SDH) are common complications after traumatic brain injury. Intracranial hematomas can be without complications or associated with life-threatening conditions, including midline shift, cerebral edema, intracerebral ischemia, and increased intracranial pressure. This study aimed to investigate the prevalence of EDH and SDH in patients with head trauma attending the emergency department. Materials and Methods: This descriptive cross-sectional study included 146 patients with head trauma referred to the Emergency Department of Shahid Mohammadi Hospital, Bandar Abbas, in 2021. Patients’ data, including age, gender, Glasgow Coma Scale (GCS) on admission, mechanism of trauma, type of hematoma, length of intensive care unit (ICU) stay, outcome (recovery/death), and neurosurgery requirements were extracted from their medical files. Results: The mean age of the participants was 20.97±15.05 years, of whom 114 (78.1%) were male. EDH and SDH were observed in 7.5% and 11% of patients, respectively. The most common mechanism of trauma was traffic accidents (39%), followed by falls (28.1%) and assaults (13%). Moreover, 11% of the patients needed neurosurgical intervention. Most patients recovered (95.9%), and 4.1% died. The mean GCS on admission was 13.47±2.34. Furthermore, SDH was significantly higher in the patients who died (P=0.001) and those aged≥18 years (P=0.028). Conclusion: The results of the current study showed a higher prevalence of SDH compared to that of EDH. Both hematoma types appeared to correlate with the mechanism of trauma, ICU admission, GCS on admission, and neurosurgery requirement, while SDH was associated with age and death.

Background. Feeling loneliness is a prevalent phenomenon, affecting 25-50% of the population over 65 years old. The present study aimed to investigate feeling lonely in the elderly in Iran. Methods. This review study was conducted by searching the keywords elderly, loneliness, isolation, elderly, old age, older people, and feeling loneliness. We retrieved all published cross-sectional articles in Persian and English languages from 2006 to 2021. Evaluation of the quality of the studies and data extraction was done by reading the full texts of the selected articles, using the STROBE Checklists for cross-sectional studies. Articles that had the required quality were included in the study. Results. In this research, 128 articles were found in the initial review. A total of 26 articles were included in the study after preliminary reviews. According to the studies, the average score of loneliness in the elderly was high. Also, due to the lack of social relations, the average score of loneliness in the elderly staying in nursing homes and far from their families was higher than the elderly living in the family. Conclusion. The average loneliness score among the elderly, especially those living in nursing homes, was relatively high. Creating the necessary conditions to maintain social relationships among the elderly can reduce their level of loneliness and prevent the adverse consequences of loneliness in them. Practical Implications. Considering the importance of improving the mental health of the elderly, it is recommended to strengthen the counseling of the elderly, reduce treatment costs, and also involve the elderly in daily activities and talk with a group of friends to reduce their loneliness. The results of this research can be used to improve the level of awareness of policymakers, people, and families and increase the mental health of the elderly.

BackgroundDiabetes mellitus (DM) poses a significant threat to public health, and the anticipated surge of over 100% in the age-standardized prevalence of type 2 diabetes in Iran between 2021 and 2050 underscores the pressing need for focused attention. The rationale for estimating the prevalence of type 2 diabetes in Iran becomes even more compelling when considering the potential cascading effects on the healthcare system, quality of life, and economic burden. The aim of this study was to estimate the prevalence and trends of DM from 1996 to 2023 in the Islamic Republic of Iran.MethodsUp to July 2023, without deadlines, the search for appropriate articles in Persian and English. Iranian sources including SID, Magiran, and Element were included in the databases, along with foreign ones like PubMed/MEDLINE, Web of Science, Science Direct, Embase, Scopus, ProQuest, and Google Scholar. Using the JBI quality checklist, the study’s level of quality was evaluated. Version 14 of STATA was used to carry out the statistical analysis. The Dersimonian and Liard random-effects models were used because of heterogeneity. To investigate the causes of heterogeneity, subgroup analysis and univariate meta-regression were utilized. Sensitivity analysis was then carried out to see how each study’s findings affected the final findings. The prevalence pattern over time was also followed using cumulative meta-analysis.ResultsThere were 53 studies in all, with a combined sample size of 1,244,896 people. Men were predicted to have a type 2 diabetes prevalence of 10.80% (95% CI: 9.1–12.4), while women were assessed to have a prevalence of 13.4% (95% CI: 11.6–15.3). Additionally, the prevalence of diabetes was much higher in the 55–64 age group, coming in at 21.7% (95% CI: 17.5–25.0). The anticipated prevalence of diabetes was 7.08% for 1988 to 2002, 9.05% for 2003 to 2007, 9.14% for 2008 to 2012, 15.0% for 2013 to 2017, and 13.40% for 2018 to 2023, among other time periods. Geographically, type 2 diabetes was most prevalent in Khuzestan (15.3%), followed by Razavi Khorasan (14.4%), Qazvin (14.3%), and Yazd (12.6%).ConclusionThe prevalence of type 2 diabetes was estimated at 10.8%, highlighting variations across gender, age groups, and geographic regions that underscore the necessity for specific interventions. These findings advocate for proactive measures, including tailored screening and lifestyle modification programs. The notable temporal increase from 2013 to 2017 signals the need for policymakers and healthcare practitioners to develop effective strategies, anticipating and addressing the potential future burden on the healthcare system.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023437506, identifier: CRD42023437506.

Background: Major depressive disorder (MDD) generally occurs together with depression in patients with no history of manic, mixed, or hypomanic episodes. The suicidal ideation in MDD patients is very common and can potentially be considered an emergency circumstance in many cases. Among the developed drugs and medicines, ketamine (KET) is a potential option to treat patients with MDD. This study aims at investigating the effect of KET on the treatment of suicidal ideation and the reduction of the intensity of symptoms in patients suffering from MDD. Materials and Methods: This randomized double-blind clinical trial was performed on 30 patients who suffered from MDD and had suicidal ideation at Ibn Sina Hospital, Bandar Abbas, Iran, during 2016-2017. The patients were divided into two groups: the KET group which received 0.5 mg/kg of intravenous (IV) KET diluted in 500 mL of normal saline over 30 minutes and the control group which received 500 mL of normal saline without KET over 30 minutes. Results: According to the statistical analysis, 24 hours after the intervention, suicidal ideation score reached 2.53 and 20.6 in the KET and control groups, respectively. In fact, KET caused a significant reduction in the score of the suicidal ideation (SSI) (SSI

One of the main aspects of supporting entrepreneurial activities is studying universities and their surrounding environments in innovation ecosystems, which is necessary to achieve economic development and technological innovations. The innovation ecosystem is a dynamic system and consists of academic, industrial, institutional, scientific, economic and governmental organizations. According to the researchers, there have been many innovations in the health section to enhance their ability to respond to the expectations of patients in terms of life expectancy, reducing costs, increasing the quality of life, improving diagnosis and treatment methods. In the field of health, more than 1425 knowledge-based companies are registered, and more than 800 technological teams are also located in the incubators of Iran's medical sciences universities. Nevertheless, universities of medical sciences are still at the beginning of the path of technology and innovation and moving towards entrepreneurial universities. It is essential that these universities, as one of the main components of the innovation ecosystem, focus remarkably on creating and strengthening their legal, financial, structural and managerial infrastructures in order to promote entrepreneurial culture and skills among their human resources. This is to commercialize knowledge and technology properly to meet the society's health needs. It is obvious that universities are facing many issues in this area, and using best practices, both domestic and foreign, can solve many challenges ahead.

