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Showing 15 results for Covid-19
Reza Dehghan, Hamideh Reshadatjoo, Kambeiz Talebi, Hossein Dargahi,
Volume 14, Issue 6 (1-2021)
Volume 14, Issue 6 (1-2021)
Abstract
Background and Aim: Health tourism is one of the most important tourism types in Iran. Iran has many strengths in health tourism. Also, there are challenges such as communication and information inconsistency in the health tourism industry and the outbreak of COVID-19 disease. Due to the unknown issues about COVID-19, it is important to determine effective strategies to control the consequences and reduce the economic and social effects of the virus in all industries, especially the health tourism industry.
Materials and Methods: In this systematic review study, 500 published papers from 2018 to 2020 were evaluated. In the group interview section, we used the views of participated health tourism experts in the scientific events in Iran, Turkey, and Oman. Also, the SWOC Analysis model (strengths, weaknesses, opportunities, and challenges) and MAXQDA software were applied.
Results: The results showed that the selected strategies were defensive and competitive. This research showed that the strengths of the health tourism industry overcome the weaknesses and development opportunities outweigh the challenges. Also, the maintenance strategy is the best strategy to support health tourism in the current situation in Iran.
Conclusion: It is necessary to be following issues for the politicians of Iran's health tourism industry to design a comprehensive document of Iran Health Tourism Diplomacy, preparation of a strategic plan for the development of health tourism, establish an independent organization of Iran Health Tourism, develop electronic health in the health tourism industry, design a health tourism insurance system, and…, with the aim of entrance to the current markets and creating new foreign markets.
Materials and Methods: In this systematic review study, 500 published papers from 2018 to 2020 were evaluated. In the group interview section, we used the views of participated health tourism experts in the scientific events in Iran, Turkey, and Oman. Also, the SWOC Analysis model (strengths, weaknesses, opportunities, and challenges) and MAXQDA software were applied.
Results: The results showed that the selected strategies were defensive and competitive. This research showed that the strengths of the health tourism industry overcome the weaknesses and development opportunities outweigh the challenges. Also, the maintenance strategy is the best strategy to support health tourism in the current situation in Iran.
Conclusion: It is necessary to be following issues for the politicians of Iran's health tourism industry to design a comprehensive document of Iran Health Tourism Diplomacy, preparation of a strategic plan for the development of health tourism, establish an independent organization of Iran Health Tourism, develop electronic health in the health tourism industry, design a health tourism insurance system, and…, with the aim of entrance to the current markets and creating new foreign markets.
Marsa Gholamzadeh, Seyed Mohammad Ayyoubzadeh, Hoda Zahedi, Sharareh Rostam Niakan Kalhori,
Volume 15, Issue 3 (8-2021)
Volume 15, Issue 3 (8-2021)
Abstract
Background and Aim: Due to the important role of radiological images for identifying patients with COVID-19, creating a model based on deep learning methods was the main objective of this study.
Materials and Methods: 15,153 available chest images of normal, COVID-19, and pneumonia individuals which were in the Kaggle data repository was used as dataset of this research. Data preprocessing including normalizing images, integrating images and labeling into three categories, train, test and validation was performed. By Python language in the fastAI library based on convolution technique (CNN) and four architectures (ResNet, VGG MobileNet, AlexNet), nine models through transitional learning method were trained to recognize patients from healthy persons. Finally, the performance of these models was evaluated with indicators such as accuracy, sensitivity and specificity, and F-Measure.
Results: Of the nine generated models, the ResNet101 model has the highest ability to distinguish COVID-19 cases from other cases with 95.29% sensitivity. Other applied models showed more than 96% accuracy in correctly diagnosis of various cases in test phase. Finally, the ResNet101 model was able to demonstrate 98.4% accuracy in distinguishing between healthy and infected cases.
Conclusion: The obtained accuracy showed the accurate performance of developed model in detecting COVID-19 cases. Therefore, by implementing an application based on the developed model, physicians can be helped in accurate and early diagnosis of cases. an application based on the developed model, physicians can be helped in accurate and early diagnosis of infected cases.
Materials and Methods: 15,153 available chest images of normal, COVID-19, and pneumonia individuals which were in the Kaggle data repository was used as dataset of this research. Data preprocessing including normalizing images, integrating images and labeling into three categories, train, test and validation was performed. By Python language in the fastAI library based on convolution technique (CNN) and four architectures (ResNet, VGG MobileNet, AlexNet), nine models through transitional learning method were trained to recognize patients from healthy persons. Finally, the performance of these models was evaluated with indicators such as accuracy, sensitivity and specificity, and F-Measure.
