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Showing 66 results for Subject: Health

Hamidollah Iri, Dr Ghahreman Mahmoudi, Dr Mohammad Ali Jahani Tiji,
Volume 5, Issue 2 (10-2017)

Background & Objective: The fair distribution of medical specialists among the population of a country is one of the requirements for the public health. We aimed to investigating the distribution of medical specialists using Gini coefficient in all governmental hospitals in two medical universities of Golestan (15 hospitals) and Mazandaran (23 hospitals) provinces.
Methods: The present practical study was conducted using descriptive and analytical methods. The research data including the number of physicians, population and number of active beds in each city and province were obtained from the deputy of treatment of medical universities in each province. The Lorenz curve and the Gini coefficient were used to analyze the distribution of specialists using Excel software. T-test was used to compare the Gini coefficients between the two provinces. Multiple regression tests were performed using SPSS software version 16 to investigate the relationship between variables.
Results: The results showed that Gini coefficients on the basis of population in Mazandaran province were within optimum limit (less than 0.2). However, Gini coefficients on the basis of population in Golestan province were undesirable (more than 0.2) and there was also an inequality in the Gini coefficients based on the number of population between the two provinces of Golestan and Mazandaran (P=0.000, t=17.89).
Conclusion: According to the findings, the distribution of specialist physicians is desirable in Mazandaran province based on population. However, there was inequality in the distribution of specialist physicians in Golestan province. The accurate and fair estimation of the required human resources and the distribution on the basis of population and required indicators could lead to a reduction in the cost of treatment for families and better efficiency of health resources.

Dr Mohammad Shokrzadeh, Reza Hoseinpoor, Dr Amir Hajimohammadi, Azam Delaram, Yaghoub Shayeste,
Volume 5, Issue 2 (10-2017)

Background & Objective: Poisonings are of the major public health challenges. Non-medicinal poisonings are of the most common types and causes of referring to medical centers worldwide. The present study was aimed to determine the non-medicinal poisonings pattern in adults of Gorgan city.
Methods: The present cross-sectional study was conducted on all non-medicinal poisoned patients referred to the 5Azar hospital from 2008 – 2015. Data were collected on checklists using census data collection method and were analyzed by Stata 11.0 software using Pearson’s Chi- square test.
Results: Of all 800 admitted poisoning cases, 227 individuals were non-medicinal and mostly male (72.7%). The ages of 34.4 % of cases were between 20 and 29 years. Moreover, 68.7% of all cases were living in urban areas, 57.7% were married and 27.8% were educated up to high school. Poisonings mostly occurred during summer (30%) and intentional (suicidal) poisonings were known as the major form (47.1%). Opium and aluminum phosphide were the most important poisoning agents (54.2%). Finally, 29 patients (12.8%) had passed away where aluminum phosphide poisoning was the main reason (55.2%).
Conclusion: Intentional poisonings by opium and aluminum phosphide were identified as the main causes of non-medicinal poisonings. It is necessary to emphasize on educational programs, prevention methods and general awareness.

Fatemeh Karimimanesh, Dr Mohammad Davarpanah Jazi, Dr Nooshin Mohammadifard,
Volume 5, Issue 2 (10-2017)