Abstract Background Cervical cancer is a common, and fatal cancer in women worldwide. This cancer is the fourth most common cancer in women after breast, colorectal, and lung cancer. Aims This study aims to investigate the age‐standardized incidence rate (ASR) and the geographical distribution of Cervical Cancer in Iran. Methods This study was designed as a descriptive cross‐sectional investigation. The study sample comprised all individuals registered as cervical cancer patients in the National Cancer Registry system in 2016. The crude rate and ASR for each province were computed independently. Furthermore, we employed ArcMap10.5 software and geographic information system to conduct an analysis of the gathered data. In order to ascertain the spatial distribution and clustering of cervical cancer incidence, we utilized Moran's I, which measures spatial autocorrelation. Results We studied a total of 808 cases of cervical cancer with a median age to be 52.19 years (IQR≈1.35). Among these cases, 685 (84.7%) were diagnosed based on the pathological reports with morphological verification, while 81 patients (10.1%) were clinically identified, and 42 cases (5.2%) were diagnosed using the death certificate‐only method. Squamous cell carcinoma accounted for 61% of all cases (n = 497). The ASR of cervical cancer in Iran was 1.90 per 100 000 populations. The provincial ASR ranged from 0.29 to 5.03 per 100 000, with the highest rates observed in Golestan (5.03), East Azerbaijan (4.07), and Ilam (3.72). We found no clustering patterns in the distribution of provincial crude, age‐specific, and age‐standardized incidence rates (p > .05). Conclusion The incidence of cervical cancer in Iran was lower than the global average, and we did not identify any significant disparities in the incidence rates among the provinces. Although there were differences in incidence rates among the areas, these were not clustered. It is crucial to remember that cervical cancer is still a major public health issue in Iran, and in order to lessen the disease's burden, national initiatives to enhance screening, early identification, and access to efficient treatment should continue to be top priorities.

Background. The effects of oligopin as an antioxidant on polycystic ovarian morphology (PCOM) have not yet been examined. Therefore, the objective of this study was to evaluate the oligopin supplementation on PCOM among patients with polycystic ovarian syndrome (PCOS). Methods. This randomized, placebo-controlled trial was carried out at Shariati Hospital, Arash Hospital, and Yas Hospital, Tehran, Iran, to determine the effect of oligopin (50 mg/d) or placebo in PCOS patients. The ultrasonographic ovarian morphology was assessed in women aged 18–40 years, before and after 3 months of intervention. Results. Among 45 randomized participants, 32 participants, of whom 17 were in the oligopin group and 15 were in the placebo group completed the trial. There was only one adverse event in the oligopin group. The mean (standard deviation) age of the patients was 30.47 (6.30) years and the median (interquartile range) BMI was 27.50 (23.42–33.55). Three months of oligopin therapy significantly decreased ovarian stromal area (p=0.01) and stromal/total area (p=0.003). However, no significant differences were observed in the ovarian volume, ovarian area, 2–9 mm antral follicle counts, or peripheral follicle distribution pattern at 3 months. Conclusion. Among participants with PCOS, the use of oligopin (50 mg) daily, as compared with a placebo, resulted in improvement of the stromal area and stromal/total area at the end of the 3 months of treatment. Further studies are, however, needed to evaluate the longer-term efficacy and safety. This trial is registered with IRCT20140406017139N3.

Introduction: The evaluation of e-prescribing systems' usability is crucial as they are integral to the quality of healthcare services. This study evaluates the usability of three e-prescribing systems and examines the impact of individual factors on system usability. Method: The objective of this descriptive study was to assess the usability of e-prescribing systems (EP, Dinad, and Shafa) as perceived by 105 physicians from three clinics at Hormozgan University of Medical Sciences in Bandar Abbas, Iran. The data was collected using the 2020 edition of the Isometric Questionnaire 9241/110, which comprises of seven axes and 66 questions. The participants were asked to rate their opinions on a 5-point Likert scale, with options ranging from completely disagree [1] to completely agree [5]. Results: EP, Dinad, and Shafa received average scores of 3.45, 3.32, and 3.24, respectively. Self-descriptiveness and User Error Tolerance axes were rated the highest ratings, with average scores of 3.60 and 3.48. Conversely, conformity and suitability axes received the lowest ratings, with average scores of 3.19 and 3.22, respectively. Upon evaluating the usability axes, the EP significantly improved controllability and user engagement compared to other systems. The usability of Dinad and Shafa in the Gynecology clinic was significantly higher than the two other clinics. Also, older physicians with more work experience rated the Shafa significantly higher than two other systems. Conclusion: The evaluated systems had average usability. although there was no statistically significant difference in the usability of these systems, the evaluation of dimensions revealed unique strengths in each system.

Abstract Background & Aims Education and counseling during marriage is an opportunity to raise some issues needed by couples on the verge of marriage. This study was conducted with the aim of improving reproductive and sexual health literacy of couples on the verge of marriage. Methods This study was a mixed‐methods participatory action research conducted based on the Find, Organize, Clarify, Understand, Select‐Plan, Do, Check, Act (FOCUS‐PDCA) model in nine steps during 2019−2020 in the city of Bandar Abbas. The Reproductive Health Literacy Scale and the Service Quality (SERVQUAL) Questionnaire were used to evaluate the interventions. Data were analyzed by SPSS version 26. A significance level of less than 0.05 was considered. Results The mean age of women and men participating in the quantitative part of the study was 21 ± 5 and 25.84 ± 3.9 years, respectively, which was similar to their counterparts in this part of the study, and the difference in the mean scores of reproductive health literacy before and after the changes in the program showed a significant difference (p > 0.001). The study results showed that, except for the understanding dimension, most participants were at an insufficient level in other dimensions of reproductive health literacy. The result of measuring the satisfaction of service recipients indicated good satisfaction in the two dimensions of warranty and accountability, and there was a gap in empathy, assurance, and tangibility dimensions, which the biggest gap was related to the empathy dimension. Conclusion The changes made in improving the reproductive health literacy of couples were effective, which can be taken into consideration based on the added items in the current program of providing educational services in marriage preparation classes for couples.

