Payavard Salamat

Evaluation of Antifungal Effect of Alcoholic Extract of Achillea Millefolium and Trachyspermum ammi Against Candida albicans Isolated from Denture Stomatitis

Kamran Amirian Chayjan

Background and Aim: Denture stomatitis is the most prevalent oral mucosal lesion among denture wearers. Because there have been multiple reports of resistance of Candida species to antifungal drugs in the last two decades, if the antifungal properties of Achillea millefolium and Trachyspermum ammi are validated, these compounds may be a suitable adjuvant drug along with the use of common antifungal drugs. Therefore, the current study aimed to assess the antifungal activity of alcoholic extracts of Achillea millefolium and Trachyspermum ammi against Candida albicans isolated from denture stomatitis.
Materials and Methods: Antifungal sensitivity of 50 isolates of C. albicans with the origin of denture stomatitis to the alcoholic extracts of Achillea millefolium and Trachyspermum ammi plants as well as the antifungal drugs miconazole and nystatin was determined by broth microdilution method and according to CLSI-M27S4 guidelines. The range of dilution for all compounds was 0.016-16 μg/ml. A concentration of compounds that showed at least 50% growth inhibition as compared to the positive control group was considered MIC (minimum growth inhibitory concentration). Statistical analysis was done using SPSS software and the significance level was considered as P<0.05.
Results: The MIC ranges in microbroth dilution method for the antifungal drugs miconazole, nystatin, as well as the alcoholic extracts of Achillea millefolium and Trachyspermum ammi plants on C. albicans, were close to each other, indicating that their effectiveness against C. albicans species does not differ significantly (P<0.05). The Achillea millefolium methanolic extract had the highest and lowest MIC values, with an average of 2.67±2.55 μg/ml and 0.067±0.057 μg/ml, respectively. A significant difference (P<0.001) was observed when the MICs outcomes the herbal alcoholic extracts and antifungal drugs were compared.
Conclusion: Based on the obtained MICs, Achillea millefolium and Trachyspermum ammi alcoholic plant extracts have a lesser efficacy than the antifungal drugs, but even though they may have a lower MIC and more effectiveness than other chemical drugs.

Factors Affecting the Acceptance of Personal Protection Measures among Patients before Having Covid-19

Mohammadreza Dinmohammadi

Background and Aim: The most recent threat to the global community is the ongoing outbreak of the disease known as Coronavirus Disease 2019 (COVID-19). Taking personal protection measures (PPM) is crucial to prevent the spread of COVID-19. This study aimed to determine the factors affecting the acceptance of PPM among patients before having COVID-19 admitted to hospitals in northwestern of Iran.
Materials and Methods: In this cross-sectional study, 560 eligible patients with a diagnosis of COVID-19 were selected by convenience sampling. Data were collected from January 6 to May 21, 2021, through a researcher-made questionnaire and were analyzed with descriptive statistics (number, percentage, mean, standard deviation), independent t-test, and multiple linear regression by SPSS. A significance level of 5% was selected.
Results: The average age of the participants was 60.1 (16.01) years with an age range of 21 to 95 years. Most of the participants were male (53.9%) and married (91.8%). The mean score of PPM acceptance among patients was 16.55 (2.59) out of 20 points. Multiple linear regression analysis determined employment status (β=0.29, P<0.001), residency (β=-0.19, P<0.001), education level (β=0.11, P=0.048), smoking (β=-0.10, P=0.03) and income level (β=0.13, P=0.01), as predictors of acceptance of PPM. Other personal and occupational variables, including age, gender, marriage, living status, having children, and history of influenza vaccination, were not found to be effective in predicting the acceptance of personal protection measures among participating patients.
Conclusion: The acceptance of personal protection measures among patients was relatively high. Acceptance of the unemployed, rural residents, illiterate, smokers, and those with low-income level was low. This study emphasizes the need to pay attention to the changes in the individual, social and economic characteristics of the community and their effects on preventive health behaviors, especially in vulnerable groups.

Public Trust in Health System: A Study in Rasht County

Ehsan Zarei

Background and Aim: In recent years, public trust in health system has been considered one of the performance evaluation indicators of health systems. However, most of the research on public trust in health system is related to developed countries, and research in this regard is limited in Iran. A better understanding of trust in health system and some influential factors helps to develop targeted interventions to increase trust. The present study was conducted to investigate the level of public trust in health system in Rasht County.
Materials and Methods: In this cross-sectional study, 680 households (510 urban and 170 rural) were included. The data collection tool was a questionnaire to measure public trust in health system with 30 items and six dimensions, whose validity and reliability were confirmed. Mann-Whitney and Kruskal-Wallis tests were used to compare and analyze the difference in public trust in health system between groups.
Results: The overall score of trust in health system was 66.7 out of 112. The highest score for the quality-of-care dimension was 16.38 out of 28, and the lowest for the cooperation quality of providers dimension was 7.47 out of 12. Among service providers, the highest trust was in nurses and specialist doctors, and the least was in traditional medicine service providers. Women, government employees, people without health insurance, people with excellent and good health status, those who had used hospital services, and those who were satisfied with the last service received had a high level of trust in the health system (P<0.05).
Conclusion: The results showed that despite people’s trust in the expertise and knowledge of physicians and other providers, public trust in health system was relatively moderate, indicating deficiencies in the health system’s performance. Focusing on physician-patient communication and improving communication skills, establishing electronic records and sharing patient information between health service providers, and respecting patient rights can build greater trust in the health system.