Results: Of the nine generated models, the ResNet101 model has the highest ability to distinguish COVID-19 cases from other cases with 95.29% sensitivity. Other applied models showed more than 96% accuracy in correctly diagnosis of various cases in test phase. Finally, the ResNet101 model was able to demonstrate 98.4% accuracy in distinguishing between healthy and infected cases.
Conclusion: The obtained accuracy showed the accurate performance of developed model in detecting COVID-19 cases. Therefore, by implementing an application based on the developed model, physicians can be helped in accurate and early diagnosis of cases. an application based on the developed model, physicians can be helped in accurate and early diagnosis of infected cases.
Marjan Ghazi Saeedi, Mozhgan Tanhapour,
Volume 15, Issue 5 (1-2022)
Volume 15, Issue 5 (1-2022)
Abstract
Background and Aim: Telemedicine provides medical services remotely. There are some problems with implementing telemedicine projects. The purpose of this study was to investigate the most common telemedicine services in Iran and other developed countries as well as examine the legal, financial and privacy challenges of telemedicine services in these countries, especially in the era of the COVID-19 epidemic.
Material and Methods: In this study, the status of telemedicine in Iran and developed countries was reviewed. Thus, related papers and grey literature were retrieved from PubMed, Scopus, SID and Magiran scientific databases. Also, related websites including the Ministry of Health and Medical Education of the Islamic Republic of Iran were examined. According to the study’s purposes, the relevant resources were selected and summarized by researchers.
Results: Radiology, psychiatry and cardiology are the most widely used telemedicine services for interaction with patients as well as emergency, pathology and radiology for healthcare professional communication. Teleconsulting is the most widely used telemedicine service in Iran. There are some laws such as article 74 from section 14 in the Iran development plan to support the provision of e-health and telemedicine services. Also, there are some limited laws for patients’ privacy. In Europe, there is a set of guidelines for health websites, mobile health and cross-border exchange of health information, etc. although there are no uniform laws about telemedicine. HIPAA in the United States and GDPR in Europe are some privacy laws in developed countries. There are some restrictions on telemedicine reimbursement in the United States including the fee-for-service payment model; however, the costs of telemedicine in the United States are usually less than face-to-face treatment.
Conclusion: In the present era using telemedicine services become a requirement due to the outbreaks of epidemics such as COVID-19. Concerning the experience of developed countries, telemedicine services development in Iran requires some considerations in terms of legal, financial and privacy aspects including the creation of explicit laws on patients and healthcare provider’s rights, providing the telemedicine guidelines in different clinical fields such as structured formats for teleconsultation as well as the explicit laws for preserving the patient’s privacy.
Material and Methods: In this study, the status of telemedicine in Iran and developed countries was reviewed. Thus, related papers and grey literature were retrieved from PubMed, Scopus, SID and Magiran scientific databases. Also, related websites including the Ministry of Health and Medical Education of the Islamic Republic of Iran were examined. According to the study’s purposes, the relevant resources were selected and summarized by researchers.
Results: Radiology, psychiatry and cardiology are the most widely used telemedicine services for interaction with patients as well as emergency, pathology and radiology for healthcare professional communication. Teleconsulting is the most widely used telemedicine service in Iran. There are some laws such as article 74 from section 14 in the Iran development plan to support the provision of e-health and telemedicine services. Also, there are some limited laws for patients’ privacy. In Europe, there is a set of guidelines for health websites, mobile health and cross-border exchange of health information, etc. although there are no uniform laws about telemedicine. HIPAA in the United States and GDPR in Europe are some privacy laws in developed countries. There are some restrictions on telemedicine reimbursement in the United States including the fee-for-service payment model; however, the costs of telemedicine in the United States are usually less than face-to-face treatment.
Conclusion: In the present era using telemedicine services become a requirement due to the outbreaks of epidemics such as COVID-19. Concerning the experience of developed countries, telemedicine services development in Iran requires some considerations in terms of legal, financial and privacy aspects including the creation of explicit laws on patients and healthcare provider’s rights, providing the telemedicine guidelines in different clinical fields such as structured formats for teleconsultation as well as the explicit laws for preserving the patient’s privacy.