Abstract This study was designed and implemented to analyze and establish documents related to the above cases in the first to third COVID-19 epidemic waves for the use of researchers and doctors during and after the epidemic. The current case series study was conducted on 24,563 thousand hospitalized COVID-19 patients by examining their clinical characteristics within a one-year period from the beginning of the pandemic on 02.22.2020 to 02.14.2021, which included the first to the third waves, based on gender and severity of COVID-19. The mean age of the participants was 56 ± 20.71, and 51.8% were male. Out of a total of 24,563 thousand hospitalized COVID-19 patients until February 2021, there were 2185 mortalities (9.8%) and 2559 cases of severe COVID-19 (13.1%). The median length of hospitalization from the time of admission to discharge or death in the hospital (IQR: 13–41) was estimated to be 21 days. The rate of hospital mortality was higher in severe (37.8%) than in non-severe (4.8%) cases of COVID-19, While the risk of severe cases increased significantly in the third (HR = 1.65, 95% CI: 1.46–1.87, P

In this research, the architecture and the functionalities of the LAMBDA (Laboratory of Aircraft Multidisciplinary Knowledge-Based Design and Analysis) framework for the design, analysis, and optimization of civil aircraft are presented. The framework is developed in MATLAB R2022a and comprises a modular architecture, which gives the potential for the use of different methods and fidelities for each discipline. The methods can be selected from a set of built-in methods or custom user-defined scripts. Disciplinary modules of the LAMBDA are Requirements, Weight, Sizing, Geometry, Aerodynamics, Engine, Performance, Cost, Emission, and Optimization. This framework has been used for different types of design and optimization problems. When it is applied for the design and optimization of a novel regional TBW (Truss-Braced Wing) aircraft, the operating cost has been reduced by 7.7% in the optimum configuration compared to the base configuration.

Background. Multiple sclerosis is a chronic disease of the central nervous system and most often occurs in people between the ages of 20 to 50 years. Orem's self-care model is one of the models that have had a special approach to human and health care issues. The aim of this study was to review the effect of self-care training based on the Orem model on the burden on caregivers of patients.. Methods. The present quasi-experimental study was performed on 76 main members of the family caring for patients with multiple sclerosis in Bandar Abbas with a pre-test, post-test design and a control group. The study units were randomly selected and divided into two groups of control and intervention. The intervention group was trained according to the Orem training program in patients with amnesia during 6-8 sessions of 40 minutes. In order to assess the burden on caregivers, a 22-item "Zarit" questionnaire was used and a questionnaire was completed before and after the intervention in both groups. The results were analyzed with SPSS software version 26. Results. The difference between the mean of burden before the intervention (44.6 13 13) and after the intervention (33.7 10 10) in the intervention group was significant (P

Goal: To quantify the regional properties of gastric motility from free-breathing dynamic MRI data. Methods: Free-breathing MRI scans were performed on 10 healthy human subjects. Motion correction was applied to reduce the respiratory effect. A stomach centerline was automatically generated and used as a reference axis. Contractions were quantified and visualized as spatio-temporal contraction maps. Gastric motility properties were reported separately for the lesser and greater curvatures in the proximal and distal regions of the stomach. Results: Motility properties varied in different regions of the stomach. The mean contraction frequencies for the lesser and greater curvatures were both 3.1±0.4 cycles per minute. The contraction speed was significantly higher on the greater curvature than the lesser curvature (3.5±0.7 vs 2.5±0.4 mm/s, p2/s) compared to the other regions of the stomach (11.16–14.12 mm2/s). Conclusions: The results showed the effectiveness of the proposed method for visualization and quantification of motility patterns from MRI data.

Introduction: Sexual activity changes during pregnancy due to hormonal and physical changes in pregnant women. This leads to a higher prevalence of sexual dysfunction in pregnancy. Evaluation of sexual function with special tools is necessary to determine sexual dysfunction during pregnancy. Pregnancy Sexual Response Inventory is one of these tools. The present study was performed aimed to translate and determine the psychometric properties, and validate the Pregnancy Sexual Response Inventory (PSRI). Methods: This correlation type descriptive-analytical study was translated from English to Persian "Forward / Backward" to translate, psychometrics, and validate the Pregnancy Sexual Response Inventory (PSRI) in 2021. After consulting the experts and pregnant mothers, the content and face validity of the scale were determined qualitatively. The final version of the questionnaire was completed by 260 pregnant women in Rasht, chosen via convenience sampling. The reliability of the questionnaire was assessed by Cronbach's alpha coefficient and Inter class correlation coefficient (ICC). The reliability and validity of the questionnaire structure was done by confirmatory factor analysis using AMOS software and other statistical analyzes using SPSS statistical software. P< 0.05 was considered statistically significant. Results: Intra-class correlation was shown for each scale between 0.602 and 0.902. There was also a moderate to high correlation between each subscale and the total score of the PSRI questionnaire. All indices of goodness indicated that all subscales of this questionnaire are suitable to measure pregnancy sexual response and activity. Conclusion: The psychometric properties of the PSRI Scale showed the high reliability and validity of this scale and the possibility of using this tool in Iran.

Background and objectives: Mycotic keratitis is a fungal infection of the cornea that can cause blindness. Its incidence, risk factors, and the etiological agents vary worldwide and nationwide. Therefore, proper documentation of these data is essential for better disease management. In this review, we aimed to make a clear picture of this infection in the Middle East. Methods: Data on fungal keratitis from 1986 to 2018 in the Middle East were systematically collected from five English databases (PubMed, Scopus, Science Direct, Web of Science, and Google Scholar) and four Persian databases (Magiran, Scientific Information Database, IranMedex, and Irandoc). A total of 35 studies were included in the review. Result: The pooled prevalence of fungal keratitis in the Middle East was estimated at 26% (95% confidence interval: 19-32%; I2=98.88%, p

Abstract Background Preeclampsia is a life-threatening disorder during pregnancy and postpartum periods. Preeclampsia can affect the activity of many organs. It is very important because if this disorder is associated with changes in thyroid function, it can affect the results of maternal and fetal tests. Accordingly, the aim of this meta-analysis study was to assess the abnormalities in thyroid function tests in preeclampsia. Methods Studies were selected through a systematic search of the MEDLINE/PubMed, Scopus, Web of Science Core Collection, and Google Scholar databases in 31st August 2021. Also, reference lists of review articles and relevant studies were manual-searched to identify other potentially eligible studies. English studies that compared TSH, T4 and T3 of normal pregnant with preeclamptic women (Known to be normotensive before pregnancy; gestational age 20 week or more; singleton pregnancy; no previous history of thyroid dysfunction) were screened. Data sets were screened for eligibility by two independent reviewers. Articles were assessed by the Newcastle–Ottawa Scale. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used for quality assessment of evidence on outcome levels. Results After reviewing 886 published studies, 63 observational studies were selected and used for this meta-analysis. The study population included 21,528 pregnant women. The findings revealed that TSH (SMD = 1.70, 95%CI: 1.39 to 2.02; p

Background: Starting vaccination in pregnant women; numerous theories have been proposed that the vaccine might affect the mother or the fetus. Objective: The goal of this research was to see whether there was a link between the Sinopharm vaccination and certain pregnancy outcomes in COVID-19-vaccinated women. Study design: This is a retrospective cohort study. Method: This study was conducted on pregnant women who delivered from 1 August 2021 to 1 January 2022 in Yazd city. We have followed the STROBE Guidelines when preparing the manuscript. In this period time, all pregnant women were 5787 people in which 5666 were in the second and third trimester. Among these women, 1222 women were randomly selected. Results: Among 1222 pregnant women, 558 (45.6%) women had received one dose vaccine, 162 (13.3%) people had received two doses, and 502 (41.1%) women had not been vaccinated. On crude analysis, there was no significant difference between vaccinated and non-vaccinated groups. After adjusting for maternal age, maternal body mass index, parity, stillbirth history, abortion history, and gestational diabetes in multivariate analysis, no differences were found between the groups in pregnancy as well. Conclusion: Vaccinations during pregnancy seem to have no negative effects on the mother or the baby. This finding may aid pregnant women in deciding whether or not to take the vaccination.

