Shiraz E-Medical Journal

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In Collaboration with Health Policy Research Center, Shiraz University of Medical Sciences

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Shiraz e Medical Journal is an open-access monthly publication by the health policy research center at Shiraz University of Medical Sciences as an Organization. The journal publishes original research articles, review articles, meeting reports, mini-reviews, and letters on all aspects of health sciences with special emphasis on public health. A full list of the types of articles can be found in the Help menu of the journal.

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Now showing 1 - 20 of 1210

Information Requirements of Clinical Decision Support Systems for the Diagnosis and Prediction of Preeclampsia
(Brieflands, 2024-12-11) Nazanin Khayatan; Nasim Aslani; Ali Garavand; Nasrin Galehdar; Vadad Khayatan
Background: Clinical decision support systems (CDSS) are valuable tools for diagnosing and predicting diseases. However, their effectiveness hinges on the quality of the information provided. Objectives: This study aimed to identify the information requirements for a CDSS designed to diagnose and predict preeclampsia. Methods: This applied study was conducted in 2024. A literature review was performed to identify relevant studies. Based on the findings, a questionnaire with a five-point Likert scale was developed and validated through the input of 22 experts in related fields. Data were analyzed using SPSS version 22, and the findings are presented in the text and tables. Results: Among 143 items identified, 115 were deemed essential for a CDSS to diagnose and predict preeclampsia. The information requirements were classified into eight main categories: Demographic information, medical history, laboratory data, pregnancy-related data, complications in other organs, medical examinations, warning signs, paraclinical data, and lifestyle. Conclusions: The findings of this study provide critical insights for developers of CDSS tailored to preeclampsia diagnosis and prediction. By addressing these information needs, such systems can significantly enhance the capabilities of women's health professionals, advancing timely diagnosis and prevention of preeclampsia.
Study of Effective Factors and Policies on the Development of Health Tourism in Iran as a Developing Country
(Brieflands, 2025-01-31) Asghar Keivan Hosseiny; Zahra Aryakian; Zeynab Aryakian
Background: Medical tourism, a byproduct of globalization, involves patients traveling beyond their national borders for healthcare. While this trend is prominent in developed countries, developing nations like Iran can capitalize on it for economic gains. Objectives: This study explores the potential and prerequisites for the advancement of medical tourism in Iran, a developing country with significant potential in health services and a need for the development of health tourism to foster further economic growth. Methods: The target group for this study includes Iranian hospitals. The methods used are "Data Collection and Analysis". First, data were gathered from official health and tourism sources through interviews. Second, relevant factors were identified and analyzed qualitatively through a systematic review of related literature. Results: The study found that beyond the quality of medical services, cultural attributes, legal frameworks, and the tourism appeal of historical sites significantly impact the growth of medical tourism. Key opportunities for Iran's medical tourism include a high number of advanced medical centers, cost-effective and high-quality healthcare, and the allure of historical and natural tourist attractions. However, challenges such as the absence of a centralized coordinating body, limited private sector involvement, and inadequate oversight pose constraints. This study aimed to answer questions about the requirements for medical tourism development and the limitations of its achievement in developing countries. Conclusions: To enhance medical tourism in Iran, it is essential to adopt a "multifaceted approach" that integrates economic, legal, cultural, and service quality considerations. This approach should improve infrastructure, such as healthcare accommodations, and encourage the participation of private healthcare providers. Furthermore, strategic development in these areas will not only contribute to Iran's economic growth but also enhance its global reputation as a hub for high-quality healthcare services.
