Search published articles


General users only can access the published articles
Showing 274 results for Subject:

Hossein Rashnoud, Davood Jalili Naghan,
Volume 20, Issue 4 (3-2023)
Abstract

Background and Aim:  Dust storms have negative effects on public health, social economy and environment and, thus, lead to many damages in human resources, health sector and agriculture. Iran is one of the areas affected by particulate matter, with serious damages annually.  For these reasons particulate matter increases should receive particular attention in Iran.
Materials and Methods: This research was conducted on solid/mineral section of dust fall in Poldokhtar, Lorestan Province, Iran. Sampling of the particles was done in nine spots in three stages during three months to measue heavy metals, cations and anions. Analysis of the samples for cations and anions was done using the Ic Metrohm system and that for heavy metals using the Icp OES-arcoss system.
Results: Sampling of dust fall was done in February, March and April 2019. Data analysis showed the most highly concentrated cation and anion were SO4 and F, respectively, while the concentrations of Fe and Al were the highest among heavy metals. 
Conclusion: The highest amounts of dust fall were found to occur in February 2019, followed by that in March 2019, and the lowest occurring in April 2019. Due to the fact that compounds/elements with both natural and unnatural origins were found in this study, it can be concluded that the origins of the compounds/elements observed could be both natural and unnatural.
 
Maryam Tajvar, Omolbanin Atashbahar, Firoozeh Dadras, Haniye Sadat Sajadi,
Volume 21, Issue 1 (10-2023)
Abstract

Background and Aim: Performance evaluation is a useful way to obtain information for decision-making and management of healthcare organizations. The purpose of this study was to assess the performance of health houses in rural areas in Kerman City, Iran during the outbreak of Covid-19.
Materials and Methods: This cross-sectional study was conducted in 2021-22 using descriptive and analytical methods. The research population included all the health houses in Kerman City (n=57), Iran. The tool for data collection was the Health House Performance Evaluation Checklist of the Ministry of Health and Medical Education developed to supervise the performance of health houses during the outbreak of Covid-19. Data analysis was done using SPSS 26 software, the statistical tests being descriptive statistics (mean and standard deviation) and analytical statistics including independent t-test, one-way analysis of variance and Pearson and Spearman correlations.
Results: The average performance score of the health houses (n =55) in managing Covid-19 was 96.37 out of 136. Installation of the village map on the wall of the health house  (92.3%), screening and following up the positive-test individuals and informing the health care team to track and isolate individuals in close contact (84.6%) were found to have the highest, and injecting the third dose (78.8%) and the second dose (75%) of the Covid vaccine the lowest,  scores. From among the characteristics investigated the variable of native Behvarzes (the personnel of health houses) had a statistically significant positive relationship with the performance score (p=0.01). In addition, the health houses with more than one Behvarz were found to perform better than those with only one Behvarz (p=0.05).
Conclusion: Assessing the performance of health care units at times of crisis, including communicable diseases epidemics, will make it possible to identify the bottlenecks that need improvement for better preparedness in the future. Based on the findings of this  research, the expansion of the coverage of the covid-19 vaccination, updating the disease incidence, the performance of health care teams at home visits, and the progress of the operational plan were the variables that needed improvement most.
 
Zeinab Azizi Mianaii, Roya Sadeghi, Mamak Shariat, Azar Tol, Abbas Rahimi Foroushani, Hossein Jalahi, Yaser Tedadi,
Volume 21, Issue 1 (10-2023)
Abstract

Background and Aim: Considering the quality of prenatal care services, indentification of the avoidable and inevitable maternal factors and proper promotion of the knowledge and skills of health care service providers is vital for providing suitable preventive and interventional services with the aim of ensuring a successful pregnancy and proper management in the health care system.  This study was conducted to compare the adverse pregnancy outcomes among women with or without a history of Covid-19 in the pregnancy and postpartum stages covered by the Babol University of Medical Sciences, Babol, Iran.
Materials and Methods: This was a descriptive-analytical cross-sectional study including 4124 women, either pregnant or after a recent childbirth (with or without Covid-19) between 20.2.2020  and  29.3.2022, registered in the Sib electronic system (hereinafter Sib) of Babol University of Medical Sciences, Babol, Iran. Using a checklist developed and validated by an expert panel data were collected on the prevalence of maternal and neonatal outcomes in mothers with or without a history of Covid-19 and compared. The data collected were analyzed with SPSS 24 using descriptive tests such as chi-square and Fisher's exact test and STATA version 22, and the adverse outcomes with high frequencies following Covid-19 were determined.
Results: Analysis of the data showed the following to be the most common outcomes among mothers with a history of Covid-19: 1. obstetric complications and maternal disorders/diseases (hypertension, type-2 diabetes mellitus, at least one case of bleeding during pregnancy, premature/delayed birth and premature rupture of the amniotic sac, n= 457, 27.8%); 2. medical and surgical problems (unhealthy pregnancy weight gain and thromboembolic events, n=206, 12.5%). In addition, there was a statistically significant difference between the two groups of pregnant mothers with and without a Covid-19 infection as regards medical and surgical problems (P=0.001) and obstetric complications and maternal diseases (p=0.002). As regards the adverse neonatal outcomes in pregnant mothers with and without a history of Covid-19, there was a statistically significant difference between the two groups in terms of Apgar score at minutes 1 and 5 (p≥0.001) and exclusive breastfeeding (P=0.001) and the presence of Covid-19 symptoms in the baby (p<0.001).
Conclusion: Based on the findings of this study it seems that Covid-19 infection during pregnancy is associated with a higher risk of some of the undesirable maternal and neonatal outcomes.  Therefore, it is essential to plan and implement programs for health education, creation of a sound attitude towards better management, enhancement of the skills and capabilities of the health-care providers and, finally, promotion of the knowledge of service recipients. 
 
