Payavard Salamat

The Effect of 8 Weeks Combined Training (Aerobic-Resistance) at Home with Quinoa Seed Supplementation on FBS, Appetite and Quality of Life in Women with Type 2 Diabetes

Mohammad Azizi

Background and Aim: Diabetes is a multifactorial disease characterized by chronic high blood sugar and insulin resistance. In general, the global increase in the incidence of type 2 diabetes is caused by poor nutrition and inactivity. Therefore, the aim of this study was to evaluate the effect of 8 weeks of combined exercise with quinoa supplementation on fasting blood sugar, appetite and quality of life in women with type 2 diabetes.
Materials and Methods: In this study, 36 women with type 2 diabetes were divided into 3 groups: exercise+supplement (n=12), supplement (n=12) and control (n=12). The exercise+supplement and supplement group consumed 25 grams of cooked quinoa seeds for 3 days a week. The exercise+supplement group also did combined exercise for 8 weeks, 3 times a week. Exercise was performed with an intensity of 10-12 pressure perception. The Persian version of the quality-of-life questionnaire was used to measure the quality-of-life index and the appetite questionnaire was used to assess appetite. Blood samples were taken 48 hours before and after the interventions, measurements and questionnaires were completed. One Way ANOVA, LSD post hoc and paired t were used at the significance level of P≤0.05.
Results: According to the results of 8 weeks of intervention in the exercise+supplement group (P=0.001)(2.59%) and the supplement group (P=0.04)(1.54%) compared to the control group (P=0.32)(1.54%) caused a significant reduction in Fasted blood sugar. There was also a significant decrease in appetite index in the exercise+supplement group (P<0.001)(54.20%) and the supplement group (P=0.001)(60.31%) as compared to the control group (P=0.11)(7.91%). Quality of life data also showed a significant increase in this index in the exercise+supplement group (P=0.008)(5.95%) and supplement group (P=0.002)(3.80%) as compared to the control group (P=0.10)(0.99%).
Conclusion: Eight weeks of combined exercise with consumption of quinoa seeds has a positive and improving effect on fasting blood sugar index, quality of life and appetite in patients with type 2 diabetes.

Synergism of Linezolid and Rifampin to Combat Multidrug-Resistant Environmental Enterococci Isolates

Leila Fozouni

Background and Aim: Wastewater is one of the most dangerous and important sources of pathogens and their treatment does not always guarantee the elimination of pathogenic bacteria. Enterococci, as opportunistic pathogenic bacteria, fastidious and cause of nosocomial infections, have a wide environmental distribution and one of the routes of their transmission to humans is water and wastewater. The increasing rate of drug- resistance among bacteria indicates the need for investigation of novel antibacterial agents or their combination effects. The aim of this study was to investigate the effect of linezolid in combination with rifampin on the elimination of multidrug- resistant enterococci in two treatment plants in Golestan province.
Materials and Methods: Enterococcus species from eighty samples were isolated from treatment plants in two cities of the Golestan Province (North of Iran) including Gorgan and Bandar-e Torkaman during January-June 2021. The isolates were identified based on the most probable number (MPN), filtration, microbiological tests and finally by using specific gene detection by ddlE primer with polymerase chain reaction. Kirby Bauer performed an antibiotic resistance pattern according to CLSI- 2020 guidelines for six classes of antibiotics. The minimum inhibitory concentration of linezolid was determined individually and by synergist effect with rifampin by broth microdilution method.
Results: After phenotypic and molecular diagnosis (PCR) of raw and treated wastewater samples, in 32 (40%) wastewater samples, enterococci species were identified and confirmed. Tetracycline was the least effective so, about 100% of Enterococcus faecalis and Enterococcus faecium isolates were resistant to it. The prevalence of linezolid-resistant E. faecalis was 11%. A total of 20 enterococcal isolates (62.5%) had multiple resistance. The concentration of linezolid in combination with rifampin, which inhibited 90% growth of the isolates (MIC90) was 1μg /ml, four-fold lower than linezolid alone (MIC90=4 μg/ml). In addition, none of the enterococci isolates showed resistance to the linezolid/rifampin combination (P=0.001).
Conclusion: The results of this research confirmed the presence of enterococci resistant to vancomycin and other antibiotics in the wastewater treatment plant samples in Golestan province. The favorable combination effect of linezolid and rifampin on the inhibition of multi-drug resistant isolates implies their synergy.