Efficacy and Complications Comparison Between Emergent and Elective Laparoscopic Cholecystectomy Surgery
(Brieflands, 2025-01-31) Hamed Gholizadeh; Mohsen Andisheh; Mohammad Raeeszadeh; Soleyman Heydari; Jamal Akhavan-Moghaddam; Mahdi Morshedi; Maryaam Rezaee; Hasanali Mohebbi; Mehrdad Daryabor
Background: Laparoscopic cholecystectomy (LC) is the preferred surgical procedure for treating symptomatic gallstone (GS) disease. Objectives: This study aimed to evaluate and compare the outcomes of emergent and elective LC, focusing on complications, conversion rates, duration of surgery (DOS), length of hospital stay, and post-operative pain. Methods: A total of 166 patients who underwent LC surgery at Baqiyatallah Hospital, Tehran, Iran, between 2021 and 2022 were included in the study. Of these, 64 patients underwent emergent LC, and 102 underwent elective LC. The groups were compared for complications, conversion rates, DOS, length of hospital stay, and post-operative pain. Results: The study revealed that while intraoperative complications did not differ significantly between the two groups (P = 0.14), there was a significant difference in the conversion of surgical methods from three to four trocars (P = 0.007). Additionally, more patients in the emergent group required drain insertion during surgery (P = 0.003). Regarding post-operative outcomes, no significant differences were observed between the emergent and elective LC groups in terms of local (P = 0.77) and systemic complications (P = 0.37). However, patients in the elective LC group experienced a significantly shorter post-operative hospital stay (P = 0.002). Pain levels one day (1.02 ± 0.80) and one week (0.14 ± 0.43) after surgery were lower in the elective LC group. Furthermore, patients in the elective group returned to daily activities earlier (3.77 ± 1.21 days). Conclusions: The findings of this study indicate that emergent LC is as safe as elective LC. However, patients undergoing elective LC may benefit from a shorter recovery period and reduced post-operative pain. Overall, LC remains a low-risk and safe option for managing emergent gallstone cases.
Contributions of Traditional Persian Medicine Lifestyle Principles in Primary Health Care: An Evidence-Based Review
(Brieflands, 2025-01-31) Maryam Iranzadasl; Mahbubeh Bozorgi; Mehdi Pasalar
Context: Traditional medicine (TM) is widely used and holds significant potential for increasing Primary Health Care (PHC) coverage and achieving universal health coverage (UHC), especially in developing countries. Persian medicine (PM), an ancient form of TM, encompasses lifestyle principles known as "Hifz-o-Siha," which aim to maintain and improve health. Methods: We conducted searches across various databases, including Science Direct, Scopus, PubMed, and Google Scholar. Our search terms included Traditional medicine, Persian, Iranian, Health maintenance, Education, and Primary health care. Results: Three randomized clinical trials conducted between 2017 and 2019 examined the impact of educating individuals about PM's lifestyle principles on their quality of life and healthcare utilization. The results indicated significant improvements in all measured outcomes. Furthermore, six clinical trials focused on PM dietary modifications in the treatment of conditions such as obesity, infertility, nephrotic syndrome, and non-alcoholic fatty liver disease. In all these studies, PM diets demonstrated significant efficacy compared to conventional medicine. Conclusions: Lifestyle modifications based on PM recommendations have the potential to positively influence PHC and promote overall health. However, the incorporation of PM into national health systems faces challenges, primarily due to the limited availability of supporting evidence.
Analysis of Organizational Resilience, Job Burnout, and Productivity Among Employees of Health System in Iran
(Brieflands, 2024-12-02) Mohammad Khammarnia; Khadijeh Tavana; Farahnaz Soheili; Fatemeh BagherBarahouei; Zahra Arabborzu
Background: There is widespread consensus that the healthcare system relies heavily on its human resources. Consequently, the capacity and capability of human resources are crucial factors in the success of healthcare systems. Objectives: This study examines the correlation between resilience, burnout, and productivity among employees of the health system in Iran. Methods: A cross-sectional study with an analytical approach was conducted at Zahedan University of Medical Sciences (ZAUMS) in southern Iran in 2023. The research population included all employees of health centers and hospitals at ZAUMS, with a sample size of 350 participants. Data were collected using three standard questionnaires: Connor and Davidson's resilience scale, Moslesh's job burnout scale, and a human resource productivity questionnaire. Data analysis was performed using SPSS software, with a significance level set at P < 0.05. Results: The findings showed that 56.6% of participants were female, and the mean age was 34.3 ± 7.6 years. The total scores for resilience, job burnout, and productivity were 90.0, 85.3, and 73.4, respectively. Job burnout was significantly higher among hospital employees compared to those in health centers (P = 0.001). The results also indicated that as staff age increased, their workplace resilience improved. Additionally, resilience was positively correlated with productivity (P = 0.001). However, no significant correlation was found between job burnout and either productivity or resilience (P = 0.532 and P = 0.476, respectively). Conclusions: Increasing employees' resilience is essential for boosting their productivity. Efforts to enhance resilience should focus on three key dimensions: Courage, optimism, and cooperation. Providing resilience-enhancing training for hospital and health center employees, along with strategies to address burnout, can be highly effective. Furthermore, managing the relationship between supervisors and employees, designing an appropriate work environment, and fostering work engagement can improve workplace interactions and reduce job-related stress by increasing resilience.
