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Statistics show that in academic, as well as the conservative part of philosophical society of contemporary Iran, the considerable part of papers, theses and research projects are devoted to comparative philosophy. In the first part of this essay we will struggle to show this domination relying on some official statistics. But this event is associated with numerous side effects and shortcomings which will be discussed in the second part of the paper. In the third part, the causes and roots of this event will be assayed. But among various mentioned causes one cause seems to be more prominent. Serious engagement with comparative studies is a stage of fundamental approach of conservative institutes, and to some extent, of experts of humanities in Iran, to western humanities in order to indigenize those sciences and this in turn has its origin in certain ideological and political motives persuaded by the quarrel with the west. [ABSTRACT FROM AUTHOR]

Background & Aims: Nowadays Most hospitals replace their paper-based medical records with Electronic Health Records or update their old Hospital Information systems (HISs). A descriptive study of nurses as end users of these systems can be helpful to design better systems and therefore achieve more advantages like more patients' safety. Materials & Methods: To assay the attitudes' of nurses toward Hospital Information systems, 400 nurses were asked to estimate whether they agree or disagree with a set of statements for each of the three diffusion of innovation theory attributes (relative advantages, complexity, and compatibility). 303 questionnaires were completed and analyzed by SPSS (Statistical Product and Services Solution, version 18). Result: A large share of the nurses agreed that the HIS system is faster (92. 7%) and easier than paper records (90. 1%), saves time (81. 1%), and increases the legibility of the data (90. 8%). 55% agreed that the system leads to computer-related problems (software and hardware), and 51. 5% agreed that HIS leads to inhumane errors. A low percentage of the nurses (13. 9%) agreed that the system leads to more adverse drug events. Conclusion: According to our results nurses' attitudes were found to be positive about using HIS system to improve clinical documentation. Moreover results can help managers understand key consideration affecting HIS development and use and may be applied as a reference for system development and improvement. [ABSTRACT FROM AUTHOR]

Background: In Iran, as in many other Asian and Middle Eastern countries, some believe that opium has beneficial effects on cardiovascular system. Dependent patients suppose that opium has positive effects on cardiovascular function and can prevent or improve cardiovascular diseases; however, only few comprehensive studies evaluating such effects have been performed.Objectives: In this study, we sought to clarify the effect of opium on cardiovascular problems by incorporating the previous findings and the current information on the issue and to explain the possible mechanisms of this effect.Methods: The available human studies published up to October 30, 2019, were searched in different databases. Case-control, cohort, and cross-sectional studies were retrieved. Papers published in English or those with an English abstract were included. The risk of bias for each included study was assessed based on the Newcastle-Ottawa Scale (NOS). We then categorized the effects of opium on cardiovascular problems along with its probable underlying mechanisms of action.Results: In this study, most of the published articles suggested the adverse effects of opium on the cardiovascular system, including atherosclerosis, myocardial infarction, arrhythmia, low ejection fraction, and cardiovascular mortality; however, some articles reported the beneficial or impartial effects of opium on the cardiovascular system. In this article, we have categorized all the effects of opium on cardiovascular system; also, the proposed mechanisms of action of opium in each of the above-mentioned disorders are summarized.Conclusion: Although the available evidences were incoherent, it was mostly suggested that opium use does not protect against or improve cardiovascular problems. [ABSTRACT FROM AUTHOR]

A national study of the Iran family planning programme is yet to be undertaken. This paper reports clinic continuation rates and causes of drop-out among Iranian pill acceptors based on patient records at three selected clinics in Shiraz and Marvdasht. All three clinics were shown to have a cumulative continuation rate of over 50% up to 1 year. Causes of clinic drop-out varied between rural and urban pill users by time of acceptance and by the acceptors’ background characteristics. The probability of drop-out for unreported reasons was related to level of motivation. The effect of follow-up by clinic motivators was clearly demonstrated in the temporal pattern of drop-out among rural acceptors. The probability of drop-out for medical side effects was related to knowledge about them and users’ own experience. Risk of accidental pregnancy was seen to reduce as pill users gained experience. [ABSTRACT FROM PUBLISHER]