The Implementation Challenges of Health Information Systems in Iran’s Southeastern Hospitals: From Managers’ Perspective

Reza Khajouei

Background and Aim: Hospital managers are one of the key decision-makers in the implementation of health information systems. This study aimed to determine the implementation challenges of health information systems based on the hospital managers’ perspective.
Materials and Methods: This descriptive-analytical study was conducted in 2019 on the hospital managers of three provinces (Kerman, Yazd, Sistan and Baluchestan). Data were collected using a self-administrated questionnaire. The face validity of this questionnaire was approved by experts in health informatics and health information management and its reliability was confirmed by Cronbach’s alpha (α=96.7%). Data were analyzed using SPSS. To investigate the relationship between the mean of each challenge with demographic variables, Pearson, Independent T-test, and ANOVA tests were used.
Results: In this study, the factors related to ignoring the hospital manager’s needs in system selection (1.333 out of 2 points), hardware purchase cost, insufficient user training to using the system (1.238), inadequate manpower and health informatics specialists (1.19), software purchase cost, insufficient financial resources (1.142), high cost of system launching, the lack of integration and interoperability among information systems, lack of support from health care professionals (1.047), and lack of management experience in choosing the best system (one out of 2) had the highest scores (out of 2 points). Also, personnel training costs to work with the system (-0.092) and Lack of improvement in work processes (-0.047) obtained the lowest scores. Data analysis showed that managers with clinical backgrounds considered financial and human challenges more important than non-clinical managers (P<0.031).
Conclusion: The hospital managers believed that financial, human, technical, managerial, and organizational factors are the most important challenges in implementing health information systems in Iran’s hospitals respectively. The health policy-makers and planners at large and small levels can address many of the challenges before implementing systems by focusing on identified priorities.

Investigating Factors Affecting of the Occurrence of Suicides Leading to Death in Bodies Referred to the Forensic Medicine Organization of Tehran Province from 2010 to 2019

Mohammad Hossein Sadeghian

Background and Aim: The American Psychiatric Association identifies suicide as the third leading cause of death among people aged 15 to 24. This study was conducted with the aim of investigating factors affecting of the occurrence of suicides leading to death in corpses referred to the Forensic Medicine Organization of Tehran Province from 2010 to 2019.
Materials and Methods: This research was a descriptive and analytical cross-sectional study in 2019 year. The statistical population includes all bodies referred to forensic medicine. The information related to all corpses referred to forensic medicine which was analyzed between 2010 and 2019 were 5471 cases. Descriptive and analytical statistical methods were used to analyze the data. P-value less than 0.05% was considered valid.
Results: The results showed that 50% of suicide deaths were under 32 years old. Sixty-nine point two percent of suicides leading to death are male and the rest are female. The highest frequency in terms of method was related to the hanging method, 39.3%, and in the youth age group, in terms of the level of education in men, high school diploma and diploma in women. The highest frequency of suicide related to singles was 47.1% and 27.4% in the summer season. The most common method of suicide was hanging, with more than 39%, followed by poisoning with poison, with more than 25% of cases. The least used method was drowning.
Conclusion: Based on the results of this study, it seems that factors such as age, sex, level of education, and even geographic and social factors are among the factors that affect suicide, which can help policymakers, managers, psychologists, psychiatrists, and related organizations. Paying attention to educational literacy, employment status and income level of people, special attention of families to adolescent and young boys and girls and especially their marital status can be effective measures to prevent suicide.

