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Background: Doxorubicin (Dox) is an anthracycline antibiotic that is widely used as a chemotherapy agent. However, the benefit of this agent is limited due to its side effects. The purpose of this study was to investigate the effect of high intensity interval training and crocin consumption on oxidative stress in liver tissue of male rats under chronic induction of doxorubicin. Materials and Methods: In the present experimental study, 40 Wistar male rats were placed in groups: Healthy control (saline), doxorubicin (control) (2mg/kg in 7 doses), doxorubicin and crocin (2mg/kg), doxorubicin training, and doxorubicin, crocin and training. The training groups ran in 80-90% of maximum speed for 8 weeks, 5 days a week, with 2-minute intervals. The level of malondialdehyde, activity of superoxide dismutase and catalase enzymes in liver tissue was measured. Results: Doxorubicin significantly increased malondialdehyde levels and reduced the activity of superoxide dismutase and catalase in the liver tissue in the groups receiving doxorubicin compared to the healthy control group (P

Background: Despite a lot of efforts made in the rabies health-care system, Iran is still in an endemic region and millions are spent annually to prevent rabies., Materials and Methods: Searching in national and international databases has been performed. The preferred reporting items for systematic reviews and meta-analyses protocol were followed. To assess heterogeneity, the I-index was calculated. In addition, sensitivity analysis was performed by the remove-one method. The publication bias was also investigated by Egger's regression test, and the trim and fill method. To perform a meta-analysis, CMA version 2 software was used., Results: Totally, 33 studies with 250,980 animal-bite cases were meta-analyzed. A summary estimate of the incidence of 1200 per 100,000 population (95% CI 1000, 1500) with a mean age of 29.97±15.13years (95%CI: 29.33, 30.61) was estimated. The rate in men was higher 76.7% (95%CI 74.7%, 78.8%) than in women and in the rural 49.7% (95%CI: 42.8%, 58.6%) was equal in the urban. Most bites occurred in the spring and summer 20.5% (95%CI: 16.1%, 25.9%). The highest of job-related bites was in students 20.1% (95%CI: 19%, 23%). The highest rate of bite location and the animal type were estimated in the order of lower limbs and by dogs respectively. The rate of complete vaccination 61% (95%CI: 43%, 76%) and immunoglobulin injection 39% (95%CI: 22%, 59%), were estimated respectively., Conclusion: Estimates reveal that there has been little change in the animal bites over the years. It is necessary to take special actions to control the disease at the national and international levels., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Research in Medical Sciences.)

Background: In Iran, community health workers (CHWs) are selected and employed according to the instructions of the Ministry of Health (MOH). The present study aimed to investigate the views of different stakeholders regarding the selection criteria, as well as the competency of CHWs., Methods: This study was conducted using a qualitative thematic analysis in Golestan Province, Iran. Data were collected using semi-structured interviews with managers, supervisors, CHWs, and common people in 2021. The interviews were recorded and then transcribed. To extract key themes, the six-step Brown model was used, which involved becoming acquainted with the data, meaningful organization of transcripts, extracting primary open codes, searching for themes in an iterative approach, theme extraction, defining themes, and preparing a report. The relationships between codes and sub-themes and themes were represented using ATLAS.ti version 8., Results: Data saturation was achieved after interviewing 22 people. The extracted data included 340 open codes, two main sub-themes of "CHW effectiveness" and "CHW sustainability", and three main themes of "criteria for employing competent people", "barriers to employing competent people", and "identifying the barriers to employing competent people", according to the MOH instructions., Conclusion: In the present study, local hiring was one of the major challenges in the competency-based selection of CHWs. One of the most repeated codes was expanding the local hiring concept and its requirements. Since different regions of Iran have different climatic, economic, cultural, and social conditions, the selection and hiring criteria for CHWs should be tailored to the needs of the community., (© 2023. The Author(s).)