Background Candida vaginitis is the second most common cause of vaginitis in women after bacterial vaginitis. Among the approved treatments, boric acid has been proposed as an effective treatment for drug resistance and disease recurrence. Objective This study compares the effectiveness and side effects of boric acid and fluconazole in the treatment of candida vaginitis. Methods In this non-random study, 50 women with candida vaginitis, based on clinical and laboratory examinations from Iranian university hospitals were selected based on the convenience sampling method. The patients were randomly divided into two groups as follows: One group received oral fluconazole 150 mg for 3 days and the other group received boric acid suppository 600 mg for 14 days. Improvement was identified by laboratory tests. Analysis and statistical analysis were done with the help of descriptive tests of frequency, frequency percentage, Mean±SD, dispersion index, and chi-square. Results Seven people from the fluconazole group and five people from the boric acid group still had a positive culture after the end of the treatment period, and the response to the treatment was 78% with boric acid and 69.5% with fluconazole (P=0.023). Two people from the boric acid group and three people from the fluconazole group had complications during the treatment, and this difference was not significant (P>0.05). Conclusion Fluconazole and boric acid both improve bacterial vaginitis. However, the success rate of boric acid treatment is higher. Also, the frequency of complications in the group receiving boric acid was less, which can result in the success of treatment with boric acid. [ABSTRACT FROM AUTHOR]

Aim: Our objective was to assess the efficacy and safety of adding alpha-pinene (a herbal terpenoid) to quadruple therapy compared to a placebo in improving symptoms and Helicobacter pylori (H. pylori) eradication rates in Functional dyspepsia (FD) patients. Background: FD is a prevalent upper gastrointestinal condition, and no definitive pharmacological treatment is available for its management. Methods: We conducted a randomized, double-blinded, placebo-controlled trial on FD patients diagnosed with H. pylori infection. We collected baseline demographic data and assessed FD symptoms in the participants. Patients were randomly allocated to receive either standard quadruple therapy with α-pinene capsules (0.25 mg/day) or quadruple therapy with a placebo for two weeks. We employed a validated questionnaire, the Short Form Leeds Dyspepsia Questionnaire (SF-LDQ), to evaluate FD symptoms. The eradication rate of H. pylori was compared between the two groups one month after completing the treatment regimens. Any reported adverse drug reactions (ADRs) were documented throughout the trial. Results: Over four months, a total of 66 patients completed the trial. Notably, there were no significant differences in baseline SFLDQ scores between the two groups (p=0.83); however, a significant divergence emerged at the trial's conclusion (p=0.03). The H. pylori eradication rates did not show notable differences between the two treatment arms (p=0.43). Importantly, there were no dropouts from the trial due to ADRs. Among reported ADRs, participants experienced abdominal pain, headache, diarrhea, and a metallic taste, with no significant variance in incidence rates observed between the two groups (p=0.62). Conclusion: These findings suggest that α-pinene could be an effective and safe agent for reducing FD symptoms. [ABSTRACT FROM AUTHOR]

Inappropriate use of drugs is a widespread problem with serious consequences such as increased adverse drug reaction and antimicrobial resistance. Proper interventions would have important financial and public health benefits. Several studies have been performed about Rational Drug Use (RUD) in Iran. To provide a picture of researches were done about RUD and highlight the existing gaps in practice in Iran, a systematic search was conducted by reviewing all papers (English and Persian) found by searching keywords in Pubmed, Web of Science, Google Scholar, CINAHL, Proquest, International Pharmaceutical Abstract (IPA), SID, Iran Medex and MagIran. Retrieved articles were extracted in Access form and exported to Excel for further analysis. After excluding duplicate and irrelevant articles, 466 related articles were remained. Number of publications increased dramatically after 2001. About 73% of studies were cross-sectional. Evaluation of prescribing pattern (15%), self-medication (11.3%) and adverse drug reaction (9.1%) were among the top topics which were studied. Despite an increasing trend in RUD publications in Iran, still large gaps remain to be investigated. Knowing the existing gaps is crucial for policy makers to make investments to solve the problems. [ABSTRACT FROM AUTHOR]