Background & Objective: Health databases contain a large amount of clinical data. Investigating the relationships and patterns in these databases can lead to new medical knowledge. Nutrition indicators are designed to evaluate the dietary quality in communities. Metabolic syndrome is a set of risk factors which may increase the risk of heart disease. Inappropriate diet is one of the most important factors in the occurrence of metabolic syndrome. The health industry is constantly producing a large amount of data in medical areas which requires a technique to disclose useful information and important relationships. The aim of this study was to compare the dietary diversity score (DDS) with healthy eating index (HEI) in terms of nutrient intake and assessing the association with metabolic syndrome with the approach of data mining.
Methods: A total of 1019 teenagers between the ages of 11 to 18 years were enrolled in this study.  Data were collected using a past 24-hour food frequency questionnaire (FFQ). Nutrition data collection and determination of anthropometric characteristics and medical examinations were performed in Isfahan Cardiovascular Institute. Data were analyzed by TANAGRA data mining tool.
Results: Statistical, regression and classification techniques were used for data exploration. The average score of DDS was 3.98 ± 1.10, while the HEI average was 59.23 ± 8.84 and the prevalence of metabolic syndrome was 17.39%. The average of DDS provided a better nutritional value in comparison to HEI. HEI was more robust in controlling received energy and carbohydrates. DDS was not significantly correlated with any of the components of metabolic syndrome, while HEI was weakly correlated with high waist circumference. High quartiles of HEI could predict a lower risk of metabolic syndrome, while high quartiles of DDS can predict higher risk of metabolic syndrome.
Conclusion: The findings of this study revealed that the DDS score may result in better nutrition uptake while adhering to the HEI was more effective in reducing the risk of metabolic syndrome.

Danial Bagheri, Dr Reza Ali Mohseni, Dr Seyed Mohammad Sadegh Mahdavi,
Volume 6, Issue 1 (3-2018)

Background and objectives: Environmental pollution is a major cause of various diseases. Massive production of hospital, industrial, and household wastes lead to several health issues, threatening community health on a daily basis. The present study aimed to determine the association between socioeconomic status and pro-environmental behaviors in the citizens of Gorgan, Iran.
Methods: This cross-sectional, descriptive-analytical study was conducted on 400 citizens of Gorgan. Participants were divided into three regions based on urban categorization. Data were collected using demographic and socioeconomic questionnaires. To assess environmental behaviors, a standard questionnaire was used based on the Dunlap spectrum. Data analysis was performed in SPSS version 16 using the analysis of variance (ANOVA), independent samples t-test and factor analysis.
Results: No positive significant correlation was observed between gender and environmental behaviors. The results of ANOVA showed a significant association between marital status and environmental behaviors. In addition, the results of factor analysis indicated that five factors explained 55.49% of environmental behaviors. The results of ANOVA also demonstrated that middle-class citizens had a more responsible attitude toward the environment compared to others (P<0.05).
Conclusion: According to the results, socioeconomic status influenced the social value orientations and responsible behaviors of individuals toward the environment. Therefore, increasing the quality of life and providing comprehensive education could enhance pro-environmental behaviors and promote community health.
Dr Babak Moeini, Hamid Abbasi, Maryam Afshari, Morteza Haji Hosseini, Soheila Rashidi,
Volume 6, Issue 1 (3-2018)

Background and objectives: Admission to university is an important event in the life of youth in every country. Homesickness is one of the most significant issues faced by university students during their education life. The present study aimed to determine the association between homesickness, happiness and the related factors in the dormitory students in Hamadan University of Medical Sciences, Iran.
Methods: This cross-sectional, descriptive-analytical study was conducted on 387 dormitory students at Hamedan University of Medical Sciences in Hamedan, Iran during February-March 2015. Subjects were selected via stratified random sampling with proportional allocation. Data were collected using self-report and using demographic and contextual questionnaires, Fenfelit homesickness questionnaire, and oxford happiness questionnaire. Data analysis was performed in SPSS version 23 using Pearson’s correlation-coefficient and general linear model (GLM) at the significance level of 0.05.
Results: The mean score of homesickness in both genders had a significant difference (P=0.009). In addition, the mean score of happiness differed in terms of economic status. Homesickness was negatively correlated with the happiness score, so that increased homesickness was associated with reduced happiness. Variables of homesickness, age, internet use, maternal education, health status, economic status, and education level could significantly predict happiness.
Conclusion: Mental health of students in dormitories is of paramount importance. Therefore, interventions and preventive programs must recognize the causes of happiness, and appropriate interventions should be developed and implemented based on the influential factors in this regard.
Hossein Torbatinezhad, Hossein Amani,
Volume 6, Issue 2 (6-2018)