Abstract Introduction: The World Health Organization on March 11, 2020 declared the outbreak of severe acute respiratory syndrome Corona virus 2 disease (COVID-19) a pandemic situation. The main aim of this study was investigating mortality of COVID 19 by considering chronic diseases. Materials and methods: this study was conducted as a cross-sectional in which all confirmed cases were examined. The variables considered in this study were age, sex, diabetes mellitus, cancers, hypertension, heart diseases, kidney diseases, and liver diseases. Independent sample t test, Chi-square and binary logistic regression were used to data analysis. All statistical analysis was done in SPSS 16 and significant level was set at 0.05. Results: Out of 22849 PCR and CT scan tests, 16061 ones were positive. According to the confirmed cases, prevalence of COVID-19 was calculated about 0.019. Also hospital case fatality rate and mortality rate were calculated 156 and about 8.2 per 100000 respectively. Hypertension, and age had significant relationship with morbidity of COVID-19, in other hand, age (OR: 4.51, p

Background: The present study attempted to determine the antibiotic susceptibility of bacteria isolated from endotracheal tube culture on patients admitted to the intensive care units (ICUs) of Shahid Mohammadi hospital in Bandar Abbas. Materials and Methods: This cross-sectional study was conducted on 114 patients hospitalized in the pulmonary ICU of Shahid Mohammadi hospital in Bandar Abbas from March 2018 to March 2019. The samples of the patients’ endotracheal tube secretions were collected for the culture purpose on the first and fifth days of hospitalization in the ICU where the disk diffusion method was used to determine antibiotic susceptibility. Results: The most common isolated microorganisms from the first day of culture were 26 Acinetobacter spp. isolates (22.8%), 10 Candida isolates (8.8%), and 9 Pseudomonas aeruginosa isolates (7.9%). The most common microorganisms which were isolated on the fifth day comprised Acinetobacter spp. with 57 isolates (51.8%), Candida with 6 isolates (5.5%), and P. aeruginosa with 6 isolates (5.5%). The highest resistant bacteria isolated from Acinetobacter spp. samples on the first-day were amikacin (92.3%) and meropenem (84.6%). The highest resistance of P. aeruginosa was against meropenem (77.8%), while the highest resistance of Acinetobacter spp. isolates was found to be amikacin (94.7%) and meropenem (86%) from the fifth-day samples. Further, P. aeruginosa isolates had the highest resistance in meropenem (83.3%), co-trimoxazole, and cefepime (66.7% for each of them). Conclusion: Ventilator-associated pneumonia (VAP) is considered a warning condition due to multidrug-resistant bacteria. According to the present study, the most common VAP-causing bacteria are gram-negative, especially Acinetobacter, with high antibiotic resistance.

Medical tourism leads to development of economic resources for many countries. This method of tourism has become common in most countries of the world which is one of the dimensions of tourism for development like metal industry or sport industry. The stability and dynamism of country's economy help the development of ecotourism. Furthermore, medical tourism with economic consequences can have significant environmental effects. For this purpose, this research was done to study and evaluate the factors affecting the development of medical tourism in developing countries. The approach governing this research is developmental, and the research method is descriptive and analytical. A multivariate regression test was used to analyze the hypotheses of research, and statistical analysis was conducted using SPSS 19.0 software. The ecotourism and economic management can have a global or local roles as suitable tools for sustainable tourism. Ecotourism is often not properly oriented and mainly defined in such a way that the practitioners are far from the declared standards to achieve and succeed in the sustainability process. The current research is descriptive-explanatory which compiled using library documents. The analysis of the path of above factors shows that all factors of price, quality, facilities, and information and communication technology directly and indirectly play a significant role to enhance the medical tourism.

Background: This study aimed to investigate the demographic factors, comorbidities, and laboratory results of diabetic patients with coronavirus disease 2019 (COVID-19) severity. Materials and Methods: This cross-sectional study enrolled 171 diabetic patients with COVID-19 admitted based on chest CT scan findings to the COVID-19 ward of Shahid Mohammadi Hospital in Hormozgan, Iran from 1 March to 1 June, 2020. Reverse-transcriptase polymerase chain reaction (RT-PCR) test was performed, and the patients were divided into three groups (mild, moderate, and severe) based on the severity of disease. Then we investigated the demographic factors, comorbidities, and laboratory results of diabetic patients with severe COVID-19 severity. Results: Regarding comorbidities, there was no significant difference between the three groups. Moreover, there was a significantly lower lymphocyte count in the severe group compared to moderate and mild groups (P = 0.001). We showed the increase in blood urea nitrogen (BUN) and creatinine to be significantly associated with increased disease severity (P = 0.001 and P = 0.009, respectively). We also showed a significant difference in aspartate aminotransferase (AST) levels between different groups of patients (P = 0.002) with a higher level of AST in the severe group (P = 0.020). Lactate dehydrogenase (LDH) and troponin were also significantly associated with an increase in COVID-19 severity in patients with diabetes (P = 0.013 and P = 0.002, respectively). Conclusion: There was a significant association between disease severity and BUN, creatinine, AST, LDH, and troponin levels in diabetic patients with COVID-19. There was no significant association between different groups regarding severity of disease and comorbidities.

Abstract Biological aerated filters (BAFs) have high filtration efficiency due to their tolerance of hydraulic and organic shocks are suitable for the treatment of complex and sanitary wastewater. In this study, for the first time, natural media of date kernel from Bam city was used as the BAF reactor media, with a meshing sand filter separated by a standard metal grid from the natural filter section used at the end of the reactor. This can be considered an innovation in the media and filtration. Aeration in the related reactor with 160 cm height was performed bilaterally as up-flow and continuously by nozzles throughout the reactor media. In this work, the actual effluent of the hospital wastewater treatment plant was employed as the inflow wastewater to the reactor, and its organic and inorganic parameters were measured before and after the treatment by the BAF reactor. The backwashing process was also studied in three ways: bottom backwashing (TB), top backwashing (BB), and top and bottom backwashing (TBBS), to determine the amount of water consumed and to achieve the desired result. According to the results obtained in this study, the removal efficiencies of inorganic and microbial contaminants, amoxicillin and azithromycin were obtained as follows: BOD5: 98.48%, COD: 92.42%, $${\text{NO}}_{3}^{ - }$$ NO 3 - : 99.4%, P: 93.3%, Coliforms: 97%, Color: 42.8%, Turbidity: 95%, Sulphate: 30%, TSS: 98.9%, Amoxicillin: 20% and azithromycin: 13%. In the backwashing process, the amount of water consumed in these three TB, BB, and TBBS methods were obtained 300, 164, and 118 L, respectively, So, TBBS method was selected as the optimal method. Based on the results obtained in this study, it is concluded that the BAF process with natural date kernel has a high efficiency in removing organic and inorganic contaminants from hospital wastewater, also the concentration of most of the effluent parameters was less or in accordance with EPA standard.