Predictive Power of Extended Parallel Process Model (EPPM) for Acceptance of Covid-19 Vaccine in Residents of Bushehr Province

Azita Noroozi

Background and Aim: Vaccination is one of the most effective preventive measures to control of infectious diseases. To create effective interventions for the acceptance of the COVID-19 vaccine, it is important to identify the factors that affect the vaccine acceptance. The aim of this study was to determine the predictive power of the Extended Parallel Process Model (EPPM) for acceptance of Covid-19 vaccine.
Materials and Methods: In this cross-sectional study, 1455 people over 18 years old covered in health centers living in Bushehr province in cities of Bushehr, Genaveh, Tangestan, and Asaluyeh in 2021 were selected by convenience method. Data collection was online by using questionnaire included three sections comprised of demographic factors, questionnaire related to model constructs, and self-administered questionnaire related to acceptance of Covid-19 vaccine. Data were analyzed using chi-square, two independent sample T-test and logistic regression; in SPSS software.
Results: Out of 1455 participants, 1067 persons (73.3%) had been vaccinated. The results showed that men (P=0.006), people with higher education (P=0.001), government employees (P=0.001), single people (P=0.01), people with history of specific disease (P=0.05), individuals with a history of Covid-19 positive test (P=0.001) and their family (P=0.03) were more than other vaccine recipients. Perceived severity, response efficacy and perceived self-efficacy were predictors of vaccine acceptance. Predictive variables and constructs explained 43.8% of changes in vaccine acceptance. Among the participants in the study, 1366 (93.9%) were in the fear control process, in which the highest defense response has been avoided.
Conclusion: In order to increase the acceptance of the vaccine, the efficacy and effectiveness of the vaccine and the severity of the complications of the disease should be emphasized. Therefore, public health campaigns aimed at increasing vaccine acceptance should provide a high level of transparency about the safety and effectiveness of vaccines to the community.

The Role of Viral and Host miRNAs in The Control, Progression and Possible Treatment of Covid-19 Disease

Alireza Monadi Sefidan

Background and Aim: Previous studies have shown that viral and host miRNAs play a role in the process of controlling or progressing the disease and can even be considered as therapeutic targets. Accordingly, the present review study was designed to evaluate the role of host miRNAs and Covid-19 virus in the disease process.
Materials and Methods: The current study was a review study that was conducted during 2012-2022. Studies were extracted from PubMed, Google Scholar, Web of Science and Scopus scientific databases. The researchers selected relevant resources and a summary of them was presented in this review.
Results: The present review study showed that some host miRNAs such as miR-23b-5p, miR-200c, and miR-125a-5p had an inhibitory effect on ACE2 receptor, while miR-3909, miR-4677, and miR-133a had a stimulatory effect on this receptor. Furthermore, host miR-98-5p had an inhibitory effect on TMPRSS2 gene expression. On the other hand, host miR-146a, miR-21, and miR-142 induced inflammation through MAPK and NF-Ƙβ signaling. While, host miR-124, miR-410, and miR-1336 inhibited factor STAT3 and prevented inflammation. Furthermore, host miR-302b and miR-372 targeted the mitochondrial antiviral signaling protein (MAVS), resulting in silencing of type 1 interferon signaling. It has also been established that host exosomal miR-7-5p, miR-24-3p, miR-145-5p, and miR-223-3p inhibited the replication of SARS-CoV-2 and the expression of S protein and their decreased expression in elderly and Diabetic subjects was associated with decreased inhibition of SARS-CoV-2 replication. Moreover, viral miR-359-5p regulated the expression of MYH9 (non-muscle myosin heavy chain 9), which caused virus invasion and release in the host cell.
Conclusion: This study showed that many miRNAs play a role in controlling or progressing the disease of Covid-19 and it is possible to treat the disease of Covid-19 by changing the expression of viral and host miRNA. However, more research is needed in this regard.