Background and objectives: Educational technology is widely used in all parts of medical education. The use and application of common educational technologies and adoption of educational design patterns in medical sciences education can greatly help in medical simulations, training, and improving of clinical skills of nurses and medical students. The aim of this research was to study computer-assisted instruction, virtual patients, and human patient simulation in medical science education based on Gagne’s educational design pattern.
Methods: The research methodology in this paper was a review-article of applied type, which helps the education designer in the field of medical education to choose the most suitable educational technologies in medical science education to achieve their desired goals by considering the advantages and disadvantages of computer-assisted instruction, virtual patients, and human patient simulation.
Results: In this article, we first reviewed the educational technology and common technologies in medical education and its advantages and disadvantages as well as the most appropriate educational technology to achieve the needed goals. We then described two multimedia (Computer-Assisted Instruction and Virtual Patients) and educational models for virtual patients as well as two simulators (virtual patient and human patient simulation). Subsequently, we explored the educational design and its patterns (including Ganja, Watson, Merrill, Reigeluth, Asher, Camp, and Siemens) and selected the best pattern (Gagne’s pattern) according to the learning theories and research background. Finally, the three approaches mentioned in this article (computer-assisted instruction, virtual patients, human patient simulation) were designed based on the Gagne’s model.
Conclusion: Based on the results, one can conclude that the computer-assisted instruction, virtual patients, and human patient simulation based on the Gagne’s educational design model can help medical education instructors in training communication skills, clinical skills, and skills of obtaining medical history from the patient as well as problem-solving skills, knowledge acquisition, and critical thinking. They can also help the educational designer in the field of medical education to select the most suitable educational technologies in medical science education due to the best educational model of virtual patients and the Meyer educational media principles and simulation-based learning-educational theories tailored to the goals and content of medical education courses. Therapies for autoimmune disorders such as SLE. 
Anis Abbasi, Amir Ashkan Nasiri Pour, Seyyed Jamalodin Tabibi, Pouran Raeisi,
Volume 6, Issue 2 (6-2018)

Background and objectives: The development and distribution of hospital beds, regardless of effective factors, may downgrade equity in access to health services through imposing costs of inefficiency. This study aimed to develop a hospital bed distribution model in Iran in order to facilitate the optimal and cost-effective development and distribution of hospital beds.
Methods: This descriptive-analytical study with mixed-methods analysis was carried out during 2015-2016. The research population encompassed 345 managers and experts in the field of health, who were selected using multistage quota sampling method from five regions of Iran (north, south, center, west and east). A total pool of 23 experts were selected from each university, and a researcher-made questionnaire was used to collect data. Content Validity Ratio (CVR) was used to evaluate the questionnaire content and face validity. Cronbach's alpha coefficient and exploratory factor analysis with Varimax rotation were run as well to determine the questionnaire reliability and item consistency, respectively. For this purpose, AMOS version 20 and SPSS version 20 software were employed. To determine the fit of the model, the fit indices were also considered.
Results: Out of 51 effective factors included in the questionnaire in accordance with content validity, 23 items were confirmed by the experts. Exploratory factor analysis detected five organizational (seven components), economic (four components), social (six components), political (three components) and geographic (three components) factors as the main dimensions of hospital bed distribution, which could explain 70.745% of variance for all variables. The organizational and geographical dimensions had the highest (1.00) and lowest (0.16) influence on the hospital bed distribution. After running confirmatory factor analysis, two components of social and economic attributes with factor load of 0.46 in social dimension and efficiency and effectiveness of existing centers with factor load of 0.31 in the economic dimension were excluded from the model.
Conclusion: This study confirmed the hospital bed distribution model with five organizational, social, economic, political, and geographical dimensions, in which the organizational dimension with high explanatory power had the greatest impact on the hospital bed distribution. Therefore, this model seems efficient to be used as a comprehensive and appropriate method in making policies and decisions about the development and distribution of hospital beds.
Shima Kazemi Malek Mahmoudi *, Kiomars Niaz Azari, Negin Jabari,
Volume 6, Issue 2 (6-2018)