Hossein Dargahi, Mahboubeh Anbari, Mahmoud Biglar,
Volume 21, Issue 1 (10-2023)
Abstract

Background and Aim: Organizational citizenship behavior (OCB) of employees in an organization as an optional and voluntary behavior may help to improve organizational productivity. It is important to know that encouraging employees to perform voluntary behaviors needs pre-employment education training in the format of organizational socialization. Therefore, this study was conducted to find the association between organizational socialization and OCB among Tehran University of Medical Sciences Senate staff members, Tehran, Iran 
Materials and Methods: This research was a cross-sectional descriptive-analytical study conducted in 2021-2022. The research population was a group of 1419 staff members in the Tehran University of Medical Sciences Senate, Tehran, Iran, from among whom an available sample of 243 was selected according to Krejcie and Morgan Table based on a response rate of 86%.  Data were collected using the Katz’s Organizational Socialization and the Organ & Konovsky’s OCB Questionnaires, the face and content validity of which had been determined by experts, and based on the Cronbach's alpha test the reliability of the questionnaires was found to be 0.83 and 0.81 for the organizational socialization and OCB questionnaires, respectively.  Data analysis for descriptive and analytical statistics was done using the SPSS software.
Results: The means of the employees’ organizational socialization and OCB scores were 3.8 and 3.35 (relatively high), respectively.  A statistically significant correlation was observed between the organizational socialization and OCB and their subthemes.
Conclusion: Explaining and encouraging voluntary behaviors of organizational citizenship among the employees through implementation of pre-employment and on-the-job training and empowerment courses may help to promote organizational productivity.
 
Gholamreza Jahed Khaniki, Nabi Shariatifar, Hedayat Hosseini , Abbas Rahim Foroushani,
Volume 21, Issue 2 (9-2023)
Abstract

Background and Aim: Considering the needs of the society food safety and hygiene graduates can be employed in positions related to their field of study and provide services to solve the food safety and hygiene problems at the community level. The aim of this research was to explain the current situation and future prospects of the food safety and hygiene field in terms of occupational positions and the needs of the society.
Materials and Methods: A descriptive and applied study was conducted with the time series analysis method regarding the current situation and the future perspective of the food safety and hygiene field in terms of occupational positions and the society's need. A valid and reliable questionnaire was developed and used for data collection. In order to predict the future of the field, the time series statistical analysis method (Autoregressive integrated moving average =ARIMA) was used. In addition, its strengths, weaknesses, opportunities and threats were identified and analysed using the SWOT qualitative content analysis.
Results: Analysis of the data obtained showed that the number of food safety and hygiene graduates has an increasing trend. The proportions of the graduates in relevant occupations, in non-relevant occupations and out of job were 48.00%, 24.75% and 27.25%, respectively. The data also revealed that this field of study had good strengths, so attempts should be made to increases them, reducing the weaknesses and threats, using the available and potential opportunities.
Conclusion: Based on the findings of this study the numbers of individuals accepted and graduated in the field of food safety and hygiene have an increasing trend, which are expected to continue in the next ten years. On the whole, the current moderate situation and the future perspective of the food safety and hygiene field in terms of the occupational positions and the society's need can be relatively favourable. In any case it is essential to make serious attempts continuously to maintain and promote this field of study.
 
Maryam Tajvar, Mohammad Sarkout Ghosi, Elham Ehsani-Chimeh,
Volume 21, Issue 2 (9-2023)
Abstract

Background and Aim: Assessment of disease risk with the ultimatevaim of implementing preventive strategies in the workplace is a necessity. This study was conducted to assess the risk of COVID-19 in hospital occupational groups in Saghez city, Iran.
Materials and Methods: This cross-sectional study was conducted in 2021 among three hospital occupational groups (total sample size = 300) in Saghez city, Iran, including physicians and nurses, as well as laboratory, administrative, financial, radiology and general service personnel, using the COVID-19 rapid risk analysis technique. Data were collected using a valid questionnaire based on the Likert scale and analysed (to determine acceptable, tolerable and intolerable risks) using the descriptive and inferential methods, the software used being SPSS-26.
Results: As regards the probability variable, the highest probability of occurrence of COVID-19 was related to the general service and administrative-financial occupational groups with an average of 1.6 and 1.5, respectively. The level of attitude was generally good and excellent. The analysis of the severity of the outcome variable was at a critical level in the physicians group (42.5) and at a catastrophic level in the other groups. In total, all occupations were rated at an unacceptable risk level (H), the general service and administrative-financial occupational groups being at a higher risk than other groups. There were statistically significant differences between the types of occupation on the one hand and the variables studied, as well as the individual characteristics and COVID-19 morbidity on the other hand.
Conclusion: Considering the high risk of occurrence of COVID-19 among the hospital professionals it is essential to develop and implement plans aiming at preventing and reducing the disease risk in them.
 