Analysis of Publishing Medical Sciences Books with Phenomenological Approach

Fatemeh Sheikhshoaei

Background and Aim: Medical resources are directly related to health of society and the book as one of the main sources has great importance. This study has been conducted to investigate pathology of medical sciences books publishing status and also identification of content, cultural and technical production challenges of these books in Iran from the viewpoint of publishers.
Materials and Methods: The present study in terms of purpose, approach, and method is applicable, qualitative and phenomenology. The research tool has been semi - structured interview and community were publishers of medical sciences books in two sections academic (Five) and private (eight) publishers. The interviews continued until the data saturation stage (13 interviews). First, open and axial coding was performed, which finally extracted 402 codes and then was categorized into 74 categories, which were analyzed using qualitative content analysis.
Results: The field of content production faced the most important challenges (53%), in which policy making absence (24 repetitions, 16%), no domestic high percentage of medical publication (23 repetitions, 16%), and the lack of expertise in medical publishers (11 repetitions, 7%), were declared by publishers. The problems of cultural production were in the second place with 39% and respectively include specialized and costly editing of the book, the lack of professional referees and the lack of structured review rules with 22 repetitions equivalent to 46%, 8 repetitions equivalent to 17% and 6 repetitions equivalent to 13%. The challenges of the technical production sector are reflected with a number equal to 8% of the total problems, which include the problems of raw materials printing and publishing (11 repetitions, 48%), lack of printing and publishing technology (5 repetitions, 23%) and the lack of technical expertise staff (3 repetitions, 13 percent).
Conclusion: According to the findings of this study and the revealed funds of damages in the medical publishing industry, it can be concluded that many publishing challenges in Iran are rooted in general policies, rules and culture. Therefore, more serious attention to the professional field of medical publishing from the government and unbiased policy making in order to divert the concerns of publishers can solve many obstacles and difficulties.

Investigating the Relationship between Factors Affecting Hip Fracture and Its Consequences in Imam Khomeini Hospital Complex during 2017-2020

Esmaeil Mohammadnejad

Background and Aim: Fractures and dislocations of the femur are a common and disruptive public health problem worldwide. One of the most common ways is to identify the factors associated with common outcomes that increase mortality, length of hospital stay, and postoperative complications. By identifying these factors, the adverse outcomes of elderly hip fractures can be prevented. Therefore, the aim of this study was to determine the relationship between factors affecting hip fracture and its consequences.
Materials and Methods: The present study was a descriptive cross-sectional observational study. The study population in this study included patients with hip fractures. Patients’ information was examined between 2017-2020 years. Data were analyzed by SPSS applying descriptive statistics, Fisher Exact test, chi-square, independent t-tests, and analytical regression.
Results: The results showed that in this study, the majority of patients with hip fracture had an underlying disease (73.9%). The most common underlying diseases in patients included high blood pressure (20.7%), diabetes (13.2%) and heart diseases (10.5%). The most common causes of death was include old age (40.4%), prevalence of covid-19 (20.2%), heart attack (11.7%), pulmonary embolism (10.6%) and surgical wound infection (10.6%). The most common cause of hip fracture was osteoporosis (26.3%) and falling from a height (24.7%). Also level of education (P=0.0001), causes of fracture (P=0.001), type of anesthesia (P=0.001), history of hospitalization in special wards (P=0.001), readmission (P=0.0001), age (P=0.001) and level of self-care (P=0.001) were significantly associated with elderly mortality. There was a significant relation between type of surgery (P=0.038), history of hospitalization in intensive care units (P=0.001), history of blood transfusion (P=0.021) and level of self-care (P=0.001) with length of hospital stay of fractured elderly hip.
Conclusion: It can be concluded that by identifying the factors affecting the length of hospital stay, surgical wound infection and mortality of the patients with hip fractures, witness better surgery results, shorter hospital stay, less postoperative complications and reduced death. Some factors such as osteoporosis are preventable, which can be prevented with timely education.