Background & Aim: Stress and anxiety are one of the major problems in patients undergoing semi-invasive and invasive procedures such as endoscopy. Different methods to reduce anxiety do not have the same effects. The aim of this study is to compare the effect of thought distraction by music therapy and the presence of caregiver on anxiety level of patients undergoing endoscopy. Methods & Materials: In this randomized clinical trial, 105 patients referred to endoscopy ward of Shahid Mohammadi hospital and Persian Gulf Bandar Abbas hospital in 2018 were selected by the convenience sampling method and assigned into three groups of music therapy, presence of caregiver and control using the random allocation (35 in each group). The demographic information form and the Spielberger anxiety questionnaire (STAL) were completed before and after the intervention. In the music therapy group, patients received natural sounds through headphones. In the caregiver’s presence group, endoscopy was performed with the presence of caregiver, and the control group only received routine pre-endoscopic care. Data were analyzed using descriptive and inferential statistics through the SPSS software version 24 at a significance level of 0.05. Results: The result of analysis of variance showed that there was no significant difference in the anxiety mean score between the three groups before the intervention (P=0.77), but a significant difference was observed after the intervention (P

The use of in silico models to improve our understanding of the fluid dynamics within the gastrointestinal tract has increased over the last few decades. Computational fluid dynamics (CFD) is an in silico technique that can be used to characterize and model the fluid mechanics driving the digestion of food and absorption of nutrients. This systematic review outlines the current methodologies used to develop CFD models of the stomach and small intestine, and summarizes the flow and mixing patterns predicted from these models. A literature search was conducted on Scopus, and 15 stomach CFD studies and 15 small intestine CFD studies were included in this review after the literature selection and exclusion process. Two primary flow patterns; retropulsive flow and recirculation regions, were identified within the stomach CFD models. The flow patterns within the small intestine were depended on the type of motility pattern present. The shortcomings of the current models are discussed, and considerations for future gastric and intestinal flow modeling are provided.

Knowledge and innovation are considered as the most crucial factors in the economic and industrial areas (especially, in this age which includes many changes). Moving towards innovations and making changes in the products and services combinations are considered as the proceedings and operations of the knowledge-based businesses. This type of businesses play an important role in the production efficiency, using knowledge in the new products and services, improving the economic and welfare levels and creating values in the society.

Abstract Background Individuals with normal weight obesity (NWO) are predisposed to having cardiometabolic disorders. This study aims to investigate the circulating levels of vaspin, leptin and their association with glycemic and lipid profiles in women with NWO. Methods Forty women with body mass index (BMI) = 18.5–24.9 kg/m2 and fat mass (FM) ≥ 30% were assigned in the NWO group. Thirty age-matched women with identical BMI range, and FM

Background & Aim: Anxiety is one of the most important mental problems in patients who are candidate for coronary angiography, which can have negative physiological and psychological consequences and ultimately lead to the increased hospital stay, increased patient need for analgesics, increased costs and increased incidence of angiographic complications. Therefore, the aim of this study was to determine the effect of aromatherapy on anxiety in patients undergoing coronary angiography. Methods & Materials: In this randomized clinical trial, 80 patients undergoing coronary angiography referred to the post-cath. ward of Shahid Mohammadi hospital in Bandar Abbas in 2018 were selected and allocated into two groups of intervention and control through the random numbers table. In the intervention group, the eye pads impregnated with 0.2 ml of peppermint oil were used, and in the control group, the pads impregnated with 0.2 ml of placebo were placed on their chest for 20 minutes. Patient’s anxiety levels were recorded before and after the intervention. A demographic characteristics questionnaire and the Spielberger standard questionnaire were used for the data collection. The data were analyzed by the SPSS software version 24 using the descriptive and inferential statistical methods in accordance with the objectives of the study. Results: The results of data analysis showed that aromatherapy reduced the anxiety of patients in the intervention group, which was significantly different from the control group (P=0.006). Paired t-test also showed that in the intervention group, the mean score of anxiety after the intervention was significantly lower than that of before the intervention (P

Introduction: Naturally, in human body, there is a balance between free radicals and the antioxidant system. Yet, cigarette consumption in smokers increases free radicals and decreases antioxidants. A vast body of research showed that the ROS level of seminal fluid is reduced using oral antioxidant complements through enhancing the clearing capacity of free radicals. Thus, the present research aimed to explore the effect of vitamin complement consumption on changing male infertility indices among smokers. Methods: In the present randomized clinical trial which was single-blinded, 50 infertile oligospermic and asthenospermic men participated. They were selected in a randomized convenient sampling method. Before the study began, a semen sample was taken from all participants for analysis. Subsequently, the patients received 30 mg of Q10 coenzyme, 8 mg of zinc, 100 mg of vitamin C, 12 mg of vitamin E, 400 mg of folic acid for a whole duration of 3 months on a daily basis (once a day) and 200 mg of selenium every other day after lunch. A second sample of seminal fluid was taken from patients and semen parameters were compared between the pre- and post-test. The relevant statistical analyses were conducted in SPSS.23. Results: A comparison of pre-test and post-test results revealed that all sperm parameters including the volume, morphology, motion, count and progressive motility were significantly increased after the intervention (p ≥ 005). Moreover, a statistically significant improvement was observed in the pH and concentration of seminal fluid. Conclusion: The present research showed that consuming vitamin complements (30 mg of Q10, mg of zinc, 100 mg of vitamin C, 12 mg of vitamin E, 400 mg of folic acid) once a day as well as 200 mg of selenium every other day can effectively improve the qualitative parameters (pH and concentration) and quantitative parameters (volume, motion, morphology, count and progressive motility) in infertile male smokers.