Background & Objectives: Knowledge-based economy is one of the major parts of the resistance economy and is recognized as the essentials of the information technology age. As one of the most important educational units and the custodian of community health, universities of medical sciences play a pivotal role in the success of resistance economy based on the knowledge-based economy. Among the employees of a university, the managers and faculty members play an important role in this regard. This study aimed to explain the dimensions of the resistance economy based on the knowledge-based economy in universities of medical sciences.
Materials and Methods: This qualitative research had a purposeful sampling method. Data were collected via library and field research. In the library method, the relevant specialized scientific texts and resources were exploited, whereas in the fieldwork, the researcher interviewed 24 faculty members. The interviews continued until saturation, and after being recorded, they were transcribed in Word software, coded, classified, and encoded by Microsoft OneNote. After that, the interviews were analyzed. It is notable that ethical considerations were observed during the research process. In the field method, the texts and books were evaluated and information searched in scientific and specialized websites. In addition, relevant articles recently published in valid international journals were translated, and primary data with the topic of translation were collected. In the field research and after coordination with faculty members and main elites with a history of article or innovation production or a management background, the opinions of the interviewees were asked about some questions in a semi-structured manner. In addition, three-stage coding, open coding, axial coding, and selective coding were applied in the research. To perform open coding, the main sentences were recorded as codes, followed by classifying the similar codes. In axial coding, the classes were related to their subclasses by comparing the primary classes of open coding and revolving the ones that resembled around the common axis. In selective coding, the integration and refining process of the categories was performed to form and present the model, and the dimensions were extracted and explained.
Results: From the perspective of the faculty members and key experts, resistance economy based on knowledge-based economy in universities of medical sciences could be explained in dimensions of information and communications technology, innovation and entrepreneurship in medical sciences, human resources and knowledge-based team, administrative and structural system, resources of equipment and abilities, policy and socio-environmental impacts. Each of these dimensions also included sub-groups and special themes.
Conclusion: According to the results of the study, it could be stated that moving towards the knowledge-based economy is one of the requirements of the country on the path to economic development, which involves dimensions such as information and communications technology, innovation and entrepreneurship, specialized knowledge-generating team, strategic planning and policy-making, formulating and ensuring the legal framework and legal system, supplying and developing electronic infrastructures, and paying attention to capabilities and resources of facilities.
Somayeh Mashmouli , Soheila Mashouf, Simin Esmaeilpour Zanjani,
Volume 6, Issue 2 (6-2018)

Background & Aim: As the most important assets of each organization, employees face numerous challenges, which can have adverse effects on the quality of their work life and productivity, physical and mental health, well-being, and different dimensions of their health-related quality of life. This study aimed to evaluate the relationship between health literacy and health-related quality of life and work life quality of the employees in Golestan University of Medical Sciences, Gorgan, Iran.
Materials and Methods: This cross-sectional research was conducted on 285 individuals working in the departments of Golestan University of Medical Sciences. Subjects were selected through proportionate stratified random sampling. Data were collected using Walton Standard Health Literacy Questionnaire, as well as Quality of Life and Work Life Quality questionnaires. In addition, data analysis was performed in SPSS version 16 using descriptive indicators (frequency, mean and standard deviation) and inferential statistics (ANOVA, Tukey’s test, and Pearson’s correlation).
Results: In this study, the mean age of the participants was 36.1263 years. According to one-way ANOVA, a significant difference was observed between the age groups and their health literacy level (P=0.04). Moreover, a significant association was found between health literacy and all aspects of health-related quality of life and work life quality of the participants (P=0.001).
Conclusion: In the present study, the lowest score of quality of work life was related to fair payment, which showed the importance of more attention to this area by authorities and managers of universities.
Ali Asghar Shaker, Ali Akbari Sari, Maryam Radin Manesh, Ghasem Fakhraei, Ahmad Fayazbakhsh, Alireza Yousefi,
Volume 6, Issue 2 (6-2018)