Somayeh Jalilvand, Atefeh Kachooei, Tayebeh Latifi, Mahdieh Motamedi‐rad, Mohammad Farahmand, Nasir Mohajel, Zabihollah Shoja,
Volume 21, Issue 2 (9-2023)
Abstract

 
1. Franco MA, Angel J, Greenberg HB. Immunity and correlates of protection for rotavirus vaccines. Vaccine. 2006; 24(15):2718-31.
2. Glass RI, Parashar UD, Bresee JS, Turcios R, Fischer TK, Widdowson M-A, et al. Rotavirus vaccines: current prospects and future challenges. The Lancet. 2006;368(9532):323-32.
3. Parashar UD, Gibson CJ, Bresee JS, Glass RI. Rotavirus and severe childhood diarrhea. Emerging infectious diseases. 2006;12(2):304.
4. Kargar M, Zare M, Najafi A. Molecular epidemiology of rotavirus strains circulating among children with gastroenteritis in Iran. Iranian journal of pediatrics. 2012;22(1):63.
5. Modares S, Rahbarimanesh AA, Karimi M, Modares S, Motamedirad M, Sohrabi A, et al. Electrophoretic RNA genomic profiles of rotavirus strains prevailing among hospitalized children with acute gastroenteritis in Tehran, Iran. 2008.
6. Shoja Z, Jalilvand S, Mokhtari-Azad T, Nategh R. Epidemiology of cocirculating human rotaviruses in Iran. The pediatric infectious disease journal. 2013;32(4):e178-e81.
7. Jalilvand S, Roohvand F, Arashkia A, Shoja Z. Update on Epidemiology and Circulating Genotypes of Rotavirus in Iranian Children With Severe Diarrhea: 1986-2015. Int J Travel Med Glob Health. 2018;6(1):7-10.
8. Desselberger U. Rotaviruses. Virus research. 2014;190:75-96.
9. http://rega.kuleuven.be/cev/ viralmetagenomics/virus-classification/ rcwg. updated 25 Mar, 2021 [.
10. Santos N, Hoshino Y. Global distribution of rotavirus serotypes/genotypes and its implication for the development and implementation of an effective rotavirus vaccine. Reviews in medical virology. 2005;15(1):29-56.
11. Banyai K, Laszlo B, Duque J, Steele AD, Nelson EA, Gentsch JR, et al. Systematic review of regional and temporal trends in global rotavirus strain diversity in the pre rotavirus vaccine era: insights for understanding the impact of rotavirus vaccination programs. Vaccine. 2012;30(1):A122-30.
12. Doro R, Laszlo B, Martella V, Leshem E, Gentsch J, Parashar U, et al. Review of global rotavirus strain prevalence data from six years post vaccine licensure surveillance: is there evidence of strain selection from vaccine pressure? Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases. 2014;28:446-61.
13. Mwanga MJ, Owor BE, Ochieng JB, Ngama MH, Ogwel B, Onyango C, et al. Rotavirus group A genotype circulation patterns across Kenya before and after nationwide vaccine introduction, 2010-2018. BMC infectious diseases. 2020;20(1):1-12.
14. Matthijnssens J, Mino S, Papp H, Potgieter C, Novo L, Heylen E, et al. Complete molecular genome analyses of equine rotavirus A strains from different continents reveal several novel genotypes and a largely conserved genotype constellation. The Journal of general virology. 2012;93(Pt 4):866-75.
15. Matthijnssens J, Ciarlet M, Rahman M, Attoui H, Banyai K, Estes MK, et al. Recommendations for the classification of group A rotaviruses using all 11 genomic RNA segments. Archives of virology. 2008;153(8):1621-9.
16. Hutson AM, Atmar RL, Graham DY, Estes MK. Norwalk Virus Infection and Disease Is Associated with ABO Histo-Blood Group Type. The Journal of Infectious Diseases. 2002;185(9):1335-7.
17. Carlsson B, Kindberg E, Buesa J, Rydell GE, Lidón MF, Montava R, et al. The G428A nonsense mutation in FUT2 provides strong but not absolute protection against symptomatic GII.4 Norovirus infection. PLoS One. 2009;4(5):e5593.
18. Tan M, Jiang X. Histo-blood group antigens: a common niche for norovirus and rotavirus. Expert reviews in molecular medicine. 2014;16.
19. Liu Y, Ramelot TA, Huang P, Liu Y, Li Z, Feizi T, et al. Glycan Specificity of P[19] Rotavirus and Comparison with Those of Related P Genotypes. J Virol. 2016;90(21):9983-96.
20. Hu L, Sankaran B, Laucirica DR, Patil K, Salmen W, Ferreon ACM, et al. Glycan recognition in globally dominant human rotaviruses. Nat Commun. 2018;9(1):2631.
21. Yen C, Steiner CA, Barrett M, Curns AT, Hunter K, Wilson E, et al. Racial disparities in diarrhea-associated hospitalizations among children in five US States, before and after introduction of rotavirus vaccine. Vaccine. 2010;28(46):7423-6.
22. Payne DC, Currier RL, Staat MA, Sahni LC, Selvarangan R, Halasa NB, et al. Epidemiologic Association Between FUT2 Secretor Status and Severe Rotavirus Gastroenteritis in Children in the United States. JAMA pediatrics. 2015;169(11):1040-5.
23. Shoja Z, Jalilvand S, Mokhtari-Azad T, Nategh R. Epidemiology of cocirculating human rotaviruses in Iran. The Pediatric infectious disease journal. 2013;32(4):e178-81.
24. Shoja Z, Jalilvand S, Mollaei-Kandelous Y, Validi M. Epidemiology of viral gastroenteritis in Iran. The Pediatric infectious disease journal. 2014;33(2):218-20.