Ali Reza Yavar, Zahra Batooli, Fatemeh Sheikhshoaei, Sara Ahmadizadeh,
Volume 16, Issue 2 (5-2022)
Volume 16, Issue 2 (5-2022)
Abstract
Background and Aim: The outbreak of the Covid-19 pandemic has led to the emergence of new information needs for people with diverse information literacy. Both infected and healthy people feel the need to have essential and practical information about this pandemic. One of the concerns of Covid-19 patients is their need for reliable and sufficient information about various aspects of the disease. Understanding the information needs of patients and the experiences of people who have been infected and recovered from the disease can be a suitable and reliable source of information. So the aim of this study was to identify the information needs of patients with Covid-19.
Materials and Methods: This research was employed a qualitative approach using conventional content analysis. Key informants were Covid-19 recovered patients in Kashan city who had a history of admission in medical centers. Sampling consisted 17 participants (11 males and 6 females) who were selected from almost different social classes through purposeful method. The data were collected using a semi-structured interview and the saturation point was reached at 17 interviews. Data were analyzed using the Diekelmann’s seven-stage method.
Results: The results of this study included 430 primary codes that after removing and merging duplicate codes, seven main themes and 30 categories were identified in the field of information needs were extracted. Main themes and categories included understanding the nature of the disease (the origin of the disease, knowledge about the symptoms, transmission and types of mutations), prevention (health protocols, prevention equipments, and vaccination), treatment (diagnostic tests, type of disease treatment, disease process, costs, psychological support), nutrition (the type of nutrition for prevention, during illness and after recovery), communication with others (type, length and conditions of quarantine, how to communicate with others), statistics, and information sources (up-to-date, valid, and types).
Conclusion: The most critical information needs of Covid-19 patients include information about the nature, treatment, and preventive measures of the disease. Social media and oral information such as doctors, friends, and acquaintances were also reported as the most important sources of information. Therefore, this study suggests that health managers provide the most up-to-date and reliable information and news related to Covid-19 through the most appropriate and accessible media.
Materials and Methods: This research was employed a qualitative approach using conventional content analysis. Key informants were Covid-19 recovered patients in Kashan city who had a history of admission in medical centers. Sampling consisted 17 participants (11 males and 6 females) who were selected from almost different social classes through purposeful method. The data were collected using a semi-structured interview and the saturation point was reached at 17 interviews. Data were analyzed using the Diekelmann’s seven-stage method.
Results: The results of this study included 430 primary codes that after removing and merging duplicate codes, seven main themes and 30 categories were identified in the field of information needs were extracted. Main themes and categories included understanding the nature of the disease (the origin of the disease, knowledge about the symptoms, transmission and types of mutations), prevention (health protocols, prevention equipments, and vaccination), treatment (diagnostic tests, type of disease treatment, disease process, costs, psychological support), nutrition (the type of nutrition for prevention, during illness and after recovery), communication with others (type, length and conditions of quarantine, how to communicate with others), statistics, and information sources (up-to-date, valid, and types).
Conclusion: The most critical information needs of Covid-19 patients include information about the nature, treatment, and preventive measures of the disease. Social media and oral information such as doctors, friends, and acquaintances were also reported as the most important sources of information. Therefore, this study suggests that health managers provide the most up-to-date and reliable information and news related to Covid-19 through the most appropriate and accessible media.
Sakineh Motayerzadeh, Rahim Tahmasebi, Behrooz Kavehie, Azita Noroozi,
Volume 16, Issue 3 (8-2022)
Volume 16, Issue 3 (8-2022)
Abstract
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.
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.
Alireza Monadi Sefidan, Reza Afrisham,
Volume 16, Issue 3 (8-2022)
Volume 16, Issue 3 (8-2022)
Abstract
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.
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.
Fahimeh Hasanzadeh, Ali Aghajanloo, Dr Mohammadreza Dinmohammadi,
Volume 16, Issue 4 (10-2022)
Volume 16, Issue 4 (10-2022)
Abstract
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.
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.
Alireza Monadi Sefidan, Ziba Majidi,
Volume 16, Issue 4 (10-2022)
Volume 16, Issue 4 (10-2022)
Abstract
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.
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.
Rahil Nahari, Saeed Hashemzadeh, Ehsan Zarei,
Volume 16, Issue 6 (1-2023)
Volume 16, Issue 6 (1-2023)
Abstract
Background and Aim: Medical tourism refers to travel for receiving health services abroad. The COVID-19 crisis affected a wide range of tourism-related businesses, including medical tourism, and caused a decrease in the supply and demand of health services in this market. This study aimed to investigate the impact of the COVID-19 pandemic on Medical Tourism in Iran.