Background and Aims: Sulfonylureas are the most secondary prescribed oral anti-diabetic drug. Understanding its genetic role in pharmacodynamics can elucidate a considerable knowledge about personalized treatment in type 2 diabetes patients. This study aimed to assess the impact of KCNQ1 variants on sulfonylureas response among type 2 diabetes Iranian patients., Methods and Results: 100 patients were recruited who were under sulfonylureas therapy for six months. 50 responder and 50 non-responder patients were selected. KCNQ1 variants were determined by the RFLP method, and their role in treatment response was assessed retrospectively. Patients with rs2237895 CC and AC genotypes demonstrated a significant decrement in FBS and HbA1c after treatment over patients with AA genotypes (All P < 0.001). Compared to the A allele, the odds ratio for treatment success between carriers with rs2237895 C allele was 4.22-fold (P < 0.001). Patients with rs2237892 CT heterozygous genotype exhibit a higher reduction rate in HbA1c and FBS than CC homozygotes (P=0.064 and P=0.079, respectively). The rs2237892 T allele carriers showed an odds ratio equals to 2.83-fold over C allele carriers in the responder group compared to the non-responder group (p=0.081)., Conclusion: Findings suggest that the KCNQ1 rs2237895 polymorphism is associated with the sulfonylureas response on Iranian type 2 diabetes patients., Competing Interests: Competing InterestWe have no conflict of interest., (© Springer Nature Switzerland AG 2022.)

Introduction: This study evaluates the effects of 8 weeks of resistance exercises on the expression of neurotrophins and Trk receptors in Alzheimer model male Wistar rats., Methods: For this purpose, 32 mature male Wistar rats with a mean weight of 230-280 g were chosen and divided into Alzheimer and Sham groups. The rats in the sham group received normal saline, while the ones in the Alzheimer group received streptomycin via intraventricular injection. These rats were then divided into the following four subgroups: 1) resting sham, 2) exercising sham, 3) resting Alzheimer, and 4) exercising Alzheimer. The two exercising rat subgroups exercised three times a week for 8 weeks. A weight was attached to their tails, and they had to carry it on a 26-step ladder in each cycle. Resting groups were handled every day to minimize the effects of stress. At the end of the eighth week and 24 hours after the last exercise session (to avoid the effects of the last exercise session), the rats were put under deep anesthesia and beheaded. Hippocampus tissues were precisely extracted, and samples were sent to the laboratory for molecular and cellular tests. To investigate gene expression, quantitative RTPCR was used., Results: The tests for comparing the mean values of BDNF, NT3, NGF, TrkA, and TrkB in two rat groups showed that with error levels of less than 5%, there is a significant difference in the amounts of BDNF, NT3, NGF, TrkA, and TrkB between exercising rats and resting ones. These amounts were much higher in the exercising Alzheimer rats group., Conclusion: Eight weeks of resistance exercises increased the expression of BDNF , NT3 , and NGF genes and TrkA and TrkB receptors in Alzheimer model Wistar rats., Competing Interests: Conflict of interest The authors declared no conflict of interests., (Copyright© 2021 Iranian Neuroscience Society.)

Objective: Physical activity leads to changes in the level of gene expression in different kinds of cells, including changes in mitochondrial biogenesis in the myocardium in diabetic patients. Peroxisome proliferator-activated receptor coactivator 1α (PGC-1α) is a gene that plays an important role in regulating mitochondrial biogenesis. The purpose of this study was to investigate changes in serum levels and cardiac muscle expression of PGC-1α in diabetic rats in response to the administration of dichloroacetate (DCA) and endurance training., Materials and Methods: In this experimental study, 64 male Wistar rats were selected and randomly divided into eight groups after induction of diabetes with streptozotocin (STZ). The endurance training protocol was performed on a treadmill for 6 weeks. Intraperitoneal injection of DCA of 50 mg/ kg body weight was used for the inhibition of Pyruvate Dehydrogenase Kinase 4 (PDK4) in the myocardium. Gene expression were measured using real-time polymerase chain reaction (PCR). One-way ANOVA and Tukey's test were used to statistically analyze the data., Results: The results of the study showed that PDK4 gene expression in the endurance training group, diabetes+endurance training group, diabetes+endurance training+DCA group and endurance training+DCA group was higher compared to the control group. Expression of PGC-1α was higher in the endurance training group compared to the control group but was lower compared to the control group in diabetes+endurance training+DCA group and diabetes+DCA group (P<0.05)., Conclusion: Considering that PGC-1α plays an important role in mitochondrial biogenesis, it is likely that by inhibiting PDK4 and subsequently controlling oxidation of fatty acid (FA) in the heart tissue, oxidative stress in the heart tissue of diabetic patients will be reduced and cardiac efficiency will be increased., Competing Interests: There is no conflict of interest in this study., (Copyright© by Royan Institute. All rights reserved.)