A Study of Research Information Management Systems in Iran: The Production of Validation Tools

Nahid Ramezanghorbani

Background and Aim: One of the most important challenges in the field of research information management is the use of reliable and qualified software to manage research resources in health domain. This study aimed to develop a validation tools for research information management systems in Iran to utilize by universities in the process of using existing research information management systems.
Materials and Methods: This was a descriptive study conducted in two stages. In the first stage, a validation tool for research information management systems (Pajoohan, Pajooheshyar, Jiro, Yektaweb, Kuiper) was designed, and in the next stage, in order to ensure the validity of the produced tool, a self-assessment survey was conducted by users of research information management systems in medical sciences universities. Therefore, this tool was completed by 104 researchers from all over the country. The collected data were analyzed by Excel and SPSS software.
Results: The developed validation tool of research information management systems included four components and 82 indicators: software design and architecture (17 indicators), usability and user environment (16 indicators), professional use (36 indicators) and management (13 indicators). Based on the self-declared results of the users, this tool has 57 mandatory features, 26 preferred and 4 optional features. The results of the validation of research information management systems based on this tool showed that the highest rank in the component of architecture, professional use and software management was related to the Kuiper system, and in the component of usability and user environment was related to the Pajoohan system. In the self-declaration done by the users ,12 cases of Jiro system ,11 cases of Kuiper system ,11 cases of Pajoohan system ,7 cases of Pajooheshyar, and 5 cases of Yektaweb system have received confirmation above 75%.
Conclusions: The validation tool which developed by this study can be used in the evaluation of current research information management systems and the selection of new systems for use in the research field. In addition, it can be used to improve current systems and purchase new systems by academic universities and research centers.

Effective Factors on the Development of Health Tourism, Study Case: Rasht Hospitals

Hamzeh Amin-Tahmasbi

Background and Aim: Today, treatment is one of the important goals of tourism. Tourism in health and healthcare is growing rapidly in the world. Despite the fact that Guilan province, as one of the most important and touristic provinces of the country, has an annual population of 500,000 foreign tourists and can be the center of health tourism in Iran. Unfortunately, this province has not been able to have a proper share of the revenues of this field and attract foreign patients in parallel with its treatment capacities.
Materials and Method: The aim of this study was to identify the factors affecting the development of health tourism. In this regard, first, literature review was used and opinions of experts in this field, who were employees in five hospitals in Rasht, including Velayat, PourSina, Aria, Pars and Qaem hospitals, were selected using the Snowball sampling method. Twenty-five effective factors were identified and using Delphi method, 14 factors were selected as the final factor. Then by used of the Best and Worst Method (BWM), the importance of each factor was determined. Finally, using DEMATEL method, the effect of this factor on each other was determined.
Results: After conducting two rounds of Delphi, 11 factors that had an average lower than the average of the total opinions of the experts and there was more disagreement about them were eliminated. Then, by implementing the best-worst method, the quality of medical services was determined as the most important factor, and the ease of booking an appointment in advance for admission and the status of the banking system were determined as the least important factors among the final factors. Also, based on the results of the DEMATEL method, the quality of medical services has the greatest effect and the ease of booking an appointment in advance for admission has the least effect on other factors. Finally, the quality of medical services is the most effective and appropriate advertising about health tourism in domestic and foreign chambers of commerce has the least effectiveness.
Conclusion: Health tourism in Iran despite the relative quality and cheap price, has not yet found its place in the market due to the lack of proper advertising is still taking the first steps. Considering the environmental conditions and the existence of tourism aspects of Rasht, carrying out measures such as improving the quality of medical services, appropriate marketing, and improving infrastructures will lead to the development and improvement of health tourism, and as a result, increasing satisfaction and attracting more customers.

Retrospective Analysis on the Development of the Program for Reforming the Structure of the Headquarters of Selected Medical Sciences Universities in Iran