Objective: To determine the temporal patterns of cumulative incidence of brucellosis using autoregressive integrated moving average models. Methods: This cross-sectional study employed yearly and monthly data of 1 117 laboratory-confirmed human brucellosis cases from January 2013 to December 2018 using the Yazd brucellosis national surveillance system. The monthly incidences constructed a timeseries model. The trend of cumulative incidence was perceived by tracing a line plot, which displayed a seasonal trend with periodicity. Thus, the ARIMA models were selected. Thereafter, Akaike information criteria (AIC) and Bayesian information criterion (BIC) values among different models indicated a preferable model from models which were expanded by diverse lags [(3, 0, 3), (2, 0, 3), (3, 0, 2), (4, 0, 3) and (3, 0, 4)]. Then, the achieved ARIMA model was applied to the forecasting cumulative incidence of monthly brucellosis incidences. All analyses were performed using Stata, version 11.2. Results: For the ARIMA (3, 0, 4) model, MAPE value was 56.20% with standard error 0.009-0.016, and white noise diagnostic check (Q=19.79, P=0.975) for the residuals of the selected model showed that the data were completely modelled. The monthly incidences that were fitted by the ARIMA (3, 0, 4) model, with AIC (25.7) and BIC (43.35) with a similar pattern of actual cases from 2013 to 2018 and forecasting incidences from January 2019 to December 2019 were, respectively, 0.50, 0.44, 0.45, 0.49, 0.55, 0.58, 0.56, 0.51, 0.46, 0.44, 0.45 and 0.49 per 100 000 people. Conclusions: In summary, the study showed that the ARIMA (3, 0, 4) model can be applied to forecast human brucellosis patterns in Yazd province, supplementing present surveillance systems, and may be better for health policy-makers and planners.

Background The present systematic review and meta-analysis aimed to ascertain if the circulating levels of apelin, as an important regulator of the cardiovascular homeostasis, differ in patients with cardiovascular diseases (CVDs) and controls. Methods A comprehensive search was performed in electronic databases including PubMed, Scopus, EMBASE, and Web of Science to identify the studies addressing apelin in CVD up to April 5, 2021. Due to the presence of different units to measure the circulating levels of apelin across the included studies, they expressed the standardized mean difference (SMD) and their 95% confidence interval (CI) as summary effect size. A random-effects model comprising DerSimonian and Laird method was used to pool SMDs. Results Twenty-four articles (30 studies) comprised of 1793 cases and 1416 controls were included. Pooled results obtained through random-effects model indicated that apelin concentrations in the cases’ blood samples were significantly lower than those of the control groups (SMD = -0.72, 95% CI: -1.25, -0.18, P = 0.009; I2 = 97.3%, PConclusion The association of apelin with CVDs is different based on the region and disease subtypes. These findings account for the possible usefulness of apelin as an additional biomarker in the diagnosis of CVD in diabetic patients and in the diagnosis of patients with CAD. Moreover, apelin/HDL-c, apelin/LDL-c, and apelin/TC ratios could be offered as diagnostic markers for CVD.

Abstract Background One of the effective indicators for determining the efficiency and optimal use of hospital resources is the length of stay (LOS). This study aimed to determine the patients’ length of stay and the factors affecting the LOS in the Children’s hospital. Method A cross-sectional study was performed on Children Hospital medical record database including 350 records (April 2015 to Dec 2015). Records were selected by stratified random sampling with proportional allocation. Then the predetermined demographic and hospital variables were extracted through the study of patients’ medical records. All statistical analysis were performed using SPSS software. Results The overall median of the LOS in the studied hospital was 3 days (IQR =3). The results showed that in this hospital the LOS has a significant relationship with the variables of time of admission, the place of residence, type of admission, and the degree of attending physician. Also, with the increasing number of visits, ultrasonography, counseling and laboratory test, LOS was increased. Conclusion Improving processes related to diagnostic procedures, providing adequate staffing for specialized services in all hours of the day, preventing unnecessary and non-emergency admissions in the evening and night, will be effective in optimizing patient LOS.

Abstract Background A high body fat percentage has a specific effect on activation of the hypothalamic-pituitary-thyroid axis. On the other hand, a slight change in thyroid hormones can affect metabolism and body composition as well as immune function. This study aims to examine the relationship between adiposity, thyroid hormone levels and immunity by comparing resting energy expenditure (REE), serum thyroid hormone levels and complement C3 in normal-weight high body fat (normal weight obesity) women and normal-weight normal body fat women. Methods In this case-control study, 40 women with normal body weight (BMI

The House of Public Participation in Health has been established to attract public participation as one of the principles of primary health care (PHC) and the missing link of socialization of the health system, with the participation of public mediators at both provincial and city levels. Members of the People's Participation Council are representatives of grassroots organizations at the provincial level that transmit health messages to the people and raise the demands of the people in the council with the cooperation of their network mediators, in this way, people can participate in comprehensive health programs.

Introduction: COVID-19 might present with other seemingly unrelated manifestations; for instance, neurological symptoms. This study aimed to evaluate the neurologic manifestations and their correlated factors in COVID-19 patients. Methods: This retrospective observational study was conducted from March 17, 2020 to June 20, 2020 in a tertiary hospital in Iran. The study population consisted of adult patients with a positive result for COVID-19 real-time reverse transcriptase polymerase chain reaction (RT-PCR) using nasopharyngeal swabs. Both written and electronic data regarding baseline characteristic, laboratory findings, and neurological manifestations were evaluated and reported. Results: 727 COVID-19 patients with the mean age of 49.94 ± 17.49 years were studied (56.9% male). At least one neurological symptom was observed in 403 (55.4%) cases. Headache (29.0%), and smell (22.3%) and taste (22.0%) impairment were the most prevalent neurological symptoms, while seizure (1.1%) and stroke (2.3%) were the least common ones. Patients with neurological manifestations were significantly older (p = 0.04), had greater body mass index (BMI) (p = 0.02), longer first symptom to admission duration (p < 0.001) and were more frequently opium users (p = 0.03) compared to COVID-19 patients without neurological symptoms. O2 saturation was significantly lower in patients with neurological manifestations (p = 0.04). In addition, medians of neutrophil count (p = 0.006), neutrophil-lymphocyte ratio (NLR) (p = 0.02) and c-reactive protein (CRP) (p = 0.001) were significantly higher and the median of lymphocyte count (p = 0.03) was significantly lower in patients with neurological manifestations. Conclusion: The prevalence of neurological manifestations in the studied cases was high (55.4%). This prevalence was significantly higher in older age, grated BMI, longer lasting disease, and opium usage.

This study aimed to summarize available data about health information system evaluation using the ISO 9241–110 (previously 9241–10) standard. A systematic review of literature from January 2000 to November 2020 was conducted in PubMed, Scopus, ScienceDirect, Web of Science, and Google Scholar as well as two Iranian national databases, Scientific Information Database and Magiran. Pooled estimates were calculated using random-effects meta-analysis. Data analyses were conducted using Stata version 14. From total of 179 studies subjected to initial screening, fifteen studies were eligible to enter the meta-analysis. The pooled mean estimates of the health information systems' overall scores (3.11; 95% confidence interval [CI], 2.82–3.41), suitability for individualization (3.82; 95% CI, 2.59–3.04), and controllability (3.82; 95% CI, 2.91–3.47) commonly had better performance compared with other dimensions. High heterogeneity was seen among the seven dimensions (I2 ≥ 98.6%, p .1). Most of the studies used the ISO 9241-110 standard as a summative assessment for evaluation of the usability of the HIS and results indicated the relative success of the evaluated systems based on this standard.