Background: In Iran, community health workers (CHWs) are native and are only employed in the health-care system. Therefore, the training and empowerment of these staff are essential. The present study was aimed to develop cooperative learning techniques in CHWs to improve both cognitive and noncognitive aspects such as accountability and other social skills in learners., Methodology: This study employed a quasi-experimental pre- and post-test design with a control group that was conducted in Kangavar City, Iran, in 2019. Forty-four CHWs were selected using a two-stage cluster sampling, of whom 22 were randomly assigned to the experimental group where the jigsaw technique was applied and the rest to the control group where the lecture method was applied. The aim was to identify job performance and motivation among the CHWs after instruction and compare the two groups. Pre- and posttests were applied to the groups before and after an in-service training course using valid questionnaires. Data analysis was performed on both descriptive and inferential statistics such as mean and standard deviation, paired t -test, and covariance analysis with the confidence level of 95%., Results: The findings showed that the intervention significantly increased the mean score of motivation and performance in the experimental group. Covariance analysis with the removal of the pretest effect was also statistically significant ( P = 0.01). Moreover, the MANCOVA test showed the jigsaw technique effect considering motivation and performance with a confidence level of 95%., Conclusion: Given the well-known effect of cooperative learning techniques and since CHWs have multi roles and tasks, it is necessary to use such techniques so that they can be accountable for developing health indicators in local areas., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Education and Health Promotion.)

Background: One of the efforts that solve complex real-world problems is to use an interdisciplinary approach. However, the contradictions among different disciplines and the absence of a theoretical model add to the difficulty of interdisciplinary activities. When interdisciplinary researchers face a complex problem, they need to integrate several different disciplines. It seems the first step in interdisciplinary activities is to have a theoretical model to understand and examine by what content and method the processes of integrating and crossing the disciplinary boundaries are done. The purpose of this study is to propose a new theoretical model for interdisciplinary development. It also show that a multilayered model can be formed based on the boundaries of scientific disciplines. Methods: In this study, the critical review strategy of Carnwell and Daly has been used to synthesize the theoretical model using online databases. The method consists of 5 stages: defining the scope of the review, identifying the sources of relevant information, reviewing the literature, writing the review, and applying the literature to the proposed study. Results: The results of this study showed for interdisciplinarity, the artificial boundaries of disciplines must be broken. Therefore, we first began to explain the disciplinary boundaries in 13 levels, then, we proposed interdisciplinary development by examining the views of the experts in this field and with the synthesis opinion of researchers of this study on each of the disciplinary boundaries of the multilayered model. Conclusion: This model can effectively support interdisciplinary programs and can bring the goals of interdisciplinary programs closer to practical reality., Competing Interests: Conflicts of Interest: None declared, (© 2020 Iran University of Medical Sciences.)

Background: Assessing the effectiveness of in-service training courses in order to achieve the desired goals and reduce the waste of costs and opportunities in the system is necessary. The purpose of this study was to determine the effectiveness of the "pharmacopeia home health" course considering its importance in different aspects using the Kirkpatrick model., Materials and Methods: The present study was a quasi-experimental conducted at community health workers (CHWs) on three levels of reaction, learning, and behavior. In each phase, a valid questionnaire was used to measure the outcome according to the Ministry of Health guidelines with pretest and posttest measurements. The data were analyzed through SPSS 23, using descriptive statistics and repeated measures test and general linear model., Results: The results of the study showed that at the level of reaction in terms of content and holding, conditions of implementation were favorable. Findings at the level of learning showed that the training course was only effective in enhancing the knowledge and awareness about drug maintenance and had no significant effect on other areas. In the third level, the results of the CHWs' performance showed that in some areas, the results were influenced by the demographic variables., Conclusion: The present study showed the effectiveness of education in different areas using on the Kirkpatrick model. Given the lack of impact of education in some areas in the present study and on the other, it is necessary to consider cooperative learning methods in order to develop the effectiveness of the courses., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Education and Health Promotion.)

