Background: During pandemics and emergencies, including infectious disease epidemics, hospitals play a vital role in the local and national response. Due to the outbreak of the COVID-19 pandemic, this study was conducted to assess the preparedness of the referral hospital to respond to the COVID-19 pandemic in 2022. Materials and Methods: In this descriptive cross-sectional study, data were collected using the World Health Organization (WHO) checklist. The checklist was completed by the managers and supervisors of the various departments in the referral hospital. Results: The preparedness of the incident management system was 98%, the increase in overall capacity was 89%, infection control and prevention was 78.5%, patient management was 83.5%, human resources management was 85%, continuity of essential health services and patient care was 83.5%, the status of the primary care and warning system was 89%, communication was 98%, drug resource management was 61%, laboratory services were 78.5% and essential support services were 82.5%. The overall preparedness of the hospital was 84%. Conclusion: The hospital demonstrated a strong performance during the COVID-19 pandemic. Key strengths included effective communication and coordination among different departments, prompt sample collection and reporting of results within 48 hours, clear separation of COVID-19 and non-COVID-19 patients, and an uninterrupted supply of essential equipment and resources to support the response. However, improvements in the management and support of pharmaceutical resources are needed. Developing new policies and preparedness plans could further strengthen the hospital's capacity to respond effectively to future epidemic or pandemic crises.
Background: Parkinson's disease (PD) is the second most common neurodegenerative disease. Oxidative stress and dyslipidemia may play a key role in the pathogenesis and progression of PD. In this experimental study, the relationship of serum levels of high-density lipoprotein (HDL) and low-density lipoprotein (LDL) with the severity of Parkinson's disease was investigated in an animal model. Materials and Methods: Rats were divided into three groups: control, sham (vehicle injection) and parkinsonian (injection of 6-hydroxydopamine, 4 μg/μl, and volume 10 μl into the striatum). The incidence and severity of Parkinson's symptoms were assessed before and after surgery by apomorphine-induced rotation behavioral test. Blood sampling was performed once before surgery and twice after surgery (weeks 3 and 10), and serum HDL and LDL levels were measured by colorimetric methods. Results: Pre-surgery serum LDL and HDL levels were 22.5±1.3 and 31.6±1.1 mg/dl, respectively. In the toxin-receiving group, HDL levels decreased significantly on weeks 3 and 10, while LDL levels increased significantly (P<0.01). The decrease in HDL was greater in rats with severe symptoms than in those with mild symptoms, whereas the increase in LDL was observed only in the severe symptom group. Conclusion: Induction of Parkinson's disease by 6-hydroxydopamine toxin in rats is accompanied by changes in serum LDL and HDL levels, and these changes depend on the severity of behavioral symptoms.
Background: Ulcerative colitis (UC) is a chronic inflammatory disease of the colon characterized by excessive production of pro-inflammatory cytokines and progressive mucosal damage. IL-36α, a member of the IL-1 cytokine family, plays an important role in amplifying inflammatory responses. This study aimed to investigate the effects of quinic acid (QA) and syringic acid (SA) on IL-36α levels in an experimental model of UC. Materials and Methods: UC was induced in male Wistar rats by intrarectal administration of 4% acetic acid. The animals were divided into control, colitis, dexamethasone-treated, QA-treated (10, 30, 60, and 100 mg/kg), and SA-treated (10, 25, and 50 mg/kg) groups. After 7 days of treatment, IL-36α levels in colon tissue were measured using ELISA. Results: Induction of UC significantly increased IL-36α levels from 106.9 ± 8.69 pg/mL in the control group to 420.6 ± 59.50 pg/mL in the colitis group (P < 0.0001). Dexamethasone significantly reduced IL-36α levels to 108.7 ± 12.18 pg/mL (P < 0.0001). QA treatment resulted in a dose-dependent reduction in IL-36α levels, with values of 390.2 ± 47.72, 332.3 ± 72.49, 232.5 ± 60.57, and 170.7 ± 24.01 pg/mL at 10, 30, 60, and 100 mg/kg, respectively. Similarly, SA significantly decreased IL-36α levels to 355.4 ± 52.43, 306.8 ± 77.06, and 183.0 ± 33.70 pg/mL at 10, 25, and 50 mg/kg, respectively (P = 0.04, P=0.0001, and P<0.0001). Conclusion: Both QA and SA exert significant anti-inflammatory effects in experimental UC and may modulate inflammatory responses through reducing IL-36α levels.