BackgroundA double blind clinical trial was performed to evaluate whether the polycystic ovary syndrome (PCOS)-specific serum markers and metabolic parameters would change in the women with PCOS during the three-month administration of oligopin.MethodsIn this double-blind multicenter trial, we randomly assigned 80 PCOS women, based on a 1:1 ratio, to receive oligopin (n= 40) or maltodextrin as placebo (n = 40) for up to 3 months. As PCOS-specific outcomes, we investigated the changes in testosterone, sex hormone binding globulin (SHBG), free androgen index (FAI), dehydroepiandrosterone (DHEA), follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Secondary end points were metabolic (fasting glycaemia, hemoglobin A1c (HbA1c), lipids, insulin resistance (HOMA-IR)), anthropometrics parameters and blood pressure from the baseline to the end of treatment. We investigated serum transaminase, alkaline phosphatase (ALP), creatinine (Cr) and blood urea nitrogen (BUN) levels as hepatic and kidney outcomes, respectively.ResultsThe first participant was enrolled on April 18, 2018, and the last study visit took place on May 14, 2019. PCOS-specific serum parameters did not change during the three-month administration of oligopin (p > 0.05), except for a small increase in the FSH levels (p=0.03). Oligopin neither changed the metabolic profile nor the anthropometric parameters or blood pressure. ALP levels was significantly increased in placebo group, as compared with oligopin (p=0.01).ConclusionOligopin supplementation does not seem to be exerting a beneficial effect on both hormonal and metabolic parameters in the women with PCOS.Clinical Trial Registrationwww.irct.ir, identifier IRCT20140406017139N3.

Anaplasma species are tick-borne pathogens that are obligatory intracellular of ruminants and other mammalians. In this investigation, we systematically reviewed the distribution of anaplasmosis among domestic ruminants in Iran. Five and four English and Persian databases were studied, respectively, based on keywords and throughout 17 years (2001–2017). Thirty-eight articles were included in this systematic review and meta-analysis. Totally, 5093 cattle, 1958 sheep, and 1232 goats corresponding to prevalence of Anaplasma infection from different areas of Iran were examined. The total prevalence of Anaplasma infection was estimated to be 34% (95% CI 27%, 41%) in domestic ruminants. Based on our data, Khozestan (54%) and Khorasan Razavi (46%) provinces were the most prevalent areas in Iran and Kerman (3%) and Hamedan (1%) provinces are the lowest. The highest prevalence of Anaplasma spp. infection was belonged to A. ovis (44%) and the lowest to A. phagocytophilum (1%) with a significant difference among them (p

Background: The rs315952 (Ser133Ser) has been reported to influence the risk for immune-mediated as well as inflammatory diseases in many studies; however, the results remain inconsistent. The current meta-analysis was performed to give a more precise estimation for the relationship between this IL-1Ra missense variant and the risk of both types of diseases. Methods: Relevant publications were retrieved through a literature search in Web of Science, Medline, PubMed, Scopus, EMBASE, and Google scholar search engines, between 2000 and 2019. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the strength of the association. Results: Twenty-two studies, including 2622 cases with and 3854 controls were identified. The IL-1Ra Ser133Ser variant does not confer an increased overall risk for immune-mediated and inflammatory diseases. This variant was statistically associated with decreased risk of systemic lupus erythematosus (under allelic, codominant heterozygous, and dominant models) or ankylosing spondylitis (in allelic and recessive models)(OR

Background: Classroom is where children spend much of their time in; this study aimed to identify the concentration of heavy metals in the classroom dust based on the results of various studies in the world using the published data up to years 2018. Methods: Fifteen studies were selected for the study according to the inclusion and exclusion criteria. The mean concentration of 11 heavy metals including arsenic, barium, cadmium, cobalt, chromium, copper, iron, lead, manganese, nickel, and zinc was extracted. Results: The highest mean concentration of heavy metal (mg/kg) in classroom dust was related to iron (3904.7, 95%CI: 3657.1-8154.3), zinc (429.9, 95%CI: 182.8-677.1) and barium (419.2, 95%CI: 274.7-253.7), respectively. Subgroup analysis showed the maximum concentration (mg/kg) of iron in Iran (16945.5), zinc in Hong Kong (2293.5), barium in China (979.8), manganese in Iran (288.9), lead in Iran (258.8), chromium in Ghana (381.3), copper in Hong Kong (274.4), nickel in Iran (50.1), cobalt in China(43.4), arsenic in China(13.7) and cadmium in Hong Kong(8.7). Conclusion: Even safe and healthy classrooms can threaten children’s health by heavy metals. These metals are important since they are naturally found throughout the earth’s crust, accumulate in the food chain and contaminate drinking water as well as alloys in school equipment.

Objectives: Human cercarial dermatitis (HCD) is a water-borne zoonotic parasitic disease. Cercariae of the avian schistosomes of several genera are frequently recognized as the causative agent of HCD. Various studies have been performed regarding prevalence of bird schistosomes in different regions of the world. So far, no study has gathered and analyzed this data systematically. The aim of this systematic review and meta-analysis study was to determine the prevalence of avian schistosomes worldwide. Methods: Data were extracted from six available databases for studies published from 1937 to 2017. Generally, 41 studies fulfilled the inclusion criteria and were used for data extraction in this systematic review. Most of studies have been conducted on the family Anatidae. Results: The overall prevalence of avian schistosomes was estimated to be 34.0% (95%CI, 28%–41%) around the world. Furthermore, results displayed that, Allobilharzia visceralis and Trichobilharzia spp. had the highest frequency and their prevalence in the birds was 50.0% (95% CI, 3.0%–97.0%) and 32.0% (95% CI, 21.0%–0.36%), respectively. The results showed that the prevalence of avian schistosomes was 43.0% (95% CI, 29% - 56%) in the US and 38.0% (27.0% -50.0%) in Europe, which were higher than other continents, respectively. Conclusions: The prevalence of 34% shows that the bird schistosomes are very common zoonotic worms among aquatic birds in the world. Also, this study shows the importance of avian schistosome research when facing animal and human health of the future.

Introduction: The first case of HIV-infection in Iran was a hemophilic child who was infected by imported blood products in 1989. Since then, the HIV epidemic in Iran has undergone significant changes. This study investigated the time variations of the epidemiology of reported HIV/AIDS -infections during 2011-2017 in Yazd, Iran. Methods: This analytical cross-sectional study was carried out using the data recorded in health centers of Yazd province from 2011 to 2017. The data were collected from the records of 98 patients using a researcher-made checklist. The rate of newly reported HIV/AIDS by gender per 100,000 people was calculated. Results: Out of 98 reported HIV/AIDS cases, 56.1% were men, and 43.9% were women; 55.1% of cases were infected through sexual contact, 30.6% through the infected needle while injecting for drug use, 1.6% through mother-to-fetus transmission, 1.3% through tattooing, and 5.1% through the unspecified mechanism. During these years the rate of newly reported HIV/AIDS in Yazd was declining, and the predominant mode of HIV transmission was through sexual contact. Conclusion: Although the rate of newly reported HIV/AIDS -infection in Yazd province has decreased, we believe that the primary mode of HIV transmission has shifted from drug injection to unsafe sex.