Background and Objective: The majority of medicines are associated with some form of side effects due to high prevalence of self- medication in Iran .There is not any drug without side effects; the prevalence of self- medication in Iran's provinces is increasing. This study was done to determine the knowledge and practice among woman about self -medication based on health belief model. Materials and Methods: This cross- sectional study carried out on 385 women whom referred to health centers in Isfahan, Iran during 2008. Data were collected by a questionnaire including knowledge, practice and health belief model structures. Results: The mean score of knowledge was 82.97±13.80 and means score of perceived susceptibility 72.48±17.11, severity 71.60±14.73, benefits 68.29±17.13 and barriers 61.64±19.67. 86% of women have done self-medication at least in one disease in 6 months earlier Including: cold 225 (57.6%), headache 28 (53.7%) and anemia 51 (13.2%). The main reasons for self -medication were previous experience and medicine accessibility .The main reasons to avoid self -medication was the side effects of medicine. Conclusion: Self-medication can be prevented thought increasing knowledge and education about severity of drug side effects. [ABSTRACT FROM AUTHOR]

Background: Palbociclib and Ribociclib are cyclin-dependent kinase 4/6 oral molecular inhibitors that have the potential to improve overall survival (OS), progression-free survival (PFS), and quality of life in patients with metastatic breast cancer (MBC). The objective of this study was to analyze the cost-utility of Palbociclib and Ribociclib in comparison with Letrozole monotherapy as the first-line treatment for hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2–) MBC patients in Iran. Methods: A Cost-Utility Analysis (CUA) was conducted using a partitioned survival model (PSM) from the perspective of the Iranian healthcare system. The comparative strategies considered were Palbociclib + Letrozole, Ribociclib + Letrozole, and Letrozole monotherapy. The model was structured with a 1-month cycle length and a 15-year time horizon. Clinical safety, efficacy, and survival data in terms of PFS and OS for Palbociclib + Letrozole and Ribociclib + Letrozole were obtained from the latest updates of the PALOMA-1, 2, and MONALEESA-2 studies, respectively. Direct medical costs, including drug costs, visits, hospitalization, CT scans, bone x-rays, monitoring and laboratory testing, as well as medication side effects, were considered. Uncertainty evaluations were performed through deterministic sensitivity analysis and probabilistic sensitivity analysis. Excel 2016 and TreeAge 2020 were used for all stages of the evaluation. Results: The base case results indicated that, despite its lower effectiveness, Letrozole monotherapy was the most cost-effective strategy, while Palbociclib + Letrozole and Ribociclib + Letrozole were not cost-effective. The incremental cost-effectiveness ratios (ICERs) for Palbociclib + Letrozole and Ribociclib + Letrozole compared to Letrozole monotherapy were estimated at $137,302 and $120,478 per quality-adjusted life-year (QALY), respectively, which exceeded the target threshold of $4565. Deterministic sensitivity analysis demonstrated that the CUA results were not sensitive to changes in the values of uncertain variables. Probabilistic sensitivity analysis also indicated that Palbociclib + Letrozole and Ribociclib + Letrozole had no chance of being cost-effective based on changes in various parameters and simulations. Conclusions: Palbociclib and Ribociclib showed significant efficacy in combination with Letrozole, as evidenced by improvements in PFS. However, in the first-line treatment of MBC in Iran, these strategies were not cost-effective compared to Letrozole monotherapy. [ABSTRACT FROM AUTHOR]