Background: Sensorineural hearing loss is a major public health concern among adults and older people, contributing to reduced quality of life, cognitive decline, social isolation, and increased healthcare costs. Despite its growing burden, Iran currently lacks a national adult hearing screening program. Materials and Methods: This policy brief was developed through a review of relevant documents and secondary analysis of data from the Hoveyzeh Cohort Study in southwest Iran. A total of 1,365 adults aged 35–70 years were included. Associations between individual-, household-, and area-level socioeconomic factors and sensorineural hearing loss were examined using multivariable logistic regression analysis. Results: Among the participants, 485 individuals had sensorineural hearing loss. Older age, male sex, diabetes, noise exposure, and a family history of hearing loss were significantly associated with a higher likelihood of hearing loss. Conversely, higher educational attainment and better household economic status were associated with a lower risk. Hearing loss was more prevalent among socioeconomically disadvantaged groups and residents of deprived areas. Conclusion: The findings indicate that hearing loss is not only a clinical condition but also a social and equity issue. Delayed detection and failure to intervene in time may lead to increased disability, cognitive decline, social exclusion, and a greater burden on the healthcare system. Addressing hearing loss should therefore be considered an integral component of healthy ageing and non-communicable disease strategies in Iran. Policy Recommendations: -Designing targeted screening interventions for older age groups. -Integrating hearing assessments into non-communicable disease (NCD) care programs. -Strengthening preventive interventions in occupational health and reducing noise exposure. -Designing hearing health education programs and increasing health literacy. -Prioritizing low-income groups and strengthening equitable access to hearing services. -Designing targeted prevention programs in high-risk workplaces.
Background: Infertility is one of the most significant reproductive health challenges and is recognized by the World Health Organization as a global concern. Given the lack of comprehensive studies in Bushehr Province, this study aimed to investigate the risk factors among couples presenting to Omid Persian Gulf Infertility Treatment Center. Materials and Methods: This cross-sectional study was enrolled 134 infertile couples who visited Omid Persian Gulf Infertility Treatment Center in Bushehr in 2021. Convenience sampling was used to select the participants. Data were collected through interviews and review of clinical and laboratory records. Demographic, clinical, and laboratory variables were assessed. Data were analyzed using descriptive statistics including mean, standard deviation, frequency, and percentage in SPSS version 26. Results: The mean age of infertile women and men was 32.02 ± 6.90 and 36.30 ± 6.47 years, respectively. Among the studied couples, 80 couples (59.7%) had primary infertility and 54 couples (40.3%) had secondary infertility. The cause of infertility was female-related in 54 cases (40.3%), male-related in 19 cases (14.2%), combined in 52 cases (38.8%), and unexplained in 9 cases (6.7%). The most common female cause of infertility was polycystic ovary syndrome, observed in 96 individuals (71.7%). The most common male factor was varicocele, reported in 35 individuals (21.6%). A family history of infertility was present in 27.6% of the participants. Conclusion: Primary infertility was more prevalent than secondary infertility. The most common male and female causes were varicocele and polycystic ovary syndrome, respectively. These findings provide valuable insights into the pattern of infertility in Bushehr Province and may inform future research priorities as well as the planning and delivery of infertility-related healthcare services.