25. Kachooei A, Tava Koli A, Minaeian S, Hosseini M, Jalilvand S, Latifi T, et al. Molecular characterization of rotavirus infections in children less than 5 years of age with acute gastroenteritis in Tehran, Iran, 2021–2022: Emergence of uncommon G9P [4] and G9P [8] rotavirus strains. Journal of medical virology. 2023;95(2):e2852.
26. Motamedi-Rad M, Farahmand M, Arashkia A, Jalilvand S, Shoja Z. VP7 and VP4 genotypes of rotaviruses cocirculating in Iran, 2015 to 2017: Comparison with cogent sequences of Rotarix and RotaTeq vaccine strains before their use for universal mass vaccination. Journal of medical virology. 2020;92(8):1110-23.
27. Jalilvand S, Afchangi A, Mohajel N, Roohvand F, Shoja Z. Diversity of VP7 genes of G1 rotaviruses isolated in Iran, 2009-2013. Infection, genetics and evolution: journal of molecular epidemiology and evolutionary genetics in infectious diseases. 2016;37:275-9.
28. Morozova OV, Sashina TA, Fomina SG, Novikova NA. Comparative characteristics of the VP7 and VP4 antigenic epitopes of the rotaviruses circulating in Russia (Nizhny Novgorod) and the Rotarix and RotaTeq vaccines. Archives of virology. 2015;160(7):1693-703.
29. Mouna BH, Hamida-Rebai MB, Heylen E, Zeller M, Moussa A, Kacem S, et al. Sequence and phylogenetic analyses of human rotavirus strains: comparison of VP7 and VP8( *) antigenic epitopes between Tunisian and vaccine strains before national rotavirus vaccine introduction. Infection, genetics and evolution: journal of molecular epidemiology and evolutionary genetics in infectious diseases. 2013;18:132-44.
30. Zeller M, Patton JT, Heylen E, De Coster S, Ciarlet M, Van Ranst M, et al. Genetic analyses reveal differences in the VP7 and VP4 antigenic epitopes between human rotaviruses circulating in Belgium and rotaviruses in Rotarix and RotaTeq. Journal of clinical microbiology. 2011; 50(3):966-976.
31. Hoshino Y, Jones RW, Ross J, Honma S, Santos N, Gentsch JR, et al. Rotavirus serotype G9 strains belonging to VP7 gene phylogenetic sequence lineage 1 may be more suitable for serotype G9 vaccine candidates than those belonging to lineage 2 or 3. Journal of virology. 2004;78(14):7795-802.
32. Jin Q, Ward RL, Knowlton DR, Gabbay YB, Linhares AC, Rappaport R, et al. Divergence of VP7 genes of G1 rotaviruses isolated from infants vaccinated with reassortant rhesus rotaviruses. Archives of virology. 1996;141(11):2057-76.
33. Bányai K, Gentsch JR, Martella V, Bogdán Á, Havasi V, Kisfali P, et al. Trends in the epidemiology of human G1P [8] rotaviruses: a Hungarian study. The Journal of infectious diseases. 2009; 200 (1):S222-S7.
34. Magagula NB, Esona MD, Nyaga MM, Stucker KM, Halpin RA, Stockwell TB, et al. Whole genome analyses of G1P [8] rotavirus strains from vaccinated and non‐vaccinated South African children presenting with diarrhea. Journal of medical virology. 2015;87(1):79-101.
35. Kulkarni R, Arora R, Arora R, Chitambar SD. Sequence analysis of VP7 and VP4 genes of G1P [8] rotaviruses circulating among diarrhoeic children in Pune, India: A comparison with Rotarix and RotaTeq vaccine strains. Vaccine. 2014;32:A75-A83.
36. Zeller M, Patton JT, Heylen E, De Coster S, Ciarlet M, Van Ranst M, et al. Genetic analyses reveal differences in the VP7 and VP4 antigenic epitopes between human rotaviruses circulating in belgium and rotaviruses in rotarix™ and RotaTeq™. Journal of clinical microbiology. 2011:JCM. 05590-11.
37. Farahmand M, Jalilvand S, Arashkia A, Shahmahmoodi S, Afchangi A, Mollaei-Kandelous Y, et al. Association between circulating rotavirus genotypes and histo-blood group antigens (HBGAs) in the children hospitalized with acute gastroenteritis in Iran. Journal of medical virology. 2021;93(8):7.
38. Ayouni S, Sdiri-Loulizi K, de Rougemont A, Estienney M, Ambert-Balay K, Aho S, et al. Rotavirus P[8] Infections in Persons with Secretor and Nonsecretor Phenotypes, Tunisia. Emerging infectious diseases. 2015;21(11):2055-8.
39. Nordgren J, Sharma S, Bucardo F, Nasir W, Gunaydin G, Ouermi D, et al. Both Lewis and secretor status mediate susceptibility to rotavirus infections in a rotavirus genotype-dependent manner. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2014;59(11):1567-73.
40. Yu Y, Lasanajak Y, Song X, Hu L, Ramani S, Mickum ML, et al. Human milk contains novel glycans that are potential decoy receptors for neonatal rotaviruses. Molecular & cellular proteomics: MCP. 2014;13(11):2944-60.
41. Huang P, Xia M, Tan M, Zhong W, Wei C, Wang L, et al. Spike protein VP8* of human rotavirus recognizes histo-blood group antigens in a type-specific manner. Journal of virology. 2012;86(9):4833-43.
42. Parker EP, Ramani S, Lopman BA, Church JA, Iturriza-Gomara M, Prendergast AJ, et al. Causes of impaired oral vaccine efficacy in developing countries. Future microbiology. 2018;13:97-118.