Mohammad Arab

Background and Aim: Reforming the structure of medical universities and its continuous adaptation to the mission of the organization and new functions is an undeniable necessity. The purpose of this article was to explain how to implement this policy.
Materials and Methods: The current qualitative study was conducted in 2020 retrospectively based on Kingdon’s multiple streams model. Data collection was done using two methods: individual interviews and document review. Sampling of the managers and experts of the administrative development and transformation centers of the Ministry of Health and 12 universities of Medical Sciences as well as vice-chancellors of the universities was done in a purposeful and snowball method until data saturation was reached by conducting 19 individual interviews. Data analysis were done with framework and content analysis methods, and using MAXQDA 2020 software.
Results: The low of structural problems included quantitative and qualitative changes in new tasks in the environmental units of universities, interference and parallel work in the tasks of university units, and bargainings for restructuring by universities. The policy low included the obligation to make structural changes in the upstream laws and documents, including the Fifth Development Plan, and the cooperation of all stakeholders. The political process included the implementation of the Health Transformation and the Family Physician Plan, and the support of relevant policymakers and the approval of the law of becoming a university trustee in the law of the fifth plan of economic development and also gaining the all-round support of the stakeholders.
Conclusion: The medical sciences universities, as the headquarters arm of the Ministry of Health at the provincial level, need to have flexible structure in line with the needs of their surrounding units. In luential context factors in policy-making the reform of the structure of the headquarters of universities/colleges, in addition to the stream of structural problems, the main of which was the change in the duties of the units, along with the political determination created in the Ministry of Health, led to the simultaneous occurrence of three streams of problems, Politics and politics and finally opening the window of opportunity and changing the structure and organization of the headquarters of medical sciences universities.

The role of inflammation in the development of complications caused by COVID-19: A Review Study

Alireza Monadi Sefidan

Background and Aim: It is important to understand how inflammation caused by COVID-19 affects patients and leads to more complications and diseases. According to the importance of controlling COVID-19 related complications, the current study was designed to evaluate the inflammation caused by COVID-19 and its related complications.
Materials and Methods: The present study is a review study. Studies were retrieved from PubMed, Web of science, Scopus and Google scholar databases. Finally, according to the purpose of the study, the relevant resources were selected by the researchers and a summary of their results was presented in this study.
Results: The present study showed that SARS-CoV-2 viruses enter their genome into the host cell after entering the cell by the spike protein (S) and the important receptor of coronavirus, angiotensin converting enzyme 2 (ACE - 2), and causes the onset of cytokine storms and consequently increase of primary cytokines involved in inflammation. IL-6, IL-8, TNF-α and IL-1 cytokines are key factors; These factors in turn activate macrophages, dendritic cells (DC) and other immune cells. Studies revealed that the inflammation caused by SARS-CoV-2 in the liver by inducing IL-6 activates the JAKs/STAT3 pathway, whose receptor is only found in the liver and immune cells, and causes cytokine release syndrome. Cytokines also cause the release of reactive oxygen species (ROS), superoxide anion, and nitric oxide, so that all of them can damage myocardial cells and cause insulin resistance and diabetes. In addition, the increase of inflammatory cytokines such as IL4, IL10 and IL6 and immune cells lead to cardiac disorders such as arrhythmia. The entry of the virus into the digestive system reduces the bacteria secreting butyrate (with anti-inflammatory effects) and leads to the induction of severe inflammation. Also, corona virus causes obsessive-compulsive disorder, depression and other neurological disorders by increasing pro-inflammatory cytokines and increasing the activity of indoleamine 2,3 dioxygenase (IDO).
Conclusion: Studies have shown that the inflammation caused by COVID-19 plays an important role in the development of the related complications such as disorders in the digestive, hepatic, cardiac, neurologic, pancreas systems and other organs. Therefore, targeting cytokines can potentially improve survival and reduce mortality.

Design and Evaluation of Mobile Application to Control Overweight with Cognitive Behavioral Therapy Approach

Negin Ebrahimi

Background and Aim: According to the report of the World Health Organization, overweight and chronic and psychological diseases caused by it have reached an alarming level in the world. Today, cognitive behavioral therapy as a specific method for controlling overweight teaches the audience how to identify and change inappropriate behavior patterns and destructive thoughts with distress that negatively affect their behavior and emotions. The purpose of this research was to provide a mobile-based application for overweight control with a cognitive-behavioral therapy approach.
Materials and Methods: This research was of applied-developmental type. In the first stage, by examining the available applications based on mobile and related to weight control and also Beck cognitive therapy protocol for weight loss, the capabilities of the application were identified and then based on a survey of experts, these capabilities were determined. Afterwards, the user interface of the application was designed and the necessary coding was done to use it. The database was then created using MySQL software and the application program was created using Flutter software and Dart programming language and was named CBTdiet. Finally, the usability of the application was evaluated by users using a standard QUIS questionnaire.
Results: Based on the entry and exit criteria, among the 247 identified applications, the capabilities of 17 applications were examined. Finally, according to the opinion of the experts, 21 capabilities, including the ability to send motivational messages to the audience and the ability to reward to achieve weight loss of one kilogram per week, were considered for the design of the application program. The application designed in this research was at a good level from the users’ point of view with an average of 7.99±1.1 and was able to obtain an acceptable level of satisfaction in the evaluation stage. The software’s overall capabilities section got the highest average score (8.12) and the screen section got the lowest average score (7.89) among all sections.
Conclusion: Based on the determined capabilities, a mobile-based application for controlling overweight was designed and created with a cognitive behavioral therapy approach, and it can be effective in overweight control by modifying lifestyle and changing destructive thoughts.