Background & Aim: Cataract disease is among the conditions that impose a substantial economic cost on countries every year due to their high prevalence rate. The prevalence of this disease has caused significant direct and indirect costs. This study aimed to estimate the economic burden caused by the costs of the cataract disease.
Materials and Methods: This descriptive, analytical, and cross-sectional study was conducted on patients with cataract disease in Farabi Hospital of Tehran, Iran in 2014. Data were collected using the cost-determination checklist, a questionnaire, interviews with experts, and previous studies in this field. In addition, the Prevalence-based and social capital approaches were exploited to estimate the economic burden and costs of the cataract disease, respectively. Costs were divided into three types of medical expenses, patient and family expenses, and productivity lost costs. Data analysis was performed in Excel software.
Results: The economic burden of the cataract disease was estimated at 6202529401500 rials. Results demonstrated that the hospitalization costs were significantly higher, compared to the other costs related to the cataract disease.
Conclusion: According to the results of the study, the economic burden associated with the cataract disease was equal to 0.13% of the gross domestic product and included 2.43% health expenditure of Iran in 2010.
Hamideh Mancheri, Mousa Alavi, Zahra Sabzi, Jahangir Maghsoudi,
Volume 7, Issue 1 (3-2019)

Background and objectives: Given its progressive nature in all life aspects, drug abuse threatens the health of individuals, families, and society and causes some economic, political and human damages to each society. In this regard, family is the first variable exposed to such a threat. Accordingly, the present study was to review the problems facing families of substance abusers.
Methods: In this study, the Scopus, Medline, SID, PubMed, Google Scholar, and Science Direct databases were surfed using keywords such as problems, substance abuse, addiction, family during 2000 to 2017. Finally, 30 full-text articles were selected.
Results: Studies have revealed that drug-related disorders affect the family system and members and bring family members different problems, including psychosocial, economic, physical, family and educational problems. These studies reported the psychological problems of family members as the most frequent one.
Conclusion: The present study indicated that family members with substance abusers face different problems in different aspects of their life; therefore, the need to expand prevention and treatment programs for such persons seems to be urgent.

Hadi Salimi, Reza Golvardi Yazdi,
Volume 7, Issue 1 (3-2019)

Background and objectives: Dental technicians are in indirect contact with patients. Microorganisms find their way to dental labs through dental impressions. Infection control is a critical procedure to prevent the spreading of diseases. The objective of this study was to evaluate the levels of infection control knowledge and practice and the factors affecting them, in DLs in Yazd – Iran.
Methods: All dental labs in Yazd – Iran were visited and all working technicians were asked to fill questionnaires including knowledge and practice questions. Data was analyzed using t-test via SPSS 17.
Results: Out of 26 filled questionnaires 73% and 50% of the technicians had respectively poor awareness and practice. Regarding adherence to infection control procedures, technicians with higher work experience had significantly higher scores (p value = 0.015). Technicians educated in the field of dental technologies had significantly higher awareness and practice scores (p value= 0.015, 0.029).
Conclusion: Technicians who have been trained at dental schools have higher knowledge and practice regarding infection control. Since dental labs are not obligated to hire only these technicians, workers without related education are occupied in dental labs. This result in the unfortunate status of infection control in dental labs. The poor status of infection control in dental labs can contribute to spread infections to patients and the related healthcare team.
Leila Fozouni, Maryam Yaghoobpour, Ania Ahani Azari,
Volume 7, Issue 2 (7-2019)