Enhancing Empathy in Medical Education: The Role of Technology and Art
(Brieflands, 2024-12-01) Zahra Saboohi; Sahar Mirzaei; Fatemeh Guderzi
This article does not have an abstract.
The Relationship Between Dietary Intake and Anthropometric Indices Between Dietary Intake and Anthropometric Indices with Anxiety in Female Medical Students
(Brieflands, 2024-11-30) Hadi Eslahi; Mansour Shahraki; Abolfazl Payandeh; Seyede Mahsa Masoumi; Salehe Shahraki
Background: Vitamins play an important role in improving mental health. Healthy diets can significantly influence the development, progression, and treatment of mental health disorders. Objectives: This study aimed to investigate the correlation between dietary intake and anthropometric profiles with anxiety in female students of Zahedan University of Medical Sciences. Methods: This cross-sectional study evaluated 200 female medical students for daily intake of B vitamins, omega-3, anthropometric indices, and their correlation with anxiety. The Food Frequency Questionnaire and Bronze Anxiety Questionnaire were used to examine the relationship between dietary intake and anxiety. The associations between parameters were analyzed using Pearson’s correlation. Results: The findings revealed that the mean age of the female medical students was 22.60 ± 2.10 years, with a Body Mass Index (BMI) of 23.37 ± 4.01, a waist-to-hip ratio (WHpR) of 0.81 ± 0.11, a waist-to-height ratio (WHtR) of 10.55 ± 0.10, and an anxiety score of 44.83 ± 17.71. Positive correlations were observed between BMI (r = 0.89, P = 0.0001), WHpR (r = 0.86, P = 0.0001), and WHtR (r = 0.898, P = 0.0001) with anxiety. The mean anxiety scores were 23.84 ± 4.36, 38.59 ± 4.62, 61.44 ± 13.63, and 74.44 ± 5.96 in underweight, normal, overweight, and obese participants, respectively. A negative correlation was identified between the consumption of vitamins and omega-3 and anxiety scores (r = -0.63, P < 0.001). Conclusions: This study suggests that a higher intake of dietary B vitamins and omega-3 is associated with lower anxiety scores in Zahedan medical students.
Comparing the Effect of Stellate Ganglion Block and Gabapentin on the Post Mastectomy Pain Syndrome
(Brieflands, 2008-04-01) H Hoseinzade; Ata Mahmoodpoor; D Agamohammadi; S Sanaie
Background: The reported incidence of post mastectomy pain syndrome following surgery for breast cancer varies considerably with reports from as low as 4-6% to as high as 100%. This pain can be severe enough to interfere with sleep and performance of daily activities. Post mastectomy pain syndrome is a neuropathic pain condition that can follow surgical treatment for breast cancer. The purpose of this study is to evaluate the effect of stellate ganglion block with gabapentin on post mastectomy pain. Materials and Methods: Sixty patients referred from department of oncology and surgery to pain clinic were allocated to two groups. In group A stellate ganglion block was performed with 8ml bupivacaine 0.25%. In group B, patients were treated with gabapentin 900mg per day in three divided doses. Drug dose was increased if necessary until eight weeks. Pain score and quality of life were determined. Data were collected before treatment, 48 hours and every 15 days after treatment until three months. Results: Pain scores at 48 hours after treating were higher in group B than group A and lower at one week, one month and three months after treatment which were statically significant. (P Conclusion: In our study gabapentin was used as an ideal treatment technique for chronic pain following breast surgery.