Materials and Methods: This cross-sectional study was conducted in Iran in 2021. The data used in this study were extracted from the information system of the Ministry of Health from 2018 to 2021, which includes the number, origin, and destination of medical tourists, per capita revenue, and monthly revenue two years before and one and a half years after the COVID-19 pandemic. For data analysis, t-tests of independent groups and interrupted time series regression were used in SPSS and EViews 10 software.
Results: The COVID-19 pandemic has caused a 42% decrease in the average monthly number of medical tourists, a 45% decrease in the monthly revenue, and a 10% decrease in the per capita income per tourist (P<0.05). The arrival of medical tourists from the Republic of Azerbaijan, Bahrain, Iraq, and Oman has decreased by more than 80%, and the largest decrease in the number of tourists has been related to Ahvaz, Urmia, Tabriz, and Shiraz. In all diagnostic groups except obstetrics and gynecology, there has been a decrease between 50 to 70% The declining trend of medical tourism indicators was stopped in the second year of the COVID-19 pandemic and has continued as a constant trend.
Conclusion: The COVID-19 crisis has hurt the number of international patients and their revenue in Iran. Relative success in controlling COVID-19 can return to a pre-pandemic situation that requires appropriate policies and administrative measures by government and industry players, such as policies to facilitate patient entry, marketing measures, branding and creating a positive image of the country to potential clients, use of telemedicine facilities for consultations and follow-up, etc.
Materials and Methods: This cross-sectional study was conducted in Iran in 2021. The data used in this study were extracted from the information system of the Ministry of Health from 2018 to 2021, which includes the number, origin, and destination of medical tourists, per capita revenue, and monthly revenue two years before and one and a half years after the COVID-19 pandemic. For data analysis, t-tests of independent groups and interrupted time series regression were used in SPSS and EViews 10 software.
Results: The COVID-19 pandemic has caused a 42% decrease in the average monthly number of medical tourists, a 45% decrease in the monthly revenue, and a 10% decrease in the per capita income per tourist (P<0.05). The arrival of medical tourists from the Republic of Azerbaijan, Bahrain, Iraq, and Oman has decreased by more than 80%, and the largest decrease in the number of tourists has been related to Ahvaz, Urmia, Tabriz, and Shiraz. In all diagnostic groups except obstetrics and gynecology, there has been a decrease between 50 to 70% The declining trend of medical tourism indicators was stopped in the second year of the COVID-19 pandemic and has continued as a constant trend.
Conclusion: The COVID-19 crisis has hurt the number of international patients and their revenue in Iran. Relative success in controlling COVID-19 can return to a pre-pandemic situation that requires appropriate policies and administrative measures by government and industry players, such as policies to facilitate patient entry, marketing measures, branding and creating a positive image of the country to potential clients, use of telemedicine facilities for consultations and follow-up, etc.
Miss Maryam Eslami, Javad Jahangirzadeh,
Volume 16, Issue 6 (1-2023)
Volume 16, Issue 6 (1-2023)
Abstract
Background and Aim: The curriculum as the heart of the educational system is one of the effective factors in achieving the goals and mission of the university and its evaluation is of particular importance. Since medical education deals with human life and clerkships also play an essential role in shaping the professional abilities of medical students, this research was conducted with the aim of determining the desirability of clerkship programs from the point of view of medical students of Tehran University of Medical Sciences during the Covid-19 pandemic based on the nine elements of Francis Klein.
Materials and Methods: In this study, a descriptive-survey method was used. The statistical population was 487 medical students of Tehran University of Medical Sciences, who were undergoing the clerkship stage at the time of the research, and the questionnaire was provided to them in the form of a census. The number of samples was determined based on Morgan’s table of 215 people. The research tool was a standard questionnaire, the validity of which was confirmed by professors in the field of educational sciences, and its reliability was calculated using the Cronbach’s alpha method of 0.794. Descriptive statistics (including statistical tables, graphs, central and dispersion indices) and inferential statistics (including one-sample t-tests and independent two-sample t-tests) were used for data analysis.