Prevalence and Distribution of Common Rotavirus Genotypes in Iran and Comparing them with Vaccine Strains Before the Start of the National Vaccination Program

Somayeh Jalilvan1, Atefeh Kachooei2, Tayebeh Latifi3, Mahdieh Motamedi‐Rad4, Mohammad Farahmand3, Nasir Mohajel5, Zabihollah Shoja6*
1- Ph.D. Associate Professor, Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
2- Ph.D. Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
3- Ph.D. Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
4- MSc. Department of Virology, Pasteur Institute of Iran, Tehran, Iran
5- Ph.D. Assistant Professor, Department of Virology, Pasteur Institute of Iran, Tehran, Iran
6- Ph.D. Associate Professor, Department of Virology, Pasteur Institute of Iran, Tehran, Iran
* Corresponding author: zabihollahshoja@gmail.com, zshoja@alumnus.tums.ac.ir
Received: May 25, 2023                                                Accepted: Oct 11, 2023

ABSTRACT
Background and Aim: Since the discovery of rotaviruses in 1973, these viruses have been identified as one of the most important and common causes of diarrhea in infants and children all over the world. Before the introduction of rotavirus vaccination, this virus led to the death of more than 500,000 children in the world annually, which mainly occurs in developing countries. With the introduction of Rotarix and RotaTeq vaccines as well as ROTAVAC and ROTASIIL in the world, the death rate has decreased by 50%. Iran, like many countries, is in the period before rotavirus vaccination, and considering putting the rotavirus vaccine in the vaccination program is one of the priorities of the country's health system. Therefore, knowing the genotypes circulating in Iran in the past and recent years and their comparison with vaccine strains is very important. Our aim in the current study is to review the prevalence of rotavirus and its genotypes circulating in Iran and whether the existing vaccines based on the circulating strains in Iran can be effective.
Materials and Methods: Studies regard to the prevalence and genotypes of rotavirus in Iran were reviewed.
Results:  G1P[8] genotype includes more than 50% of circulating genotypes. Non-G1P[8] genotypes, including G4P[8], G3P[8] and G9P[8], have also had a high frequency in some studies. In addition, in a recent study, it has been shown that the rare and uncommon genotype G9P[4] has been introduced as a common genotype.
Conclusion: Studies in Iran have shown that the country may face a change in the rotavirus genotype pattern in the future. This study can provide useful information to recommend appropriate policies for rotavirus vaccination before the start of the national vaccination program and may even change policies for the use of existing vaccines.
 
Soheila Keshavarz, Kourosh Holakouie Naeini , Abbas Rahimi Foroushani ,
Volume 21, Issue 2 (9-2023)
Abstract

Background and Aim: Despite all the current diabetes prevention programs, only a limited number of patients are identified and receive care.
Materials and Methods: This was a cross-sectional descriptive-analytical study including individuals over 30 years old in Buin Zahra city, Iran selected using the multi-stage sampling method (sample size = 1154). Data were collected using a questionnaire for the general public and the health team, the validity and reliability of which had been determined based on the CVR and CVI indexes and the correlation coefficient, respectively.
Results: The average age of the sample and the prevalence of diabetes were 48.42 ± 14.45 years and 9.9%, respectively. Further analysis of the data showed the following:
1. the prevalence of diabetes in at-risk people: women with a history of abortion and large children, 12.8% and 31.7%, respectively; gestational diabetes 36.5%;
2. obesity during pregnancy: 19.7%; a family history of diabetes: 22.4%;
3. waist circumference>90 cm: 14.08%, BMI>25: 13.95%; and
4. triglyceride<200: 22%, hypertension: 32.97%.
Further analysis of the data showed statistically significant associations between diabetes and blood sugar level above 100 mg/dl (OR = 2.73), waist circumference >90 cm (OR = 3.02) and gestational diabetes (OR =12.22); no other significant associations were found.
Only 55% of the health team personnel had received diabetes prevention training.
Conclusion: It can be concluded that patient care and education are not of a proper quality. The considerable prevalence of diabetes among people at risk shows that more follow-up and care are needed for them. The training of health team personnel should be very efficient and the number of trainings related to the diabetes program should increase.
 
Ahmad Nejati, Alireza Asgari Golzardi, Farshad Khodakhah, Katayoun Samimi-Rad, Seyedeh Maryam Yousefi, Yaghoub Mollaei-Kandelousi, Maryam Keyvanlou, Mohammad Razaghi, Parastoo Soheili, Delaram Yaghoubzadeh, Nastaran Ghavami, Susan Mahmoudi, Seyed Mohsen Zahraei, Shohreh Shahmahmoodi,
Volume 21, Issue 3 (12-2023)
Abstract

Background and Aim: During the COVID-19 pandemic public health measures and protocols such as regular hand washing and wearing a face mask were recommended at the national level. The implementation of these health protocols reduced the prevalence of respiratory diseases, but no study has been conducted to investigate the impact of the implementation of these protocols on the spread of viruses that are transmitted through fecal-oral route. Considering that non-polio enteroviruses (NPEVs) are mainly transmitted through fecal-oral route, this study was conducted to determine the prevalence of non-polio enteroviruses in patients with acute flaccid paralysis (AFP) in Iran before and during the COVID-19 pandemic.
Materials and Methods: To detect non-polio enteroviruses stool samples of AFP cases received by Iran National Polio Laboratory in 2019 (before the COVID-19 pandemic) and 2021 (during the COVID-19 pandemic) were tested. To isolate NPEVs by cell culture, the WHO standard protocol was used, and the TaqMan One-Step Real Time PCR was used for molecular testing.
Results: In 2019, a sample of 21 out of 1070 patients and a sample of 12 out of 100 patients were found to be positive for non-polio enterovirus by cell culture and the molecular method, respectively; these ratios decreased to10 out of 678 and 3 out of 100 in 2021.
Conclusion: Based on the findings of this study, it can be concluded that the observance of personal hygiene and public health protocols during the COVID-19 epidemic  have, in addition to the general reduction of respiratory transmission of viruses, also affected the faecal-oral transmission of viruses.
 