 Background and objectives: Acinetobacter is a genus of opportunistic pathogens that are commonly found in the environment. Given the unique ability of these bacteria to survive in the hospital, they are considered as one of the main causes of hospital-acquired infections. The emergence of multidrug-resistant Acinetobacter spp., particularly Acinetobacter baumannii has become a major health threat worldwide. In this study, we investigate antibacterial effects of probiotic isolates from goat milk on clinical isolates of A. baumannii.
Methods: In this study, 100 clinical specimens were taken from patients hospitalized in six hospitals in the Golestan Province, north of Iran. Following isolation and identification of A. baumannii strains, antibiotic resistance patterns of the isolates were investigated using the Kirby-Bauer method according to the Clinical and Laboratory Standards Institute (CLSI-2015) guidelines. Probiotic bacteria in goat milk were isolated and identified by culture in MRS and M17 media and carbohydrate fermentation tests. Antibacterial effects of the probiotic bacteria against resistant A. baumannii isolates were evaluated using the agar well diffusion method.
Results: Overall, 55% of the isolates were identified as A. baumannii. The highest resistance rates were observed against tobramycin (76.3%), mezlocillin (74.5%) and cefotaxime (74.5%). Resistance to levofloxacin, tetracycline, imipenem and minocycline was detected in 72.7%, 72.7%, 70.9% and 29.1% of the isolates, respectively. The most common probiotic isolates were Lactobacillus plantarum and Lactococcus piscium (30% each). The highest and lowest effects were exerted by Lactococcus lactis (34.54%) and Lactobacillus bulgaricus (3.63%), respectively.
Conclusion: Our results demonstrate that the prevalence of drug-resistant A. baumannii strains is high in the hospitals. Given the promising antimicrobial effects of the isolated probiotic bacteria, goat milk can be recommended as an adjuvant therapy or an alternative to common antibiotics for improving treatment outcome of infections caused by drug-resistant A. baumannii.
Maryam Kazemipoor, Fatemeh Owlia, Mehri Esfandyar, Ali Dehghani, Hossein Fallahzadeh, Amir Houshang Mehrparvar, Mohammad Javad Zare Sakhvidi, Masoud Mirzaei,
Volume 7, Issue 2 (7-2019)

Backgrounds and Objectives: Afew large population-based studies have been conducted on the prevalence of oral mucosal lesions in relation to fertility status in the Iranian population. The aim of study was determine the prevalence of oral mucosal lesions in relation to fertility status in women participants of Shahedieh cohort study. 
Materials and Methods: A descriptive cross-sectional study was conducted on 4935 women who participated in the Shahedieh cohort study. The age range of participants was 35-71 years with a mean age of 47.12 years. The prevalence of oral mucosal lesions considering fertility variables including pregnancy, number of pregnancy, oophorectomy, tubectomy, hysterectomy, infertility, menopause, normal menopause, and abortion, application of infertility and oral contraceptive drugs and hormone replacement therapy were recorded.
 Results: The total prevalence of oral mucosal lesions in the studied women were 3.8%. The most commonly affected age group was 40-49 years, followed by 30-39, 50-59 and 60-71 years, respectively. Considering the fertility variables, only menopause (P=0.047) and normal menopause (P=0.024) significantly related to the prevalence of oral mucosal lesions.
Conclusions: The findings of the present study provide information on the prevalence of the oral mucosal lesions considering fertility status in a large population-based study in Iran. With due attention to the higher prevalence of oral mucosal lesions in menopause women, an improved comprehension of oral manifestations at menopause and preventive and treatment approaches during this period should be programmed with health care services to meet the needs of patients deservingly.

Masoomeh Gholami, Majid Najafzadeh, Naser Behnampour, Zahra Abdollahi, Farzaneh Sadeghi Ghotbabadi, Farhad Lashkarboluki, Mohammad Reza Honarvar,
Volume 7, Issue 3 (9-2019)