Background: A error in intravenous injection in pediatric wards can cause irreparable injuries. This study aimed to determine the level of knowledge and performance of nurses in terms of preparation and injection of intravenous drugs in pediatric wards of hospitals affiliated to Isfahan University of Medical Sciences. Methods: This cross-sectional study was conducted in 2022 on 156 nurses working in pediatric wards. The data was collected with demographic information questionnaire and the knowledge and performance of the participants were determined using a researcher-made questionnaire, including the five rights of medication administration (preparation and injection, medication error, drug side effects, family empowerment, and documentation) using self-reporting and observation methods. Formal and content validity was calculated using the opinions of 10 experts and Cronbach's alpha with 40 samples. Results: The mean and standard deviation of total nurses' knowledge and performance scores were 58.31 + 10.1 and 66.1 + 14.4, respectively. Moreover, the mean and standard deviation of nurses' knowledge scores were 63.55 + 14.3 for documentation, 46.1 + 7.9 for preparation and injection, 73.9 + 12.3 for drug side effects, 58.4 + 10.2 for medication error, and 69.4 + 9.4 for family empowerment. Besides, the mean performance was 69.1 + 17.6 for documentation, 61.3 ± 9.9 for preparation and injection, 78.21 + 12 for drug side effects, 58.6 + 15 for medication error, and 65.4 + 17.7 for family empowerment. Conclusion: The results showed that the mean knowledge and pharmacological performance of nurses working in pediatric wards in different areas of the principles of medicine were not at the desired level, and this can affect children adversely. [ABSTRACT FROM AUTHOR]

Background. Different epidemiologic aspects of drug-induced Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in children are scarce. Aim. To compare the clinical and epidemiological features of patients with drug-induced SJS and TEN in children and adults. Method. This retrospective study was conducted at two academic referral centers (Isfahan, Iran) over 5 years. SJS and TEN were clinically diagnosed and confirmed by skin biopsy as needed. Results. One hundred one patients (31 children and 70 adults) with a female to male ratio of 1.1 : 1 was identified in the present study. SJS was more commonly diagnosed in both pediatric and adult patients. The most frequent reason for drug administration identified was the infection (45.2%) and seizure (45.2%) in children and infection (34.3%) and psychiatry disorder (27.1%) in adults (P = 0.001). The most common culprit drugs in the pediatric were phenobarbital (9/31), cotrimoxazole (4/31), and amoxicillin (4/31); however, in the adult group, the most common drugs were carbamazepine (11/70) and lamotrigine (9/70). Fever was significantly more common in adults (44.3%) compared to pediatric patients (22.6%) (P = 0.03). Multiple logistic regression models showed that pediatric patients had significantly lower odds of hospitalization (OR [odds ratio]: 0.14; 95% CI 0.02, 0.67). In addition, patients with SCORTEN 1 had significantly higher odds of hospitalization (OR: 6.3; 95% CI: 1.68, 23.79) compared to patients with SCORTEN 0. Conclusions. The present study showed several differences between the pediatric and adult patients with SJS and TEN, including the reason for drug administration, culprit drugs, length of hospital stay, presence of fever, and final diagnosis of disease. [ABSTRACT FROM AUTHOR]

Background: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are common hypertension medications. We aimed to investigate the association between treatment with ACEIs/ARBs and disease severity and mortality in patients with hypertension hospitalized for coronavirus disease 2019 (COVID-19). Methods: Information from the medical records of 180 hospitalized patients diagnosed with COVID-19 infection admitted in 2020 to Loghman Hakim Hospital, Tehran, Iran, was collected. Clinical histories, drug therapies, radiological findings, hospital courses, and outcomes were analyzed in all the patients. The demographic and clinical characteristics of the patients were also analyzed, and the percentage of patients with hypertension taking ACEIs/ARBs was compared between survivors and nonsurvivors. Results: The study population consisted of 180 patients at mean±SD age of 67.76±18.72 years. Hypertension was reported in 72 patients (40.0%). Patients with hypertension were older than those without it (mean±SD age =72.35±12.09 y). Among those with hypertension, death occurred in 33 patients (45.8%), of whom 60.6% were men. Fifty-three patients (73.6%) with hypertension were on ACEIs/ARBs. The ACEIs/ARBs group had a significantly lower mortality rate than the non-ACEIs/ARBs group (37.7% vs 68.4%; OR: 0.192; 95% CI: 0.05--0.68; P=0.011). Conclusion: This single-center study found no harmful effects associated with ACEIs/ARBs treatment. Patients on ACEIs/ARBs had a lower rate of mortality and disease severity than the non-ACEIs/ARBs group. Our study supports the current guideline to continue ACEIs/ARBs in patients with hypertension. [ABSTRACT FROM AUTHOR]