Razieh Khalili Nezhad, Parastoo Golshiri,
Volume 21, Issue 3 (12-2023)
Abstract

Background and Aim: Primary levels of health services are designed to provide, maintain and promote the health of healthy young people, while the goal of higher levels is to screen and restore the health of the patients. One of the challenges is the personal culture of some of the health service providers and the recipients of these services. One of the recent reforms in the healthcare system has been the implementation the Health System Reform Plan based on the family physician and the referral system. This study investigated the status of the referral system in the family physician program in Isfahan metropolitan area in 2018.
Materials and Methods: This was a qualitative study with a contractual content analysis conducted on a sample of 28 individuals selected by purposeful snowball sampling continued until saturation. Interviews were held with male and female healthcare workers (n = 14), midwives (n = 10), and managers (n = 4). Data analysis was done using the SPSS.25 statistical software.
Results: This study succeeded to explain strategies to improve the quality of the referral system and the views of health service personnel and, finally, find the strengths, weaknesses and solutions for improving the referral system.
Conclusion: The findings show that the performance of the referral system in the city of Isfahan is in line with the goals. However, visiting referred patients, providing feedback and referral to the laboratory are not as effective as they should be. Therefore, planning is needed to remove obstacles and solve problems such as shortage of human resources, non-human resources and infrastructure, insufficient provision of medicines and job insecurity so that goals can be reached.
 
Maryam Tajvar, Omolbanin Atashbahar, Parisa Pourfarokh, Ebrahim Jaafaripooyan, Haniye Sadat Sajadi,
Volume 22, Issue 1 (10-2024)
Abstract

Background and Aim: Considering the growing trend of cosmetic surgery it is essential to adapt a different approach to provide the relevant services in response to the community needs. In this study we aimed to assess the current state of cosmetic surgery services in Iran in terms of frequency distribution according to the type of surgery and other features.
Materials and Methods: This was a descriptive study using the information in the Statistics and Information Technology Management Center (SITMC) of the Ministry of Health and Medical Education. The data in the SITMC medical records of the information system of the reference hospitals for cosmetic surgery, including admission type, status at the time of discharge, average cost, average length of stay, type of center (ownership) and demographic characteristics of the patients undergoing cosmetic surgery were extracted between January 2017 and June 2021. Data analysis was done using Excel software and descriptive statistics (frequency, percentage and mean).
Results: During the study period a total of 62,387 surgeries had been performed for 56 cosmetic surgery codes. The majority of cosmetic surgery centers (79.7%) were governmental. The demands for cosmetic surgery by different groups were as follows: women 73.9%, Iranian nationals 97.7%, married individuals 40.6%, and the aged individuals 16-45 years 82.7%. Rhinoplasty accounted for approximately 60% of the cosmetic surgeries, while septorhinoplasty and lower eyelid blepharoplasty had the highest and lowest average costs and lengths of stay, respectively.
Conclusion: Considering the average cost of surgical operations, financing arrangements and the framework of providing the relevant services should be specified with more precision and transparency. In addition, prior to making decisions in this area policies should be checked in terms of efficiency, effectiveness and cultural compatibility.
 
Aram Halimi, Goljamal Jorjani, Leyla Sharifi Aliabadi, Mohammad Reza Taherian, Haniyeh Yeganeh, Matin Shokrgozar, Gholamreza Ebrahimi, Mohammad Hossein Panahi,
Volume 22, Issue 1 (10-2024)
Abstract

Background and Aim: This study aimed to assess and prioritize the health needs of a community served by the Imamzadeh Ghasem Health Center in Tehran city, Iran.
Materials and Methods: This study was conducted based on the North Carolina model for comprehensive community health assessment. General information and available facilities were extracted from secondary sources, while insights into specific community needs were gathered through interviews with 76 individuals representing diverse demographics. The assessment was made by secondary data analysis and direct interviews.
Finally, the prioritization of health needs of the community was based on a scoring system based on severity, extent, and ease of being solved.
Results: The findings revealed that sewage problems, construction issues and waste management were considered to be the primary health concerns in the region. Comparative analysis with the situation in other regions in Iran emphasizes the unique challenges faced by the community in the present study.
Conclusion: The prioritized health issues highlight the community's urgent needs, requiring targeted interventions. Proposed solutions include legal measures, public education and municipal interventions to address the sewage, construction and waste management problems.
 
ُsamane Miresmaeelii, Ali Mohammad Mosadegh Rad, Ebrahim Jaafaripooyan,
Volume 22, Issue 2 (9-2024)
Abstract

Background and Aim: Accreditation as an external assessment model is considered a key program for evaluating health care organizations. The new health service accreditation system in Iran seems to lack the necessary standards for evaluating outpatient services and general clinics. The objective of this study was to design, based on the experiences of other countries, a model for accreditation of general clinics in Iran
Materials and Methods: This research was a qualitative review study conducted in two phases First, the methods and standards of accreditation of general clinics of selected countries were identified through a comparative review. In the second phase, the conceptual framework of the accreditation of these clinics was developed by an expert panel.
Results: The proposed framework for the accreditation of clinics starts with registering the application in the system and updating the information. After the clinic's self-evaluation and external evaluation, amendments will be made.
The key areas proposed for the accreditation of clinics included management and leadership, information management, process management, human resource management, salaries,  and operational results. The country's clinics can be ranked in five levels, namely, excellent, good, average, poor, and substandard.
Conclusion: Considering the processes and areas determined in this study and the lack of a systematic approach, the proposed accreditation model could provide a scientific and practical method for the internal and external evaluating bodies to provide a relevant and valid evaluation of the general outpatient clinics in Iran.
 