Value of Core Needle Biopsy as the First Diagnostic Procedure in the Palpable Breast Masses
(Brieflands, 2008-10-01) F Karimian; A Aminian; E Hashemi; AP Meysamie; R Mirsharifi; A Alibakhshi
Background: Breast core needle biopsy (CNB) provides enough tissue for histopathologic diagnosis and is considered a reliable method for establishing preoperative tissue diagnosis. The purpose of this study is to evaluate CNB as the first diagnostic step instead of excisional biopsy in palpable breast masses. Materials and Methods: In this prospective study, patients with palpable breast mass who underwent CNB were enrolled. Based on pathology report, patients with malignant lesions revealed by CNB were immediately candidate for surgery and those who had benign lesions were followed up to 3 years. Results: 112 females with palpable breast mass were enrolled in the study. In 103 (91.9%) of cases first attempt CNB provided adequate sample tissue. CNB detected malignant lesion in seventy eight (69.6%) patients. All (100%) malignant CNB reports were confirmed at surgery specimen pathology. In 34 (30.4%) patients CNB revealed benign lesion. At the end of 3 years follow up period, 25 (73%) of these patients underwent open biopsy leading to the detection of 1 (3%) malignant tumor. Overall, according to the gold standard defined as positive surgical biopsy or positive follow-up, sensitivity of CNB was calculated as 98.7% (95% CI, 94.1-100%) and its accuracy was 99.1% (95% CI, 97.4-100%). The specificity of the CNB procedure was 100%. Conclusion: These findings suggest that the malignancy detection power provided by CNB may be weighed equal to that of open biopsy. Therefore, we propose CNB as the first choice in diagnostic evaluation of palpable breast mass especially for those in accessible sites and in experienced hands.
Stapled Hemorrhoidopexy, Initial Experience in Iran.
(Brieflands, 2009-01-01) R Azizi; MM Danesh-Pageuh; L Zahedi-Shoolami
Purpose:: we report initial experience of stapling hemorrhoidopexy in Iran. Methods:: Forty-nine patients with symptomatic hemorrhoids were treated in three medical centers; 29 with Procedure for Prolapse and Hemorrhoids (P.P.H) (Ethicon Endo-surgery), and 20 with Straightforward Trans Anal Mucohemorrhoidectomy (STRAM-kit) (Tyco Healthcare, Norwalk, US). Patients were prospectively evaluated for postoperative pain, anorectal functional status, morbidity and postoperative complications. The follow up period was at least 6 months. Results:: Forty-nine patients were evaluated. The mean age of the patients was 49.3 years. There were 23(46.9%) males and 26(53.1%) females. The median duration of symptom was 7.5 years. No mortality was reported. Urinary retention was the most common complication. Three patients had delayed bleeding. Postoperative pain was classified as painless, mild, moderate and severe. 39 cases (79.6%) had a mild to moderate pain relieved by an Acetaminophen tablet or NSAID. Thirty-six patients (73.5%) were fully satisfied with the operation result. All patients except one (99%) had returned to their normal functional life and their normal activity within 48 hours post-operation. Conclusion:: Stapled hemorrhoidopexy is a safe effective procedure with low complication, minimal postoperative pain and early recovery.
Health-Related Quality of Life in Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis Compared to the Healthy Population in Shiraz, Iran
(Brieflands, 2017-03-01) Negar Darvish; Negin Hadi; Elham Aflaki; Khadijeh Salehi Rad; Ali Montazeri
Background: Systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are chronic and complex autoimmune diseases, involving multiple organs. Therefore, quality of life (QoL) in SLE and RA patients can be affected. The current study aimed to compare SLE and RA patients with the healthy population in terms of health-related QoL (HRQoL) in Shiraz, Iran. Methods: The present cross sectional, analytical study was performed on 100 SLE patients, 100 RA patients, and 200 healthy controls, who were referred to the rheumatology clinics (Motahari and Hafez clinics) of Shiraz University of Medical Sciences. Demographic data including age, gender, educational level, and disease duration were evaluated. The Persian-translated version of 36-item short-form health survey (SF-36) was used as a tool for evaluating HRQoL. For statistical analysis, Pearson’s correlation test, t-test, and ANOVA were performed, using SPSS. Results: Comparison of SLE and RA patients with healthy controls showed that the control group obtained higher scores in 8 subscales of SF-36 questionnaire. Based on the findings, RA patients had the lowest scores between the groups. Age and disease duration had a significant negative linear correlation with HRQoL, while educational level had a significant positive linear correlation with HRQoL. Nevertheless, there was no significant correlation between gender and HRQoL. Conclusions: HRQoL was lower in RA patients in comparison with the SLE group. In fact, RA patients, who suffered from body pain and disability, obtained lower scores in both physical and mental domains. Therefore, promoting the patients’ health literacy, as an empowerment strategy, plays a key role in improving HRQoL.