An outbreak of pneumonia, caused by a novel coronavirus (SARS-CoV-2), was identified in China in December 2019. This virus expanded worldwide, causing global concern. Although clinical, laboratory, and imaging features of COVID-19 are characterized in some observational studies, we undertook a systematic review and meta-analysis to assess the frequency of these features. We did a systematic review and meta-analysis using three databases to identify clinical, laboratory, and computerized tomography (CT) scanning features of rRT-PCR confirmed cases of COVID-19. Data for 3420 patients from 30 observational studies were included. Overall, the results showed that fever (84.2%, 95% CI 82.6-85.7), cough (62%, 95% CI 60-64), and fatigue (39.4%, 95% CI 37.2-41.6%) are the most prevalent symptoms in COVID-19 patients. Increased CRP level, decreased lymphocyte count, and increased D-dimer level were the most common laboratory findings. Among COVID-19 patients, 92% had a positive CT finding, most prevalently ground-glass opacification (GGO) (60%, 95% CI 58-62) and peripheral distribution opacification (64%, 95% CI 60-69). These results demonstrate the clinical, paraclinical, and imaging features of COVID-19., Competing Interests: The authors declare that they have no competing interest regarding the publication of this paper., (Copyright © 2020 Hamidreza Hasani et al.)

Background: Tuberculosis is one of the top 10 causes of mortality worldwide. It is also the leading cause of death in HIV-positive patients. In this study, we aimed to assess the educational needs of general practitioners regarding tuberculosis in the North Health Center of Tehran, Iran., Materials and Methods: This quantitative and qualitative study was conducted in 2017. In the quantitative phase, 31 general practitioners from the North Health Center of Tehran were included. The educational needs assessment was performed using the knowledge assessment and self-assessment scales. Data were entered in SPSS version 21 and analyzed using descriptive tests and Pearson's correlation coefficient test. In the qualitative phase, data were collected by interviewing six managers of tuberculosis monitoring program and analyzed using the content analysis method., Results: The mean score of the knowledge assessment scale was 22.8±6.4. The most and the least important educational needs were related to treatment and general information about tuberculosis, respectively. Moreover, tuberculosis treatment and general information about tuberculosis were the most and the least important educational needs in the self-assessment scale, respectively. There was a poor correlation between the mean scores of self-assessment scale and knowledge assessment scale regarding tuberculosis prevention (P=0.01, r=0.27). Also, a moderate correlation was found regarding tuberculosis screening (P=0.001, r=0.56). However, no significant correlation was found in terms of general information (P=0.31), diagnosis (P=0.43), and treatment (P=0.29) of tuberculosis. Five major themes were extracted in the qualitative phase of the study, including "training time", "educational content", "educational references", "teaching method", and "organizational factors"., Conclusion: An appropriate educational program should be developed for general practitioners in form of continuing education and educational reform., Competing Interests: Conflict of Interest The authors declare that they have no conflict of interests., (Copyright© 2019 National Research Institute of Tuberculosis and Lung Disease.)

Background: Recent studies indicate an increased incidence of pertussis disease in recent years. The aim of this study was to evaluate the efficacy of the acellular vaccine for children (as a replacement of current whole cell vaccine in the Expanded Program on Immunization) and for high-risk adults in Iran through updating current best available evidence. Methods: We performed a systematic literature review in relevant databases we focused on previously published systematic reviews to select those that address our questions. The AMSTAR (assessing the methodological quality of systematic reviews) tool was used for screening available reviews. Then search in databases was done until Feb 2014 to update the evidence. We pooled results using meta-analysis methods by Stata statistical package. Results: Eleven systematic review articles were included in the initial evaluation. In the end, two systematic reviews on acellular vaccine booster doses and the acellular vaccine in children were selected as the baseline evidence. In the update phase, new clinical trials were screened, and the results were updated. Overall pooled estimate of relative efficacy of acellular to whole cell was 0.68 (95% CI, 0.55-0.81) for children immunization Pooled estimates for the efficacy of acellular versus placebo were 0.70 (95% CI, 0.60-0.80). Overall pooled estimate of efficacy of booster dose of acellular was 0.87(95% CI, 0.85-0.88) compared to placebo. In addition pooled estimate of acellular vaccine efficacy based on response to antigen was 0.78(95% CI, 0.64-0.93) in highrisk group. Conclusion: The results show higher performance and safety of the acellular vaccine in the prevention of pertussis in children versus the whole cell vaccine. Moreover, the efficacy of the acellular vaccine in high-risk adult groups is acceptable. This study provides evidence in favor of the introduction of an acellular vaccine to the national program of immunization. Studies on cost effectiveness and aspects of policy analysis are recommended.