Background: The duration of surgery in orthopedic surgeries is often longer than one hour. Therefore, these patients are at further risk of complications induced by general anesthesia. The present study aimed to determine the prevalence of anesthesia complications in orthopedic surgeries and its related factors. Methods: This cross-sectional study was performed on 400 patients undergoing orthopedic surgery in Shahid Beheshti Hospital of Kashan Province, Iran, in 2020. The study subjects were recruited by convenience sampling and included those who underwent general anesthesia for elective surgery and were transferred to Post-Anesthesia Care Unit (PACU). The research instruments included a demographic questionnaire and a checklist for recording complications (shivering, pain, nausea, vomiting, & vital signs). The necessary data were recorded after the patient was admitted to the PACU, as well as half an hour and one hour later. The obtained data were analyzed using the Chi-squared test, Independent Samples t-test, one-way Analysis of Variance (ANOVA), Pearson correlation coefficient, and logistic regression analysis in SPSS v. 16. Results: The present research results suggested that the most and least frequent complications were vomiting (91.8%) and changes in blood pressure (5%), respectively. Gender was significantly associated with pain, nausea, and hypertension (P<0.05). The Pearson correlation coefficient data indicated a significant relationship between the duration of anesthesia and the mean scores of shivering, pain, nausea, tachycardia, and tachypnea (P<0.05). There was also a significant relationship between the types of surgery and shivering, pain, blood pressure, and nausea (P<0.05). Pulse rate was significantly associated with complete intravenous anesthesia and the duration of anesthesia (P<0.05). Conclusion: The relatively high incidence of post-anesthesia complications in orthopedic surgeries indicates the significance of employing skilled personnel as well as using adequate monitoring equipment at the PACU. Such measures help to decrease mortality and morbidity among patients, also save on hospital costs. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus disease 2019 (COVID-19) has become a pandemic with 1771514 cases identified in the world and 70029 cases in Iran until April 12, 2020. The co-prescription of psychotropics with COVID-19 medication is not uncommon. Healthcare providers should be familiar with many Potential Drug-Drug Interactions (DDIs) between COVID-19 therapeutic agents and psychotropic drugs based on cytochrome P450 metabolism. This review comprehensively summarizes the current literature on DDIs between antiretroviral drugs and chloroquine/hydroxychloroquine, and psychotropics, including antidepressants, antipsychotics, mood stabilizers, and anxiolytics. Methods: Medical databases, including Google Scholar, PubMed, Web of Science, and Scopus were searched to identify studies in English with keywords related to psychiatric disorders, medications used in the treatment of psychiatric disorders and COVID-19 medications. Results: There is a great potential for DDIs between psychiatric and COVID-19 medications ranging from interactions that are not clinically apparent (minor) to those that produce lifethreatening adverse drug reactions, or loss of treatment efficacy. The majority of interactions are pharmacokinetic interactions via the cytochrome P450 enzyme system. Conclusion: DDIs are a major concern in the comorbidity of psychiatric disorders and COVID-19 infection resulting in the alteration of expected therapeutic outcomes. The risk of toxicity or lack of efficacy may occur due to a higher or lower plasma concentration of medications. However, psychiatric medication can be safely used in combination with COVID-19 pharmacotherapy with either a wise selection of medication with the least possibility of interaction or careful patient monitoring and management. [ABSTRACT FROM AUTHOR]