The Shiraz Adult Respiratory Disease Study, a Population-Based Survey: Rationale, Design and Methods
(Brieflands, 2017-04-30) Seyed Masoom Masoompour; Hamideh Mahdaviazad; Seiyed Mohammad Ali Ghayumi; Mehrab Sayadi
Background: Despite preventable and curable nature of chronic obstructive respiratory diseases (CORDs), these are still remains as a growing problem, both in developed and developing countries. One of the major reasons for this ignorance is lacking of precise information on the prevalence of CORDs and their major determinants. Objectives: This protocol study aimed at providing a population-based data for the prevalence of CORDs and exploring its socioeconomic determinants in adult population of Shiraz, Iran. Methods: This adult respiratory disease study was designed as a cross sectional survey among urban and suburban population of Shiraz, Iran, during August to December 2015. The local ethics committee of Shiraz University of Medical Sciences authorized the protocol, which adhered to the tenets of the declaration of Helsinki (1975). The study included more than 6,000 noninstitutionalized inhabitants older than 20 years, from the 9 municipal districts of Shiraz city. The sample consisted of 0.5% of the 1,219,237 total inhabitants in the survey area. The sample selection was based on the stratified random sampling method proportionate to the number of municipal districts and strata. After obtaining official permissions, trained interviewers visited the selected homes and completed the data collection form and main questionnaire. Following the completion of recruitment and an initial analysis process, we called and invited the participants with the COPD diagnosis score more than 19.5 to pass the spirometry test in the clinic. The main questionnaire that covered respiratory symptoms was developed from prior validated questionnaires that had been used in several studies. Data were analyzed using the SPSS software version 15.0 (SPSS Inc, Chicago, Illinois, USA). A P-value of less than 0.05 was considered as statistically significant. Results: In this protocol study, we shared our standard protocol considering perfect selection of the study samples and precise examination procedure with effective quality assurance strategies. Conclusions: We anticipate that future reports from the Shiraz adult respiratory disease study would estimate the prevalence of CORDs and their related determinants in the community. Moreover, it will identify patients who should be targeted by respiratory disease prevention programs.
Investigating Transport Protocols for Mobile Health Applications of WSNs
(Brieflands, 2018-01-15) F S Tabei; B Askarian
Teaching Evidence-Based Medicine (EBM) to Undergraduate Medical Students through Flipped Classroom Approach
(Brieflands, 2018-02-28) Mohammad Mahdi Sagheb; Mitra Amini; Mahboobeh Saber; Mohsen Moghadami; Parisa Nabiei; Roya Khalili; Rita Rezaee; Leila Bazrafcan; Ali Asghar Hayat
Introduction: Medical students should be trained about the fundamental skills of evidence- based medicine (EBM) during undergraduate medical education curriculum. This article introduces an innovative model for initiation and development of a flipped classroom for teaching EBM to sixth- year undergraduate medical students in Shiraz Medical School, affiliated to Shiraz University of Medical Sciences. Methods: After conducting needs assessment and setting objectives for the program, blended leaning format and flipped classroom strategy were used. A student satisfaction measurement form was designed to evaluate the flipped classroom based on a 5-point Likert scale. The validity of the questionnaire was determined by experts, and the reliability of the questionnaire was 0.86 after a pilot study. We also used the questionnaires based on Berlin questionnaire to measure students’ knowledge, attitude, and practice about the EBM course in a pre- and posttest design. The validity and reliability of the questionnaire had been approved in our previous study. Also, the result of a summative examination after finishing the course was used as a measure of course goal achievement. Results: A total of 280 medical students on their sixth year of study participated in the flipped classroom in 6 different rotations. A total of 266 (95%) students passed the course and only 14 (%5) failed. The results of posttest scores based on the EBM domains revealed that the best result was obtained in teaching clinical questions’ format (patient, intervention, comparison, and outcome). The lowest posttest scores were in the domain of biostatistics. The overall quality of flipped classroom was reported well by the students. The students stated that the ability to apply knowledge and skills in managing patients were developed in this course. Discussions: In our experience, flipping classroom was a practical and essential activity to educate a large number of medical students about EBM. We acknowledge that the development of deep learning is instructors’ responsibility and that implementing blended learning and flipping classroom can facilitate students’ knowledge and skills about this important topic. We hope that other medical schools all over the world use the flipped classroom discussed in this article to redesign their classrooms in such a way that enables students to develop necessary skills and get involved in deep learning. This will improve the health of the society in the near future.