Background: Evaluation is a key process to improve the organization. The maintenance and improvement of the health is the priority of the people of each country these days. Ensuring the provision of appropriate services requires the evaluation of the health system performance. European Foundation for Quality Management (EFQM) model is a self-assessment model and allocates more for health and care organizations and almost evaluates an organization in all structural and functional aspects. This study was conducted with to the aim of evaluating the performance of a public hospital in Tabriz according to the model of Europe Foundation for Quality Management. Methods: This study was a cross - sectional study in 2015 in a public hospital in Tabriz. Data collection tools had been standard questionnaire of Europe Foundation Model for Quality Management. Data was gathered through standard and prestigious questionnaire of Europe Foundation Model for Quality Management which consisted of 90 questions, same in the field of nine criteria. After visiting the hospital by experts, meeting was hold among them and proceeded to consult and complete the questionnaire. The data was reported by descriptive tests and software of EXCELL was used for data analysis. Results: The mean score of performance evaluation in terms of leadership was 73.6 points out of 100 points, in terms of policy and strategy, 46.8 points out of 80, in terms of human resources 54.1 out of 90 points, in terms of strategies and policy 41.9 points out of total 90 points, in terms of processes 59.8 points out of 140 points, 66 points out of 200 in terms of customer results, in terms of human resources results 23.76 points out of a total of 90 points, 40.2 points out of a total of 60 points, in terms of society results and in terms of key performance the result was 71.35 points out of 150 points . The average total score of 477 points out of 1000 points was performance evaluation. The results of the report are 47.75%. Finally, the results showed that the hospital had relatively appropriate status. Conclusion: The findings showed the need for more attention to human resources and customer results. Enhancing employee's satisfaction factors to increase their satisfaction and efficiency, identifying foreign customers, categorizing and measuring different needs of patients in order to response and upgrade the system of addressing the complaints through the reform the processes are those cases that are proposed to improve the organization and increase compliance with organizational excellence model .

Introduction: Food Craving Questionnaire (FCQ) is a popular tool in assessing food craving which consisted of a trait (FCQ-T) and state (FCQ-S). The aim of the current study was to provide reliability and validity of the Persian version of FCQ-Trait-reduced (FCQ-T-r 15-items) in overweight and obese women. Material and methods: The subjects were 168 overweight and obese women who were consented to participate. The subjects completed the FCQ-T-r and subsequently, anthropometric, body composition and psychometric assessments performed to assess the inter-correlations and concurrent validity. The confirmatory factor analysis was done to derive the potential factors and internal consistency of the questionnaire was assessed. Two weeks later, FCQ-T-r repeated for 126 subjects to assess test-retest reliability. Results: The confirmatory factor analysis of by varimax rotation, show that three principal components were loaded on expected factors. The Cronbach’s alpha coefficient was 0.90. (0.91, 0.78, and 0.71, for factors). The test–retest analysis shows an acceptable level of reliability ( P=0.001) and Pearson correlation coefficient of 0.92 between the two administrations. In split-half reliability analysis the Cronbach’s alpha coefficient of the part 1 was 0.80 and for the part 2 was 0.86. The correlation coefficient between part 1 and part 2 was 0.81. Conclusion: This preliminary study provides evidences in favor of reliability and validity of the Persian version of the FCQ-T-r. In general, the results showed a high level of internal consistency for FCQ-T-r, and none of the 15 items had to be deleted to improve α.

Background The main objective of medical education development centers is to improve the quality of medical education. However, after more than two decades since the formation of these centers, they are still facing numerous challenges. Objectives Given the importance of these centers, this study was conducted to identify their challenges. Methods A qualitative study was carried out in 2013 on 40 managers of Iranian medical education development centers. Data was collected during a national conference held in Tehran in the form of a questionnaire and analyzed using content analysis. Results Key challenges of the centers were identified to be resource shortage, continuous modifications in policies, weak management, structural problems, lack of communication, regulatory problems and centralization in decision making. The key challenges were divided into 17 sub-challenges. Conclusions Although decades have passed since the formation of medical education development centers, they are still facing serious challenges. To unveil the true potential of these centers in improving the quality of education, integrated interventions were addressed in this study to help reduce identified challenges.

Aim: Theileriosis is a protozoal disease caused by Theileria spp. mostly in warm-blooded vertebrates worldwide. It is one of the common tick-borne diseases among domestic animals in tropical and sub-tropical regions, which have a variety of unlikable effects on health economy and animal welfare. In the present study, the prevalence of theileriosis among domestic farm animals in Iran was systematically evaluated. Methods: To identify the related papers, 10 English and Persian databases, including PubMed, Science Direct, Scopus, Web of Science, Medical Subject Headings, Google Scholar, Magiran, Barakatns (formerly Iranmedex), Elm net, and Scientific Information Database, were appraised for articles published throughout 1999-2017. Results: A total of 56 papers, providing the examination of 11,317 cattle, 9394 sheep, 2991 buffaloes, 1504 horses, 600 goats, and 212 donkeys were analyzed, matching for the prevalence of theileriosis from different parts of Iran were permitted for our allowing checklist. The overall prevalence of theileriosis among domestic herbivores was expected to be 19% (95% confidence interval: 15%, 22%). Our findings highlighted the average of the maximum prevalence in Razavi Khorasan (60.4%) and West Azerbaijan (49.1%) and the minimum in Mazandaran (1.1%) and East Azerbaijan provinces (2.2%), respectively. The high prevalence of Theileria infection in the herbivores (mainly sheep) verifies the well-known enzootic episode of theileriosis in Iran, predominantly in northeastern and western parts of the country. Conclusion: Our results suggested updated and imperative information on the true burden of theileriosis in Iran. Moreover, it could be supporting the gaps among monitoring, prevention, and control arrangements to improve the health economy, particularly among dairy farm animals.

Background: Aspergillus sensitization (AS) and allergic bronchopulmonary aspergillosis (ABPA) can occur as a cause of permanent lung damage in patients with cystic fibrosis (CF) and non-CF bronchiectasis. Objective: The aim of this study was to determine the frequency of AS and ABPA in patients with CF and non- CF bronchiectasis in southwestern Iran. Methods: This cross-sectional study was conducted on 33 patients with CF and 27 patients with non-CF bronchiectasis from southwestern Iran who were referred to Namazi Hospital affiliated to Shiraz University of Medical Sciences from July 2015 to February 2016. Skin prick test to Aspergillus fumigatus, peripheral blood eosinophil count, total serum IgE, specific IgE and IgG against Aspergillus fumigatus as well as radiologic chest studies were done for each patient. Statistical analysis was done by Mann-Whitney U test, Fisher Exact test, and Kappa weighted in SPSS software version 18. Level of significance was set at p