BACKGROUND The anti-TNF drugs are shown to be highly effective in treatment of patients with moderate-tosevere inflammatory bowel disease (IBD). Here, we aimed to assess the efficacy and safety of anti- TNF therapy at the national level. METHODS IBD patients aged 15 > years who received Infliximab and/or CinnoRA® between 2013 to July 2018 were identified. The data extracted from medical dossier and telephonic interview. The efficacy of therapy was defined as time to drug discontinuation or need for IBD-related surgery. The safety was assessed based on patient's reported adverse events. RESULTS We included 315 patients. The mean age of patients was 37.2 years and 62.2% of them developed the disease before age 30 years. Involvement of masculoskeletal system was reported in 7.3% of patients. Partial and complete response to Anti-TNF therapy was seen in 67% of patients. About 16% of patients did not respond to induction therapy and 16.9% of patients lost their response to Anti-TNF during one year. No serious adverse events, serious opportunistic infection, tuberculosis and malignancies reported by patients. Two patients reported pneumonia. CONCLUSION This study for the first time in our country, provides the evidences for efficacy of anti-TNF therapy in moderate to severe IBD patients. [ABSTRACT FROM AUTHOR]

Background: Drug-Drug Interaction (DDI) among the elderly is one of the major healthcare challenges worldwide. The present study assessed the rates of DDI and inappropriate drug prescription among the elderly in Kashan City, Iran. Methods: This descriptive-analytical study was designed, conducted, and reported according to the guideline of Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). A random sample of 368 elderly who lived in Kashan City, Iran, was selected through cluster sampling technique. Data collection tools were a demographic questionnaire and a drug checklist. The obtained data were analyzed by the Chi-squared test, logistic regression analysis, and Odds Ratio (OR) in SPSS. Results: In total, 308 (88%) participants used at least one drug. The Mean±SD scores of daily consumed drugs and the number of inappropriate drugs taken daily by the study participants were 6.21±3.52 and 0.28±0.62, respectively. Most of the study participants were taking more than two drugs (n=267, 86.68%) and more than four drugs (n=200, 64.9%) per day. The OR of DDI among the study participants who were taking =2 drugs per day was 2.49 times greater than those who were taking one or two drugs (OR=2.49, 95% confidence interval=1.20-5.18). The most frequent DDIs were between non-steroidal anti-inflammatory drugs and beta-blocker agents (n=84, 18.22%) and between non-steroidal anti-inflammatory drugs and nitrates (n=46, 9.9%). Conclusion: The rate of inappropriate drug use among the elderly living in Kashan, Iran, is low, however, polypharmacy and DDIs are highly prevalent among them. To reduce the rates of DDI and polypharmacy, educational programs for different healthcare providers are required to improve their knowledge. Moreover, further studies are needed to assess the effects of polypharmacy and DDI preventive measures, like drug history cards. [ABSTRACT FROM AUTHOR]

Background: Obesity and physical inactivity are currently on the rise due to industrialization of the communities, which has recently led to increased incidence of different diseases such as diabetes. Epidemiological studies and figures have demonstrated the growing incidence of diabetes. Relevantly, the side effects of chemical drugs have led patients to use medicinal plants and traditional approaches despite advances in development of chemical drugs. The aim of this review article is to report the medicinal plants and their traditional uses to prevent and treat diabetes according to the findings of ethnobotanical studies conducted in different regions of Iran. Evidence Acquisitions: The search terms including ethnobotany, ethnomedicine, ethnopharmacology, phytopharmacology, phytomedicine, Iran, and traditional medicine in combination with diabetes, blood sugar and hyperglycemic were searched from scientific databases. Results: The results of this article can be a comprehensive guideline, based on ethnobotany of different regions of Iran, to prevent and treat diabetes. According to this review article, certain plant species such as Urtica dioica L., popularly called nettle, in eight regions, Teucrium polium L., popularly called poleigamander, in five regions, and Trigonella foenumgraecum L., Citrullus colocynthis (L.), Schrad., and Juglans regia L. in four regions, were reported to be frequently used to prevent and treat diabetes Conclusions: The introduced medicinal plants in this review can be investigated in further research and produce new drugs with limited side effects. [ABSTRACT FROM AUTHOR]