Teaching Evidence-Based Medicine (EBM) to Undergraduate Medical Students through Flipped Classroom Approach
(Brieflands, 2018-02-28) Mohammad Mahdi Sagheb; Mitra Amini; Mahboobeh Saber; Mohsen Moghadami; Parisa Nabiei; Roya Khalili; Rita Rezaee; Leila Bazrafcan; Ali Asghar Hayat
Introduction: Medical students should be trained about the fundamental skills of evidence- based medicine (EBM) during undergraduate medical education curriculum. This article introduces an innovative model for initiation and development of a flipped classroom for teaching EBM to sixth- year undergraduate medical students in Shiraz Medical School, affiliated to Shiraz University of Medical Sciences. Methods: After conducting needs assessment and setting objectives for the program, blended leaning format and flipped classroom strategy were used. A student satisfaction measurement form was designed to evaluate the flipped classroom based on a 5-point Likert scale. The validity of the questionnaire was determined by experts, and the reliability of the questionnaire was 0.86 after a pilot study. We also used the questionnaires based on Berlin questionnaire to measure students’ knowledge, attitude, and practice about the EBM course in a pre- and posttest design. The validity and reliability of the questionnaire had been approved in our previous study. Also, the result of a summative examination after finishing the course was used as a measure of course goal achievement. Results: A total of 280 medical students on their sixth year of study participated in the flipped classroom in 6 different rotations. A total of 266 (95%) students passed the course and only 14 (%5) failed. The results of posttest scores based on the EBM domains revealed that the best result was obtained in teaching clinical questions’ format (patient, intervention, comparison, and outcome). The lowest posttest scores were in the domain of biostatistics. The overall quality of flipped classroom was reported well by the students. The students stated that the ability to apply knowledge and skills in managing patients were developed in this course. Discussions: In our experience, flipping classroom was a practical and essential activity to educate a large number of medical students about EBM. We acknowledge that the development of deep learning is instructors’ responsibility and that implementing blended learning and flipping classroom can facilitate students’ knowledge and skills about this important topic. We hope that other medical schools all over the world use the flipped classroom discussed in this article to redesign their classrooms in such a way that enables students to develop necessary skills and get involved in deep learning. This will improve the health of the society in the near future.