Results: The results showed that clerkship programs from the point of view of medical students of Tehran University of Medical Sciences during the covid-19 disease, considering that the t-statistic of all research variables is less than 1.96 (educational objectives t=-4.735, educational content t=0/666, learning activities t=-7.812, teaching strategies t=-4.246, educational materials and resources t=-0.970, grouping of learners t=-5.223, learning space (place) t=-4.029, learning time t=-5.043, and learning evaluation t=-7.348) were not desirable in terms of all elements. It was also found that there is no significant difference in attitudes between male and female students regarding the desirability of these programs except for the element of educational goals.
Conclusion: According to the results of the research, the medical clerkship programs of Tehran University of Medical Sciences are facing challenges during the Covid-19 pandemic. Therefore, it is necessary to provide a program that is compatible with the conditions and can meet the educational needs of the learners.
Materials and Methods: In this study, a descriptive-survey method was used. The statistical population was 487 medical students of Tehran University of Medical Sciences, who were undergoing the clerkship stage at the time of the research, and the questionnaire was provided to them in the form of a census. The number of samples was determined based on Morgan’s table of 215 people. The research tool was a standard questionnaire, the validity of which was confirmed by professors in the field of educational sciences, and its reliability was calculated using the Cronbach’s alpha method of 0.794. Descriptive statistics (including statistical tables, graphs, central and dispersion indices) and inferential statistics (including one-sample t-tests and independent two-sample t-tests) were used for data analysis.
Results: The results showed that clerkship programs from the point of view of medical students of Tehran University of Medical Sciences during the covid-19 disease, considering that the t-statistic of all research variables is less than 1.96 (educational objectives t=-4.735, educational content t=0/666, learning activities t=-7.812, teaching strategies t=-4.246, educational materials and resources t=-0.970, grouping of learners t=-5.223, learning space (place) t=-4.029, learning time t=-5.043, and learning evaluation t=-7.348) were not desirable in terms of all elements. It was also found that there is no significant difference in attitudes between male and female students regarding the desirability of these programs except for the element of educational goals.
Conclusion: According to the results of the research, the medical clerkship programs of Tehran University of Medical Sciences are facing challenges during the Covid-19 pandemic. Therefore, it is necessary to provide a program that is compatible with the conditions and can meet the educational needs of the learners.
Ashraf Dehghani, Maryam Ghanbari Khoshnood, Somayeh Amini Sarteshnizi, Arezoo Farhadi,
Volume 17, Issue 1 (3-2023)
Volume 17, Issue 1 (3-2023)
Abstract
Background and Aim: The emergence and continuity of Corona has forced universities and higher education centers to change their educational strategy to take appropriate and consistent action to improve their educational programs. Due to the importance of e-learning and e-learning in response to these conditions, the present study investigated the experience of students of Hamadan University of Medical Sciences from e-learning in the Covid-19 crisis condition.
Materials and Methods: This was a qualitative research with an interpretive phenomenological approach. The purposeful sampling method was used. Semi-structured interviews were used to collect data. After the thirteenth interview, the theoretical saturation of the data was achieved and the interview process with the sixteenth person was completed. In order to analyze the text of the interviews, the Colaizzi method was used.
Results: From the analysis of the obtained data, three main themes: “Communication and interaction” with five sub-themes (lack of proper interaction between student/professor and student/student, lack of motivation, security and mental health, knowledge sharing and efficiency atmosphere in time and cost), “Management of time and learning style” with six sub-themes (low quality of teaching, stress, access and provision of resources, exam health, gaining experience and skills and opportunity to learn again and innovation in education) and “Infrastructure and technical facilities” were extracted with three sub-themes (weak support, ignoring educational equality and promoting media literacy). Weak interaction between professor and student, increasing level of anxiety and individual responsibility to achieve success in learning and weak technical and management infrastructure were the main challenges obtained from these three themes. Providing a platform for research, self-regulation and self-management in learning, increasing the knowledge and skills of information and communication technology are among the opportunities that are included in these themes.
Conclusion: The results of the current research require attention to the approach of interaction and communication between the learner and the learner, to review the methods of teaching and skill-learning, to improve the quality of electronic learning and to prepare suitable infrastructures for optimal use of electronic learning.
Materials and Methods: This was a qualitative research with an interpretive phenomenological approach. The purposeful sampling method was used. Semi-structured interviews were used to collect data. After the thirteenth interview, the theoretical saturation of the data was achieved and the interview process with the sixteenth person was completed. In order to analyze the text of the interviews, the Colaizzi method was used.