Background: Drug package inserts (PIs) are the most accessible source of information for users and are designed to aid the safe use of medicines and avert adverse events. This study measured the conformity of PIs with the health communications standards of Iran's Food and drug Administration (FDA). Methods: This descriptive cross-sectional study evaluated 92 PIs related to 22 best-selling neurological and psychiatric drugs in Iran based on criteria approved by Iran's FDA. Six categories of criteria were considered in evaluating the extent of conformity: I) writing and formatting, II) references, III) drug description, IV) warnings and precautions, V) interactions, and VI) side effects. Each PI was scored based on observation of standards; data was analyzed using Microsoft Excel pivot tables. Results: In total, 2929 items from 92 PIs were evaluated, of which 37 (40.2%) were related to antidepressants, 31 (33.7%) to sedatives and hypnotics, and 24 (26%) to anticonvulsant drugs. The PI content was insufficient in various aspects of conformity with standards in each category. Among the six categories, the best match was found in warnings and precautions with 667items (72.5%), followed by writing and formatting with 663 (69.1%). The lowest conformity was found in the reference category with 194 (26.4%) items. Conclusion: The PIs of Iranian neurological drugs do not fully meet Iran's FDA standards. It is strongly recommended that smart PIs be developed using mobile apps to overcome this problem. [ABSTRACT FROM AUTHOR]

This research study explores the background, rationale and characteristics of recent urban interventions having the aim of regeneration in Rasht, Iran. An introduction to the context-specific factors that play a role in urban changes is followed by a critical focus on finding the possible side effects and consequences of the resultant changes on everyday life of long-time residents of Chellehkhaneh, an old neighbourhood located in Rasht inner city, by way of a qualitative analysis of several in-depth interviews. The narratives about the changing relationship between interviewees and their neighbourhood represent the conflation of person--place emotional tensions with socioeconomic pressures. By observing pressures caused by urban regeneration in the everyday life of long-term residents, sufficient evidence was gathered to prove the existence of an interrelationship between regeneration and the pressures associated with gentrification in the absence of real strategies that could be adopted to control changes and their effects. The chosen reduction of social relations and involvement in social affairs related to the neighbourhood by long-term established residents of Chellehkhaneh as a prevailing behavioural mechanism adopted to tolerate imposed pressures was thus one of the main consequences of changes caused by urban regeneration in Rasht inner city. [ABSTRACT FROM AUTHOR]

Introduction: Alcoholic liver disease is the most important side effect of alcohol consumption. Falcaria vulgaris (F. vulgaris) plant or long leaf contains antioxidant and antimicrobial ingredients. This plant is consumed in western Iran as a vegetable in the spring. Aim: To evaluate the effects of F. vulgaris against toxic effects of ethanol on the liver of rats. Materials and Methods: In this study, hydroalcoholic extract of F. vulgaris was prepared. Sixty four Wistar rats (male rats) were randomly assigned to eight groups: control normal and ethanol control groups; F. vulgaris groups (50, 100, 150 mg/kg) and ethanol + F. vulgaris treated groups (50, 100, 150 mg/kg). Treatments were administered by gavage daily for 28 days. Griess technique was assessed for determined Serum nitric oxide level. Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT) and Alkaline Phosphatase (ALP) concentrations were determined for liver functional disturbances. In addition, liver weight, total antioxidant capacity, the diameter of hepatocytes and the Central Hepatic Vein (CHV) were investigated. Results: Ethanol enhanced significantly total antioxidant capacity, nitric oxide level, the mean diameter of CHV, and hepatocyte and liver enzymes and significantly decreased liver weight compared to the normal control group (p<0.05). The F. vulgaris and F. vulgaris+ethanol at all doses reduced significantly the mean diameter of hepatocyte and CHV, liver enzymes and nitric oxide levels and increased liver weight compared to the ethanol control group (p<0.05). Conclusion: The present study concluded that F. vulgaris provides protection against oxidative stress resulting from ethanol in the liver and such an ability of the F. vulgaris might be due to its strong potential antioxidant attributes. F. vulgaris administration moderates the detoxification enzymes and the antioxidant agents in the extract bring about hepatic tissue recovery and prevention of ethanol adverse-effects on nitric oxide, ALT, AST and ALP as evidenced in the above mentioned examination of the male rats. [ABSTRACT FROM AUTHOR]

A conference paper on an open trial of cyproheptadine for Iran versus Iraq combat related post-traumatic stress disorder (PTSD) patients nightmares is presented. Five of the 25 patients were excluded from the study because of side effects, including dizziness and somnolence. Average nightmare severity dropped from 6.85 to 5.05, which was statistically significant. It is concluded that cyproheptadine may be effective in PTSD nightmare treatment.