Background: Postpartum pain is a common condition during the puerperium and may adversely affect maternal recovery and the quality of newborn care. Therefore, the use of complementary and noninvasive approaches for pain management is of clinical importance. This study aimed to determine the effect of auriculotherapy on the intensity of postpartum pain. Material & Methods: This randomized clinical trial enrolled 106 women with vaginal delivery at a selected hospital in Isfahan, Iran. Participants were selected through convenience sampling from among eligible women and were then randomly allocated into intervention (receiving auriculotherapy) and control groups using block randomization. Pain intensity was assessed using the Visual Analogue Scale (VAS) on the first and tenth days postpartum. Data were analyzed using independent-samples t-test and paired-samples t-test in SPSS version 26. Results: Based on the independent-samples t-test, the mean postpartum pain score on the first day after delivery showed no statistically significant difference between the intervention (2.87 ± 0.56) and control groups (3.25 ± 1.44) (t=−1.29, p= 0.200). However, on the tenth day postpartum, pain intensity in the intervention group (1.64 ± 0.98) was significantly lower than that in the control group (3.11 ± 1.70) (t=−5.44, p < 0.001). Paired t-test results indicated a statistically significant reduction in pain scores from day 1 to day 10 in the intervention group (t=6.46, p<0.001), whereas no significant change was observed in the control group (t=0.644, p=0.523). Conclusion: Auriculotherapy appears to be an effective complementary, noninvasive intervention for achieving a gradual and sustained reduction in postpartum pain.
Background: Hospitals account for the largest share of the healthcare expenditures. Therefore, understanding the overall structure of these costs is essential for financial sustainability. The aim of this study was to analyze the trend and structure of expenditures in hospitals affiliated with Neyshabur University of Medical Sciences. Material & Methods: This retrospective descriptive-analytical study was conducted using expenditure data from two hospitals, Hakim and 22 Bahman, covering the period from 2019 to 2023. Hospital expenditures were classified into six main categories: personnel, drugs and consumables, maintenance and depreciation, contractual services, energy/transportation/communications, and support and miscellaneous. Results: The total expenditures of the two hospitals increased from approximately 1.7 trillion IRR in 2019 to more than 8.1 trillion IRR in 2023– representing an increase of approximately 375%. Expenditures at Hakim Hospital rose from about 0.7 to over 4.2 trillion IRR while those at 22 Bahman increased from about 1.0 to 3.9 trillion IRR. After adjusting for inflation using constant prices, total expenditures of the two hospitals increased from 1.7 to 2.2 trillion IRR (about 29%) over five years. In real terms, expenditures increased from approximately 0.7 to 1.1 trillion IRR at Hakim Hospital and from approximately 1.0 to 1.1 trillion IRR at 22 Bahman Hospital. Personnel costs accounted for the largest share of expenditures in both hospitals: 68% at Hakim Hospital and 63% at 22 Bahman Hospital. The share of drugs and consumables was 20% and 27% in the two hospitals, respectively. Conclusion: The overall growth of expenditures, particularly personnel costs, highlights the need for policies that enhance workforce productivity, optimize staffing patterns, and improve procurement and utilization of consumables. Achieving an appropriate balance between investment in human resources and technology, along with increasing the efficiency in support services, may contribute to the long-term financial sustainability of hospitals.
Background: Knowledge translation is a purposeful process that facilitates the transfer of research findings to policymakers, decision-makers, and end users with the aim of improving health system performance. This study aimed to investigate the status of knowledge translation from the perspective of faculty members at Ahvaz Jundishapur University of Medical Sciences. Materials and Methods: This descriptive-analytical study included faculty members from both basic and clinical sciences who voluntarily participated after providing informed consent. Data were collected using a standardized questionnaire consisting of two sections. The first section assessed participants’ demographic characteristics, and the second evaluated the status of knowledge translation. The reliability of the questionnaire was confirmed by a Cronbach’s alpha coefficient of 0.79. Statistical significance was set at P < 0.05. Results: The mean overall knowledge translation score was 2.66 ± 0.47. The mean scores for the dimensions of knowledge application, knowledge production, and audience needs assessment were 2.71 ± 0.51, 2.64 ± 0.48, and 2.57 ± 0.56, respectively, indicating a relatively favorable level of knowledge translation. A significant association was found between academic group and knowledge translation score, with faculty members in the basic sciences obtaining higher scores than those in the clinical sciences (P=0.033). Conclusion: Faculty members demonstrated a relatively favorable level of knowledge translation. However, strengthening institutional and educational infrastructures that support knowledge translation is essential. Educational programs aimed at enhancing knowledge translation skills, coupled with establishment of supportive structures that facilitate interaction between researchers and administrators are recommended to promote the effective use of research evidence in practice.