Background: Rotavirus diarrhea is one of the most important causes of death among under-five children. Anti-rotavirus vaccination of these children may have a reducing effect on the disease., Objectives: this study is intended to contribute to health policy-makers of the country about the optimal decision and policy development in this area, by performing cost-effectiveness and cost-utility analysis on anti-rotavirus vaccination for under-5 children., Patients and Methods: A cost-effectiveness analysis was performed using a decision tree model to analyze rotavirus vaccination, which was compared with no vaccination with Iran's ministry of health perspective in a 5-year time horizon. Epidemiological data were collected from published and unpublished sources. Four different assumptions were considered to the extent of the disease episode. To analyze costs, the costs of implementing the vaccination program were calculated with 98% coverage and the cost of USD 7 per dose. Medical and social costs of the disease were evaluated by sampling patients with rotavirus diarrhea, and sensitivity analysis was also performed for different episode rates and vaccine price per dose., Results: For the most optimistic assumption for the episode of illness (10.2 per year), the cost per DALY averted is 12,760 and 7,404 for RotaTeq and Rotarix vaccines, respectively, while assuming the episode of illness is 300%, they will be equal to 2,395 and 354, respectively, which will be highly cost-effective. Number of life-years gained is equal to 3,533 years., Conclusions: Assuming that the illness episodes are 100% and 300% for Rotarix and 300% for Rota Teq, the ratio of cost per DALY averted is highly cost-effective, based on the threshold of the world health organization (< 1 GDP per capita = 4526 USD). The implementation of a national rotavirus vaccination program is suggested.

Background: The recent studies show that Rotavirus is important cause of the acute gastroenteritis. The aim of this review is to estimate the number of Rotavirus infection among Iranian children by performing a systematic review and estimating a pooled data., Methods: We performed a systematic literature review in relevant databases including PUBMED, MEDLINE, OVID, SID, MAGIRAN, and IRANMEDEX. Search in databases was done in October 10, 2013. Meta-analysis was performed using the STATA statistical package version 11. We assessed heterogeneity by Q-test and used random model for pooling measures of proportion of Rotavirus infection among Iranian children with diarrhea (and 95% confidence intervals [CI]). Sub group analysis between in-patient and outpatient group were done and publication bias was assessed by Egger and Begg tests., Results: A total of 154 records were identified in our searching. There were 36 studies including a total of 15,368 children with diarrhea. Out of 15,368 children, 6,338 were positive for Rotavirus gastroenteritis. Overall pooled estimate of infection with Rotavirus among cases of gastroenteritis was 0.35 (95% CI, 0.28-0.41). Pooled estimates for hospitalized children and outpatient subgroups were 0.39 (95% CI, 0.30-0.48), and 0.31 (95% CI, 0.23-0.38), respectively., Conclusions: This study supports the importance of Rotavirus in the Iranian population such as common cause of diarrhea among children. Therefore, decision to adopt immunization programs to prevent Rotavirus infection might be helpful in Iran.

Background: Haemophilus Influenzae type b (Hib) is an important cause of morbidity and mortality in children. Although its burden is considerably preventable by vaccine, routine vaccination against Hib has not been defined in the National Immunization Program of Iran. This study was performed to assess the cost-benefit and cost-utility of running an Hib vaccination program in Iran., Methods: Based on a previous systematic review and meta-analysis for vaccine efficacy, we estimated the averted DALYs (Disability adjusted life years) and cost-benefit of vaccination. Different acute invasive forms of Hib infection and the permanent sequels were considered for estimating the attributed DALYs. We used a societal perspective for economic evaluation and included both direct and indirect costs of alternative options about vaccination. An annual discount rate of 3% and standard age-weighting were used for estimation. To assess the robustness of the results, a sensitivity analysis was performed., Results: The incidence of Hib infection was estimated 43.0 per 100000, which can be reduced to 6.7 by vaccination. Total costs of vaccination were estimated at US$ 15,538,129. Routine vaccination of the 2008 birth cohort would prevent 4079 DALYs at a cost per averted-DALY of US$ 4535. If we consider parents' loss of income and future productivity loss of children, it would save US$ 8,991,141, with a benefit-cost ratio of 2.14 in the base-case analysis. Sensitivity analysis showed a range of 0.78 to 3.14 for benefit-to-cost ratios., Conclusion: Considering costs per averted DALY, vaccination against Hib is a cost-effective health intervention in Iran, and allocating resources for routine vaccination against Hib seems logical.