Results: From the analysis of the obtained data, three main themes: “Communication and interaction” with five sub-themes (lack of proper interaction between student/professor and student/student, lack of motivation, security and mental health, knowledge sharing and efficiency atmosphere in time and cost), “Management of time and learning style” with six sub-themes (low quality of teaching, stress, access and provision of resources, exam health, gaining experience and skills and opportunity to learn again and innovation in education) and “Infrastructure and technical facilities” were extracted with three sub-themes (weak support, ignoring educational equality and promoting media literacy). Weak interaction between professor and student, increasing level of anxiety and individual responsibility to achieve success in learning and weak technical and management infrastructure were the main challenges obtained from these three themes. Providing a platform for research, self-regulation and self-management in learning, increasing the knowledge and skills of information and communication technology are among the opportunities that are included in these themes.
Conclusion: The results of the current research require attention to the approach of interaction and communication between the learner and the learner, to review the methods of teaching and skill-learning, to improve the quality of electronic learning and to prepare suitable infrastructures for optimal use of electronic learning.
Maryam Aghajarinezhad, Yahya Salimi, Shahab Rezaeian, Ghobad Moradi, Mehdi Moradinazar, Fatemeh Khosravi Shadmani, Roya Safari_ Faramani, Mitra Darbandi, Farid Najafi,
Volume 17, Issue 2 (5-2023)
Volume 17, Issue 2 (5-2023)
Abstract
Background and Aim: All people living in a society are not equally at risk of COVID-19 infection and hospitalization. The current study is aimed to determine the factors related to COVID-19 infection and hospitalization among participants of Ravansar Non-Communicable Disease (RaNCD) cohort study.
Materials and Methods: The present study was conducted between 28th February, 2020 to 27th November, 2021. Data from the RaNCD study, morbidity and hospitalizations cases (extracted from the medical care monitoring system, SAMA system and the handwritten list of the health department) and positive serological results were used. For the case-cohort study, 626 confirmed and/or probable cases and 2107 randomly selected participants as sub-cohort were recruited. For the case-control study, 188 COVID-19 hospitalized patients from RaNCD (as cases) and 632 positive outpatients identified as controls. Data were analyzed using Cox and logistic regression, respectively.
Results: In case-cohort study, the hazard ratio of COVID-19 among people living in rural areas, in smokers and those in middle socioeconomic status was, 0.37 (0.24, 0.58), 1.50 (1.07, 2.11), as compared to the reference groups. While the hazard ratio of people aged 46-64 and those ≥65 years old, as compared to the reference group within the first year, was 3.47 (1.76, 6.86) and 6.45 (2.80, 14.85), the corresponding value after one year was 2.23 (1.13, 4.40) and 3.52 (1.53, 8.10), respectively. The hazard ratio among those with at least one comorbidity was 2.45 (1.53, 3.92) in the first year of study and after one year decreased to 1.82 (1.14, 2.92). In addition, moderate and vigorous physical activity decreased the hazard ratio. In case-control study the odds ratio of hospitalization increased by 0.03% (1.03(1.01, 1.05)) with an increase of one year in age and in people with at least three comorbidities was 2.43 (1.24, 4.73) times of those without comorbidity.
Conclusion: Overall, one year after starting the study the decrease in hazard ratio of COVID-19 was significant. Increase in age and having comorbidities are factors that increased the odds ratio of hospitalization. Such people can be considered for the next waves of COVID-19 prioritized for health care and booster vaccination.
Materials and Methods: The present study was conducted between 28th February, 2020 to 27th November, 2021. Data from the RaNCD study, morbidity and hospitalizations cases (extracted from the medical care monitoring system, SAMA system and the handwritten list of the health department) and positive serological results were used. For the case-cohort study, 626 confirmed and/or probable cases and 2107 randomly selected participants as sub-cohort were recruited. For the case-control study, 188 COVID-19 hospitalized patients from RaNCD (as cases) and 632 positive outpatients identified as controls. Data were analyzed using Cox and logistic regression, respectively.