Background: Early detection of chemotherapy-induced cardiotoxicity plays an important role in preventing its progression. This study aimed to investigate early changes in myocardial perfusion distribution after chemotherapy with doxorubicin in patients with breast cancer. Materials and Methods: Resting myocardial perfusion imaging was performed before and after chemotherapy in 61 women with breast cancer without a history of cardiovascular disease or radiotherapy. The standard deviation and 95% bandwidth of the histogram of the mean uptake in the segments of Bull's-eye image were compared before and after chemotherapy. The relationship of changes in these indices with the cumulative dose of doxorubicin, age and body mass index of the patients were also investigated. Results: The mean percentage of uptake in the Bull's-eye segments was 69.60 before and 68.10 after chemotherapy (P>0.05). The standard deviation and 95% bandwidth of histogram of the mean segmental uptake before chemotherapy were 5.48 and 18.58, respectively, which increased to 5.56 and 19.52, respectively, after chemotherapy. This increase was mainly seen in patients who received a cumulative dose of more than 400 mg of doxorubicin. However, none of these changes were statistically significant (P>0.05). No significant association was observed between changes in left ventricular perfusion distribution and either age or body mass index. Conclusion: Chemotherapy did not produce significant early changes in left ventricular myocardial perfusion. However, further studies with pixel-based myocardial perfusion imaging are recommended.
Background: Effective communication and trust are essential components of the nurse-patient relationship within the emergency department. Patient trust influences adherence to treatment. Negotiation can improve mutual understanding and enhance trust. This study aimed to investigate the effect of nurse-patient negotiation on trust in nurses in the emergency department. Materials and Methods: This parallel-group randomized controlled trial with 1:1 allocation was conducted in the emergency department of Imam Reza Hospital, Birjand, Iran, in 2025. This single-blind study recruited seventy patients selected by convenience sampling and randomly assigned to intervention and control groups (n=35 each). The intervention group received 10-15 minutes of individual negotiation based on Botelho's six-step model (1992); the control group received routine care. Trust was measured using the Radwin & Cabral questionnaire. Data were analyzed using ANCOVA. Results: Nurse-patient negotiation significantly increased trust in nurses in the intervention group compared to controls (P<0.001, F (1,67) =22.48). Mean trust score in the intervention group increased from 15.94 at pretest to 18.35 at posttest. Eta squared showed that 39% of the variance in trust was explained by nurse-patient negotiation. Conclusion: Nurese-patient negotiation significantly increases trust in nurses. Investing in communication skills training for nurses, especially in high-pressure environments like emergency departments, can yield substantial benefits.
Background: Chronic psychiatric disorders are associated with a substantial burden of disease, reduced quality of life, and frequent hospitalizations. High readmission rates indicate significant challenges in the continuity of care and access to psychiatric services, often influenced by structural factors such as poverty, limited service availability, and insurance-related barriers. This study aimed to examine the role of telepsychiatry in reducing recurrent hospitalizations among patients with chronic mental disorders and to identify policy options to improve access to care and continuity of services. Methods: This policy brief was conducted using a targeted evidence synthesis approach and following the official WHO EMRO format. Data and findings from five relevant published studies on telepsychiatry were reviewed and analyzed. Results: The evidence review indicates that the implementation of telepsychiatry is associated with a significant reduction in hospital readmissions, improved clinical outcomes, increased patient satisfaction, lower healthcare costs, and enhanced access to services—particularly in underserved areas. Based on these findings, several key policy options are proposed: 1.Systematic integration of telepsychiatry services into the mental health service package and post‑discharge care. 2. Reducing access barriers and the digital divide through the development of technological infrastructure and support for disadvantaged populations. 3. Standardizing and ensuring the quality of telepsychiatry services in accordance with clinical guidelines and ethical frameworks. 4. Ensuring sustainable insurance coverage for telepsychiatry services. 5. Supporting large-scale, high-quality research to monitor outcomes and promote continuous program improvement. Conclusion: Implementing these policy options can improve the quality of care, enhance equity in access to mental health services, reduce recurrent hospitalizations among patients with chronic psychiatric disorders, and strengthen overall health system performance.