Parisa Berimavandi, Narjes Shokri, , Masoud Karimi, Seyed Mansour Kashfi,
Volume 22, Issue 3 (3-2024)
Abstract

ABSTRACT
Background and Aim: The corona epidemic and home quarantine have affected the participation in physical activities of the elderly however the elderly, especially the frail older adult with obesity, have to do regular exercise to maintain or improve their health.the aim of this research effectiveness of Physical Exercises on the Cognitive Performance and Instrumental Activity of Daily Living of Frail older adult.
Materials and Methods: The statistical population in this semi-experimental research was the elderly women of Shiraz.  80 women participated in the research according to the goal-based method and according to the entry criteria, and were randomly divided into two groups of 40 people, test and control.  The test group received and performed their exercise program during 8 weeks in 3 sessions (one hour) via WhatsApp.  Before the intervention and one month after the last intervention session, the two groups of participants completed demographic questionnaires, Tilburg vulnerability index, short cognitive status test and Lawton index.  To analyze the data, independent team and paired t-tests were used in SPSS version 27 software.
Results: The results showed that performing movement exercises on the Frailty (Cohen’s d =1/39) (p<0/001), Cognitive status (Cohen’s d =1/41) (p=0/04) and doing instrumental life activities independently (Cohen’s d =0/40) (p=0/007) It had a positive effect on Frail Older Women.
Conclusion: The findings of this research support the dominant effect of the exercise protocol implemented in this research on the mentioned variables; Therefore, it is recommended to use these exercises during periods such as corona quarantine at home.
 
Maryam Mahmoudi, Mina Hajimohammadi,
Volume 22, Issue 3 (3-2024)
Abstract

Background and Aim: Assessing dietary intake and nutritional status of dialysis patients can be challenging. Accurate and regular assessment of patients ensures adequate macronutrient and micronutrient intake, thereby reducing morbidity and mortality and improving patients' quality of life.
Materials and Methods: A scientific search was conducted in scientific databases and search engines such as PubMed, Google scholar, Science Direct, and Scopus with the keywords dialysis, peritoneal dialysis, end-stage renal disease, renal failure, chronic kidney disease, nutritional needs, and nutritional assessment in English to find studies published between 2014 and 2024. A total of 18 articles were found and reviewed based on the inclusion criteria.
Results: The goals of medical nutrition therapy for the management of end-stage renal disease (ESRD) include the following: preventing nutritional deficiency and maintaining appropriate nutritional status (in children, growth support) through adequate intake of protein, energy, vitamins, and minerals; controlling edema and electrolyte imbalance by controlling sodium, potassium, and fluid intake; preventing or delaying the progression of renal osteodystrophy by controlling calcium, phosphorus, vitamin D, and parathyroid hormone; enabling the patient to consume a balanced diet that is appropriate to the patient's lifestyle to the extent possible; coordinating patient care with family, dietitians, nurses, and physicians; providing initial nutrition education, periodic counseling, and long-term monitoring of patients with the aim of receiving adequate education to be able to control their diet.
Conclusion: Dialysis is a treatment for the survival of patients with end-stage renal disease (ESRD), and nutritional care is an integral part of the patient's treatment process.
 
Zeinab Khaledian, Javad Moazzeni, Liela Najafi, Nasim Badiei, Fatemeh Yonesi,
Volume 22, Issue 4 (3-2025)
Abstract

Background and Aim: Providing high-quality prenatal and postnatal care plays a crucial role (during pregnancy and at labor) in reducing maternal and neonatal mortality and complications, improving outcomes, and increasing patient satisfaction and enhancing healthcare system efficiency. This study aimed to assess the quality of intrapartum care using the Comprehensive Quality Measurement in Health Care (CQMH) model.
Materials and Methods: This was a descriptive study conducted in 2020 at Ommol banin hospital in Mashhad, Iran, including 324 mothers admitted for childbirth. Participants were selected through simple random sampling and data were collected using the CQMH questionnaire, which assesses three dimensions of care quality, namely, technical quality, service quality, and customer (client) quality. Data analysis was performed using the SPSS version 27.
Results: The overall quality index score was 80.9. Technical quality was rated as favorable (mean score: 90.3), while service quality (mean score: 79.5) and customer quality (mean score:73) were rated as moderate. As regards service quality communication, continuity of care and preventive measures had the lowest scores.
Conclusion: While the technical quality of intrapartum care was found to be satisfactory, there is a pressing need to strengthen provider–patient communication and empower mothers to actively participate in theirown care during childbirth.
 