Background and objectives: Iran was reported in the high-risk group of World Food Security Map in 2008 .Identifying food insecurity is first step for executing interventions. Measuring household food security is its cornerstone. SAMAT System was designed to provide a variety of GIS-based reports to policy makers and managers in the field of food security.
Methods and Materials: SAMAT system was developed by a team working with various specialties. The system was analyzed using Rational Unified Process methodology and after optimization and normalization process, centralized database was formed. SQL Server 2014 software was used for its implementation. SharpMap open source engine was used to render spatial data and display maps on the web, and many parts of the engine were coded specifically to meet different organizational needs. The system was designed using the WEB GIS engine.
 Results: SAMAT system was executed in nine provinces of the country in different periods. SAMAT dashboard provides a variety of information for executive managers. Based on demographic data, the state of food insecurity can be identified at different levels from city to village, in a variety of graphs. A spectrum from the urban distribution to the local distribution of food insecurity can be identified on the GIS map. Zooming in on different areas can help to identify more food insecure neighborhoods within the village or town, thus giving managers the priority of food insecurity interventions at the neighborhood or village level. One can view household characteristics and the results of questionnaire information .
Conclusion:  SAMAT system can be useful for managing food security at the national, provincial, city and even rural or urban levels. we recommend periodically prioritizing points, Identifying the provinces and re-evaluating the effectiveness of interventions through the SAMAT-based system after comprehensive implementation of food insecurity reduction 

Sakine Beygom Kazemi, Mehrnoosh Jafari, Seyed Mojtaba Hosseini, Ali Maher, Mohammad Karim Bahadori,
Volume 8, Issue 1 (3-2020)

Background and Objective: One of the important and common applications of telemedicine is the diagnosis and treatment of skin diseases. However, teledermatology requires further commitments to provide standard services and appropriate electronic data transfer for reliable diagnostics to comply with technical standards and legal requirements. The present study aimed to determine the factors affecting the establishment of Teledermatology in the qualitative and quantitative sections .
Material and Methods: A mixed-method study (including quantitative and qualitative sections) was conducted in 2018. In the qualitative section, experts were selected by purposive sampling and the data were collected through 2 focus group discussions and 6 semi-structured interviews. The content of sessions and interviews were transcribed and then analyzed by the content analysis method. In the quantitative section, 384 participants were selected randomly. The data were collected using a researcher-made questionnaire whose validity and reliability were confirmed. Data analyses were performed in SPSS.
Results: A total of 8 categories and 58 subcategories were extracted. The 8 categories of the factors affecting the establishment of teledermatology in Iran included service provider, service recipient, structural, technological, economic, policymaking, legal, and cultural. Cultural factors (3.95±0.77) and policymaking factors (3.22±0.84), respectively, had the highest and the lowest effects on the establishment of teledermatology in Iran.
Conclusion: Factors affecting the establishment of Teledermatology are diverse and extensive, which the most effective factors were cultural factors, technological factors and factors related to service providers. These findings can help the policymakers and managers interested in the establishment of teledermatology in Iran.

Farideh Kaikhosravi, Farhad Daryanoosh, Maryam Koushkie Jahromi, Javad Nemati,
Volume 8, Issue 1 (3-2020)

Background and objective: Proper exercise and nutrition can help prevent bone disorders in old age, therefore present study aimed to investigate the effects of high intensity interval training (HIIT) with genistein (Ge) on biomechanical properties of femur bone in elderly female rats.
Material and Methods: In this experimental study, 40 elderly female rats with mean age of 18- 24 months and mean weight of 220.15±15.28 g were divided into five groups of eight rats including: 1) control (C), 2) sham (Sh), 3) HIIT, 4) HIIT + Ge, and 5) Ge. During eight weeks groups 3 and 4 performed HIIT for three sessions per week with an intensity of 90 to 95% of maximum oxygen consumption (VO2max) in high intensity intervals and 40 to 45% VO2max in low intensity intervals and groups 4 and 5 received 60 mg/kg/day Ge peritoneally. Maximum bending strength (Fmax) measured with three- point bending test and serum levels of calcium (Ca) and phosphorus were measured by o-Cresolphthalein and molybdate methods, respectively. Shapiro- Wilk, one way ANOVA with Tukey’s post- hoc tests were used for analysis of data (P≤0.05).
Results: HIIT (P=0.02), Ge (P=0.001) and HIIT+Ge (P=0.001) significantly increased Fmax also Ge (P=0.04) and HIIT+Ge (P=0.03) had more favorable effect on increasing Fmax compare to HIIT nevertheless HIIT, Ge and HIIT+Ge had not significant effect on Ca and phosphorus (P≥0.05).
Conclusion: Although HIIT and Ge alone can enhance Fmax in femur of elderly female rats, nevertheless HIIT+Ge has more favorable effect on increase of Fmax compare to HIIT.