Results: In case-cohort study, the hazard ratio of COVID-19 among people living in rural areas, in smokers and those in middle socioeconomic status was, 0.37 (0.24, 0.58), 1.50 (1.07, 2.11), as compared to the reference groups. While the hazard ratio of people aged 46-64 and those ≥65 years old, as compared to the reference group within the first year, was 3.47 (1.76, 6.86) and 6.45 (2.80, 14.85), the corresponding value after one year was 2.23 (1.13, 4.40) and 3.52 (1.53, 8.10), respectively. The hazard ratio among those with at least one comorbidity was 2.45 (1.53, 3.92) in the first year of study and after one year decreased to 1.82 (1.14, 2.92). In addition, moderate and vigorous physical activity decreased the hazard ratio. In case-control study the odds ratio of hospitalization increased by 0.03% (1.03(1.01, 1.05)) with an increase of one year in age and in people with at least three comorbidities was 2.43 (1.24, 4.73) times of those without comorbidity.
Conclusion: Overall, one year after starting the study the decrease in hazard ratio of COVID-19 was significant. Increase in age and having comorbidities are factors that increased the odds ratio of hospitalization. Such people can be considered for the next waves of COVID-19 prioritized for health care and booster vaccination.
Majid Babaei, Shila Hasanzadeh, Sadeq Rezaei, Davoud Alirezazadeh Sadaghiani, Mohammadreza Sheikhy-Chaman,
Volume 17, Issue 2 (5-2023)
Volume 17, Issue 2 (5-2023)
Abstract
Background and Aim: As a result of the COVID-19 pandemic, the global and Iranian economies have been affected in various ways. The tax sector seems to have reacted relatively quickly to this pandemic. This study examined the impact of the COVID-19 pandemic on tax revenues in West Azerbaijan Province.
Materials and Methods: This descriptive-analytic and cross-sectional study was conducted in the second half of 2021. Primary data for 17 cities of West Azerbaijan Province were provided by the General Administration of Tax Affairs of this province in the form of 9 variables in Excel Format. The data were related to 2019 (Before the COVID-19 pandemic) and 2020 (After the COVID-19 pandemic). The data were analyzed by SPSS using descriptive statistics (Frequency, Percentage, Median, Interquartile range) and analytical statistics (Wilcoxon signed rank test) at a 5% significance level.
Results: Based on the descriptive results, the COVID-19 pandemic caused an increase in the tax revenues of West Azerbaijan province in the fields of government employees’ salary tax, stock transfer tax, inheritance tax and stamp duty tax and a decrease in these revenues in the areas of private employee’s salary tax, income tax on legal entities, business income tax, property transfer tax and value-added tax. Based on the analytical results, the impact of this pandemic on the private employee’s salary tax (P=0.003), income tax on legal entities (P=0.019), business income tax (P=0.013), property transfer tax (P=0.015) and value-added tax (P=0.001) was found to be negative and significant. Furthermore, the effect on stock transfer tax (P=0.030) and inheritance tax (P=0.001) was positive and significant. On the other hand, the impact of this pandemic on government employees’ salary tax (P=0.287) and stamp duty tax (P=0.356) was not statistically significant.
Conclusion: The COVID-19 pandemic hurt most of the tax revenue sectors. To compensate for the decreased income in vulnerable sectors, the government must develop international trade with comprehensive support from the non-governmental sector while creating new tax lines. Also, stabilizing the financing cycle and designing mechanisms to prevent tax evasion, especially in high-paying jobs, can be fruitful.
Materials and Methods: This descriptive-analytic and cross-sectional study was conducted in the second half of 2021. Primary data for 17 cities of West Azerbaijan Province were provided by the General Administration of Tax Affairs of this province in the form of 9 variables in Excel Format. The data were related to 2019 (Before the COVID-19 pandemic) and 2020 (After the COVID-19 pandemic). The data were analyzed by SPSS using descriptive statistics (Frequency, Percentage, Median, Interquartile range) and analytical statistics (Wilcoxon signed rank test) at a 5% significance level.
Results: Based on the descriptive results, the COVID-19 pandemic caused an increase in the tax revenues of West Azerbaijan province in the fields of government employees’ salary tax, stock transfer tax, inheritance tax and stamp duty tax and a decrease in these revenues in the areas of private employee’s salary tax, income tax on legal entities, business income tax, property transfer tax and value-added tax. Based on the analytical results, the impact of this pandemic on the private employee’s salary tax (P=0.003), income tax on legal entities (P=0.019), business income tax (P=0.013), property transfer tax (P=0.015) and value-added tax (P=0.001) was found to be negative and significant. Furthermore, the effect on stock transfer tax (P=0.030) and inheritance tax (P=0.001) was positive and significant. On the other hand, the impact of this pandemic on government employees’ salary tax (P=0.287) and stamp duty tax (P=0.356) was not statistically significant.