Background: Toxoplasmosis is one of the most common parasitic infections, which, when transmitted congenitally, can lead to severe complications in neonates. The present study aimed to investigate the presence of anti-Toxoplasma gondii antibodies in the blood samples of newborns in Bushehr, Iran. Materials and Methods: This descriptive–analytical cross-sectional study was conducted on 181 newborns delivered in Bushehr hospitals between 2022 and 2023. Blood samples were collected from each neonate, and the levels of anti-Toxoplasma IgG and IgM antibodies were determined using the enzyme-linked immunosorbent assay (ELISA) method. The obtained results, along with questionnaire data, were analyzed using the Chi-square statistical test in SPSS software. Results: Among the 181 neonates examined, 33 (18.2%) had a positive titer of anti-Toxoplasma IgG antibody, while 148 (81.8%) showed no detectable IgG antibodies in their serum. Of the IgG-positive samples, two neonates also showed the presence of specific anti-Toxoplasma IgM antibodies. The remaining 179 samples (98.9%) were negative for IgM antibodies. Conclusion The findings of this study emphasize the necessity of increasing maternal awareness and establishing toxoplasmosis screening programs during pregnancy. Although the prevalence of acute Toxoplasma infection among the examined neonates was low, early diagnosis and follow-up of infants with positive IgM results can greatly reduce potential long-term complications.
Background: Despite the large volume of published health information, pregnant women still face barriers to accessing pregnancy-related resources. The aim of the present study is to identify barriers to and facilitators of information for pregnant women by reviewing resources in this field. Materials and Methods: This study was conducted as a scoping review. English and Persian databases were searched to retrieve articles, theses, research projects, and governmental reports pertaining to the study objectives. Of the 2,135 initial records, after a two-level screening process by six individuals (including four primary reviewers with a kappa agreement coefficient of 0.82 and two specialists for resolving disagreements), 23 studies were ultimately included in the final analysis. Results: The following barriers emerged from a review of the studies: contradictory information on a single topic regarding pregnancy; confusion, worry and anxiety when facing a large volume of information; financial constraints; low health literacy; lack of professional information search skills; limited access to healthcare providers (nurses, midwives, doctors); low social support from family, friends, and peers. On the other hand, healthcare providers, use of social media, launching and introducing reputable websites and systems in the field of pregnancy, support from families, friends, and acquaintances were some of the facilitators of providing information for pregnant women. Conclusion: Information barriers and facilitators for pregnant women are a multidimensional issue. Empowering pregnant women to access and evaluate health information requires the cooperation among health and information sector officials, individuals and the community.
Background: In recent years, complementary methods, including imaging-based approaches, have been proposed for better grading of glioma tumors due to the inherent limitations of histopathology as the standard method. This study aimed to determine the diagnostic performance of semi-quantitative parameters of dynamic T1-weighted magnetic resonance imaging (T1W-MRI) for presurgical glioma grading. Materials and Methods: Patients with brain tumors referred to the imaging department of a referral cancer center between February 2021 and July 2023 were retrospectively reviewed. Thirty-one patients with glioma confirmed by pathology results met the inclusion criteria. The mean age of the patients was 39.2±1.14 years, and 18 participants were male (58.06%). Semi-quantitative parameters (IAUC, Peak, and Initial Slope) were quantified using dynamic T1W-MRI data. The Mann-Whitney U test was used to assess the significance of the difference between these parameters in different grades of glioma. The performance of these parameters for glioma grading was evaluated using receiver operating characteristic (ROC) curve analysis. Results: IAUC, Peak, and Initial slope parameters showed significant differences between different glioma grades (P≤0.041), and the results indicated that IAUC had the best grading performance compared to the other studied parameters. Conclusion: Semi-quantitative parameters quantified using dynamic T1W-MRI are valuable indices that can reliably discriminate between glioma grades. These non-invasive physiological imaging parameters can serve as a powerful complement to the standard histopathological grading system.