Eraj Baghery Nasab Najaf Abad, Ali Khajehlandi, Amin Mohammadi,
Volume 8, Issue 1 (3-2020)

Background and objective: Type 2 diabetes (T2D) is a metabolic disease that leads to increased levels of lipids, therefore the present study aimed to investigate the effect of eight weeks of aerobic training(AT) with silymarin (S)consumption on lipid profile in men with type 2 diabetes.
Material and Methods: 60 middle-aged male volunteers were randomly divided into 4 groups, including: (1) control(C) + placebo, (2) AT + placebo, (3) S consumption and (4) AT+S consumption. The AT groups performed for eight weeks, three sessions per week and 20-45 minutes per session at an intensity of 60 to 85% of the reserve heart rate, and the S groups of consumed 140 mg / kg of S daily (in two meals).  Serum levels of Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL), Cholesterol (CHO), and Triglyceride (TG) were measured before and after the test. Data were analyzed using one-way ANOVA and Bonferroni’s test, and P value less than 0.05 was considered significant.
Results: AT reduced serum levels of LDL, CHO, TG and increased HDL in men with T2D(P ≥ 0.05). Consumption of S reduced LDL, CHO, TG and increased HDL in men with T2D(P ≥ 0.05). AT and S consumption reduced LDL, CHO, TG and increased HDL; also, decrease in LDL, CHO, TG and increase in HDL in the AT and S consumption group was more favorable than the effect of S alone (P ≥ 0.05).
Conclusion: It seems that AT and S consumption simultaneously have interactive effects on reducing LDL, CHO, TG and increasing HDL in men with T2D.

Roghieh Golsha, Nona Gorgitabar, Behnaz Khodabakhshi, Abdullah Abbasi, Hamed Kalani,
Volume 8, Issue 1 (3-2020)

Background and objective: Currently, due to an increase in the number of individuals with immune deficiency, long-term chemotherapy, and underlying diseases, an appropriate situation has been provided for the development of opportunistic infections, including fungal infections. This study was conducted with the aim of evaluating clinical symptoms, laboratory findings, and the treatment outcome of mucormycosis in diabetic individuals.
Material and Methods: In this cross-sectional retrospective study, all recorded cases of mucormycosis in the health centers of Gorgan city, northeast of Iran, in diabetic individuals were extracted during 15 years from 2002 to 2016. All information was extracted from patient-related records and then was analyzed. In the period from 2002 to 2016, 12 diabetic individuals with mucormycosis were referred to health centers.
Results: There were statistically significant differences in the categories of sex, residence, education, taking drug, addiction, diabetes status, methods of diagnosis, involved area with mucormycosis, treatment type of mucormycosis, and treatment outcome of mucormycosis. Furthermore, no statistically significant difference was observed in the categories of age, underlying diseases (other than diabetes), hospitalization, and diagnostic time.
Conclusion: Due to the rareness or lack of an appropriate diagnostic method, and in addition, due to lack of an appropriate treatment, attention should be paid to invasive mucormycosis in individuals with immunodeficiency.

Maryam Chehrehgosha,
Volume 8, Issue 1 (3-2020)

The COVID-19 crisis has changed the world and many aspects of our lives, even the way we treat the elderly. Evidently, the pandemic has put tremendous pressure on the healthcare system of every country, and there have been insufficient healthcare resources for the affected patients. We should seek to develop more care models for the elderly, so that when all human services are stopped.

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