Conclusion: The COVID-19 pandemic hurt most of the tax revenue sectors. To compensate for the decreased income in vulnerable sectors, the government must develop international trade with comprehensive support from the non-governmental sector while creating new tax lines. Also, stabilizing the financing cycle and designing mechanisms to prevent tax evasion, especially in high-paying jobs, can be fruitful.
Leila Erfannia, Azita Yazdani,
Volume 17, Issue 3 (8-2023)
Volume 17, Issue 3 (8-2023)
Abstract
Background and Aim: With the spread of the Corona pandemic, the statistics of the number of mobile health applications have grown significantly. This research was conducted with the aim of evaluating the content of Persian language applications in the management of Covid-19.
Material and Methods: In this review research, a systematic search for Persian language programs in the field of Covid-19 management was conducted in four mobile application markets including Myket, Bazzar, Google Play and App Store. The content of the programs was evaluated based on a researcher-made checklist, which was verified according 3 specialist comments, in the five axes of ease of use, education, monitoring, privacy and data sharing. Programs that received more than 50% of the evaluation score were introduced as selected programs. By removing duplicate programs, 119 programs were extracted, of which 21 programs entered the final stage of quality evaluation based on the inclusion and exclusion criteria and after a complete review of the content and capabilities.
Results: Based on the total points of the program, Safiran Salamat received the most score (31), Ac19 and mask were ranked next with 27 and 22 points, respectively. These three programs along with Corona Amar Tashkhis as fourth program received more than 50% of the content review and 17 other programs received less than 50% of the total score. Government has a great role in programs development (three program were government and one was non- government base). All 4 programs, had acceptable score in ease of use but none of them develop for user tracking. Pearson’s correlation test was used to test the relationship between the quality (total scores of apps) and the popularity (amount of downloads), and no significant correlation was observed.
Conclusion: The results of the present study showed that Iranian mobile applications have an acceptable performance in the fields of education and information sharing, but their low popularity makes the achievement of these goals far from expected. Marketing strategies can be effective as one of the useful policy in increasing the use of mobile health programs. Also, the inclusion of capabilities such as contact tracing and online consultations can be fruitful in the pursuit of goals.
Zohreh Javanmard, Marziyhe Meraji, Mahsa Gholizad, Fatemeh Ameri,
Volume 17, Issue 4 (10-2023)
Volume 17, Issue 4 (10-2023)
Abstract
Background and Aim: With the increase of the covid-19 epidemic, wearable devices have received a lot of attention in the field of managing this disease. The present systematic review study was conducted with the aim of investigating the role of wearable devices in the management of the covid-19 disease.
Materials and Methods: The present study was conducted according to the guidelines of PRISMA. For this purpose, Web of Science, PubMed, and Scopus databases were searched to retrieve English articles without time limit, until August 16, 2022. The search strategy included the terms “Wearable Device” and “COVID-19”. The inclusion criteria for the study were original and English-language articles that have been carried out to design and implement wearable tools in managing Covid-19. All short articles, letters to the editor, conference abstracts, observational studies, review articles, as well as articles whose full version was not available and in a language other than English, as well as unimplemented items, were excluded from the study process. In order to evaluate the quality of articles, the AXIS evaluation tool was used to evaluate the quality of cross-sectional studies. After selecting the studies, data was collected based on the data extraction form. Then the data was analyzed through the content analysis method.
Results: Finally, 10 articles were included in the present review and the wearable devices introduced in them were examined. Seventy percent of wearable devices are used for symptom monitoring, health status, and quarantine, and 30% for diagnosis. The primary users of these tools were patients, the general public, doctors, and Authorities of statistics and information. The types of wearable devices used were bracelets and smart watches (60%), sensors (30%), pulse oximeters, and chest patches (10%).The most important capability and feature of wearable devices include transferring data and activities to mobile phones and low energy consumption. Using the AXIS quality assessment tool, four studies were rated as very good, five as good, and one as poor.
Conclusion: The review of studies showed that wearable devices provide many capabilities for disease monitoring and patient empowerment, disease diagnosis, and remote monitoring of vital signs of Covid-19 patients. These tools are presented in different forms. It is suggested to develop new tools with the aim of monitoring the covid-19 disease with an emphasis on the use of patients in the form of bracelets and smartwatches, and also the necessary attention should be paid to privacy and confidentiality issues.
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