Mohammad Bidkhori, Mahdi Akbarzadeh, Noushin Fahimfar, Bagher Larijani, Iraj Nabipour, Afshin Ostovar, Kourosh Holakouie-Naieni,
Volume 23, Issue 1 (6-2025)
Abstract

Background and Aim: The Trabecular Bone Score (TBS) is a novel tool for assessing bone microarchitecture and identifying individuals at risk for osteoporotic fractures. This study aimed to evaluate the association between Single Nucleotide Polymorphisms (SNPs) of the SOST gene and TBS in Iranian postmenopausal women.
Materials and Methods: This study included 1/071 postmenopausal women from the Bushehr Elderly Health (BEH) Cohort study. Relationship between Seven independent SNPs in the SOST gene located on chromosome 17q21.31 were investigated with TBS L1–L4. Associations were tested using generalized linear models under additive, dominant, and recessive genetic models. A genetic score was also calculated by summing the weighted number of risk alleles based on the regression coefficients of the SNPs.
Results: After adjustment for age and Body Mass Index (BMI), SNP rs2023794-C showed a statistically significant association with TBS in the additive model (β = 0/ 03, P = 4/7×10⁻⁵, PFDR = 0/0003) and the dominant model (β = 0/033, P = 2/5×10⁻⁵, PFDR = 0/0003). Furthermore, higher genetic scores were positively associated with increased TBS values.
Conclusion: Our findings highlight the potential role of SOST gene variants and derived genetic score in predicting bone quality in postmenopausal women. These genes could aid in identifying individuals at higher risk of poor bone quality and in developing personalized osteoporosis prevention strategies.
 
Azar Houri, Roya Sadeghi, Azar Tol, Mahdi Yaseri, Yaser Tedadi,
Volume 23, Issue 2 (9-2025)
Abstract

Background and Aim: Adolescence is a critical period for educational investment, which can enhance individual quality of life and reduce the future burden of disease and healthcare costs. This study aimed to compare the effectiveness of direct education and peer education on health-promoting behaviors among first-grade middle school students in Shush, Khuzestan, in 2024.
Materials and Methods: This quasi-experimental study with pre-test, post-test, and three-month follow-up was conducted on 448 female first-grade middle school students in Shush using multistage cluster sampling. In the peer education group, selected students served as peer educators after receiving training and passing written and practical evaluations. Data were collected using the Walker Health-Promoting Lifestyle Profile (HPLP-II). The intervention was delivered in eight 60–90-minute sessions. Data was analyzed using descriptive and inferential statistics in SPSS software version 27, with a significance level of 0.05.
Results: Both direct and peer education significantly improved health-promoting behaviors (p< 0.05). Direct education had greater effects on overall scores and the dimensions of health responsibility, physical activity, and stress management, which persisted up to three months. Peer education had the strongest impact on interpersonal relationships and spiritual growth.
Conclusion: Both direct and peer education are effective in promoting health behaviors; however, direct education provides more durable effects on core health dimensions, while peer education primarily enhances interpersonal and motivational aspects. A combination of these methods may yield better outcomes in promoting student health.
 
Vida Saghari, Hossein Jalali, Nabi Shariatifar, Mona Belandi,
Volume 23, Issue 2 (9-2025)
Abstract

Background and Aim: Edible films represent an innovative solution for meat preservation, helping to reduce spoilage and extend shelf life. This study aimed to investigate the effect of edible films containing whey protein and free-form or Pickering emulsion of Trachyspermum copticum L. essential oil on the properties of beef during refrigerated storage.
Materials and Methods: Edible films containing whey protein and T. copticum L. essential oil (in free and Pickering emulsion forms) were prepared. Their physical, microbial, and chemical properties, as well as sensory attributes, were evaluated.
Results: Physical tests demonstrated successful film preparation, with the average zeta diameter of nanoliposomes ranging from 73.91 to 110.53 nm, polydispersity index (PDI) from 0.451 to 0.471, zeta potential from −5.12 mV to −3.64 mV, and encapsulation efficiency from 49.61% to 64.23%. The best performance in microbial, chemical, and sensory evaluations was observed in the treatment containing whey protein with nano-essential oil (Pickering emulsion), compared to the control and free essential oil samples.
Conclusion: The results indicate that edible films containing whey protein and nano-essential oil of T. copticum L. can be an effective strategy for storing beef under refrigerated conditions, improving product shelf life.
 
Afsaneh Mosleh, Najmolmolook Amini, Masumeh Sehati, Maryam Soroush, Houra Askarian,
Volume 23, Issue 2 (9-2025)
Abstract

Background and Aim: Rationalizing drug use is a priority in drug policy-making. The World Health Organization (WHO) recommends the evaluation of prescriptions using drug prescribing indicators. Improving prescribing patterns leads to closer alignment with WHO indicators and, consequently, promotes rational drug use.
Materials and Methods: In this study, ten prescriptions were randomly selected from each pharmacy on a monthly basis. WHO prescribing indicators, including the average number of drug items per prescription and the percentage of prescriptions containing at least one antibiotic, one injectable drug, and one injectable corticosteroid, were calculated. The sample size of the prescriptions evaluated over eight consecutive years, stratified by network/center, was 4,800 in Shahr-e Rey, 14,520 in Eslamshahr, and 5,880 in the South Tehran Health Center.
Results: The average number of drug items per prescription ranged from a minimum of 2.5 to a maximum of 3.99, showing a considerable difference from the WHO-recommended average of 1.7. The percentage of prescriptions containing at least one antibiotic fluctuated from 33.36% to 63.93%, which was substantially higher than the WHO-recommended average of 20.3%.
Additionally, the percentage of prescriptions containing at least one injectable drug ranged from 23.7% to 44.9%, differing markedly from the WHO-recommended average of 18.75%.

Conclusions: Rationalizing drug use should be prioritized in drug policies. Adopting a principled prescription-writing model based on WHO indicators can serve as an appropriate criterion for evaluating physicians’ prescriptions at the primary health care (PHC) level.
 

Page 13 from 14     

© 2026 , Tehran University of Medical Sciences, CC BY-NC 4.0

Designed & Developed by : Yektaweb