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Prevalence and Distribution of Common Rotavirus Genotypes in Iran and Comparing them with Vaccine Strains Before the Start of the National Vaccination Program
Somayeh Jalilvand, Atefeh Kachooei, Tayebeh Latifi, Mahdieh Motamedi‐rad, Mohammad Farahmand, Nasir Mohajel, Zabihollah Shoja,
Volume 21, Issue 2 (9-2023)
Abstract
 
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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.
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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.
 
Investigating the Status of Type-2 Diabetes Prevention and Control in the Population of Buin Zahra City, Iran Based on the Goals and Strategies of the National Program
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.
 
Frequency of Non-Polio Enteroviruses Among Acute Flaccid Paralysis Patients in Iran Before and During the COVID-19 Pandemic
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.
 
The Status of the Referral System in the Family Physician Program in Isfahan Metropolitan Area: a Qualitative Study
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.
 
Profile of Cosmetic Surgery in Iran: A Descriptive Study
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.
 
Community Health Assessment for Identification and Prioritization of Issues in the Area Under Coverage of Imamzadeh Ghasem Health Center, Tehran City, Iran
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.
 
Developing a Model for Accreditation of General Clinics in Iran
ُ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.
 
Effectiveness of Eight Weeks Physical Exercises on the Cognitive Performance and Instrumental Activity of Daily Living of Frail Older Women
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.
 
A Review of Medical Nutrition Therapy in Dialysis Patients and Prevention of Malnutrition
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.
 
Quality of Intrapartum Care Based on a Comprehensive Quality Assessment Model at the Ommol Banin Hospital, Mashhad, Iran
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.
 
The Role of the SOST Gene in Identifying Postmenopausal Women at Risk for Low Bone Quality
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.
 
Comparison of the Effect of Direct Education and Peer-Led Education on Health-Promoting Behaviors among Female Students
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.
 
Effects of Edible Film Containing Whey and Trachyspermum Copticum Essential Oil (in Free Form and Pickering Emulsion) on Physical, Chemical, Microbial and Sensory Properties of Beef
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.
 
Analysis of Prescriptions in Pharmacies of Tehran University of Medical Sciences at the Primary Health Care (PHC) Level, Based on WHO Drug Prescribing Indicators: A Cross-Sectional Study 2016-2023
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.
 
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