Correlation Between Anxiety Disorders and Asthma Severity Indices in Asthmatic Children
(Brieflands, 2023-06-30) Mahsa Rekabi; Parisa Honarpisheh; Mahboobeh Karimi-Galougahi; Vahab Rekabi; Maryam Vasheghani; Narges Eslami; Samin Sharafian; Hooman Sharifi; Alireza Mahdaviani; Mahboubeh Mansouri; Sasan Vasegh; Armin Shirvani; Paniz Pourpashang
Background: Anxiety and depression in patients with asthma have been linked to frequent exacerbations, increased use of healthcare resources, and poor asthma control. Objectives: In the current study, we examined the correlations between asthma and symptoms of depression/anxiety in adolescents with asthma referred to Masih Daneshvari and Mofid hospitals during 2020 - 2021. Methods: The current observational, cross-sectional study was conducted by administering the Spence Children Anxiety Scale and a demographic information checklist among 105 subjects. Asthma severity was measured using forced expiratory volume in 1 second (FEV1), FEV1/forced vital capacity (FVC), the number of short-acting β-2 agonists used per week or month, the number of night awakenings per week or month, having asthma symptoms in daily activities, the number of asthma attacks needing oral corticosteroids per year, and the number of disease exacerbations per week or month. Data were analyzed, and the correlation between the variables was investigated through linear regression and ordinal logistic regression. Results: Patients with a mean age of 11.3 ± 2.5 years showed a mean overall anxiety score of 14 ± 9 out of 114. There was a significant negative correlation between the overall score of anxiety disorders and FEV1 and FEV1/FVC (P < 0.001). There was also a direct correlation between the overall score of anxiety disorders and the frequency of using β-2 agonists, the number of night awakenings, interference with normal functions, and exacerbation frequency (P < 0.001). Conclusions: Our findings indicated a significant association between anxiety disorders and asthma in children. Considering the high prevalence of asthma in Iran than the global average, studying the underlying mechanisms of anxiety and psychological and environmental variables in children with asthma can aid in developing effective psychological therapies.
Evaluation of Inappropriate Admission and Hospitalization According to Appropriateness Evaluation Protocol and Estimation of Direct Financial Burden
(Brieflands, 2019-11-03) Siamak Soltani; Mohamad Hoseini Kasnavieh; Hosein Shaker; Ahmad Abbasian; Alireza Amanollahi; Ali Tahmasebi
Background: Appropriate allocation of resources is an important issue in the delivery of services that can reduce the health system costs. The inappropriateness of healthcare services is one of the problems that increase the pressure on hospitals and patients. Methods: In this study, the data were collected using the appropriateness evaluation protocol by a medicine specialist at Rasoul Akram Hospital. In total, 248 participants were selected through systematic sampling. To calculate the financial burden simultaneously with the evaluation of inappropriate hospitalization days, the medicine and facility costs along with the cost of bed-day were estimated. Data were analyzed by SPSS software. Results: The type of treatment was surgery in 56.8% of the patients and 43.2% of them were admitted to the hospital for internal medicine. The mean length of stay was 4 ± 6 days. The inappropriate admission rate was estimated at about 6% and the rate of inappropriate hospital stays was 21.5%. The most important factors influencing the inappropriateness of hospitalization were delayed medical consultations, delayed surgery, conservative practitioner, and the follow-up of clinical test results. The sum of the direct financial burden of inappropriate hospitalization for the patients was estimated at around 1060 dollars. Conclusions: The findings of this study indicated that inappropriate hospitalization and admission imposed a huge financial burden on the health system and community. Hospital authorities by considering issues such as delayed medical consultations and delayed surgery can decrease the financial burden of inappropriate hospitalization to a large extent.
Mobile Health and HbA1c in Diabetics: A Review Study
(Brieflands, 2018-01-15) Behnam Honarvar; K.B lankarani
Use of AlloDerm Graft for Repairing Nasoseptal Perforation
(Brieflands, 2020-09-30) Alireza Mohebbi; Hosna Zobairy; Hesam Jahandideh; Ayda Sanaei
This article does not have an abstract.
Reducing Self-Medication in Iranian Women Based on Health Belief Model: A Brief Report
(Brieflands, 2020-11-15) Afsaneh Behroozpour; Mohsen Shams; Masoumeh Mousavi; Rahim Ostovar
Self-medication is a serious health problem in Iran. In this quasi-experimental study with a control group, four healthcare facilities were selected and divided into intervention and control groups. Based on the health files of women in healthcare facilities, 192 women were selected randomly and completed a self-reported questionnaire to measure Health Belief Model constructs and self-medication. After analyzing the data, perceived susceptibility was found as the main predictive factor for self-medication, and an intervention was developed to increase it. The intervention consisted of lectures and group discussions, along with distributing pamphlets and sending short messages for four weeks. Three months later, the data was collected again and analyzed. Perceived susceptibility was improved, and self-reported behavior was reduced significantly in intervention groups compared to the control groups.

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