Objectives: We will evaluate the efficacy and safety of favipiravir and interferon beta-1a compared to lopinavir/ritonavir and interferon beta-1a in patients with confirmed COVID-19, who are moderately ill.Trial Design: This is a phase 3, single-center, randomized, open-label, controlled trial with a parallel-group design carried out at Shahid Mohammadi Hospital, Bandar Abbas, Iran.Participants: All patients with age ≥ 20 years admitted at the Severe Acute Respiratory Syndrome Departments of the Shahid Mohammadi Hospital, Bandar Abbas, Iran, will be screened for the following criteria.Inclusion Criteria: 1. Confirmed diagnosis of infection with SARS-CoV-2 using polymerase chain reaction and/or antibody tests. 2. Moderate COVID-19 pneumonia (via computed tomography and/or X-ray imaging), requiring hospitalization. 3. Hospitalized ≤ 48 h. 4. Signing informed consent and willingness of the participant to accept randomization to any assigned treatment arm.Exclusion Criteria: 1. Underlying conditions, including chronic hepatitis, cirrhosis, cholestatic liver diseases, cholecystitis, peptic ulcers, acute and chronic renal failure, and peptic ulcers. 2. Severe and critical COVID-19 pneumonia. 3. History of allergy to favipiravir, lopinavir/ritonavir, and interferon beta-1a. 4. Pregnancy and breastfeeding.Intervention and Comparator: Intervention group: favipiravir (Zhejiang Hisun, China) with interferon beta-1a (CinnaGen, Iran). This group will receive 1600 mg favipiravir twice a day for the first day and 600 mg twice a day for the following 4 days with five doses of 44 mcg interferon beta-1a every other day.Control Group: lopinavir/ritonavir (Heterd Company, India) with interferon beta-1a (CinnaGen, Iran). This group will receive 200/50 mg lopinavir/ritonavir twice a day for 7 days with five doses of 44 mcg interferon beta-1a every other day. Other supportive and routine care will be the same in both groups.Main Outcomes: The primary outcome of the trial is the viral load of SARS-CoV-2 in the nasopharyngeal samples assessed by RT-PCR after 7 days of randomization as well as clinical improvement of fever and O2 saturation within 7 days of randomization. The secondary outcomes are the length of hospital stay and the incidence of serious adverse drug reactions within 7 days of randomization.Randomization: Eligible patients will be allocated to one of the study arms using block randomization in a 1:1 ratio (each block consists of 10 patients). A web-based system will be used to generate random numbers for the allocation sequence. Each number relates to one of the study arms.Blinding (masking): This is an open-label trial without blinding and placebo control.Numbers To Be Randomized (sample Size): A total of 60 patients will be randomized into two groups (30 patients in the intervention group and 30 patients in the control group).Trial Status: The trial protocol is version 1.0, 22 July 2020. Recruitment began on 25 July 2020 and is anticipated to be completed by 25 September 2020.Trial Registration: Iranian Registry of Clinical Trials (IRCT) IRCT20200506047323N3 . Registered on 22 July 2020.Full Protocol: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting the dissemination of this material, the familiar formatting has been eliminated; this letter serves as a summary of the key elements of the full protocol. [ABSTRACT FROM AUTHOR]

Background: Obesity seems to be a critical issue nowadays because of its high prevalence and its adverse effects on health. There is some evidence indicating the relationship between obesity and lower serum 25-hydroxyvitamin D [25(OH)D] concentration. The aim of the present study was to examine serum 25(OH)D status of obese and non-obese Iranian children and compare their therapeutic response with identical oral vitamin D3 treatment.Methods: In a non-randomized clinical trial, serum 25(OH)D level of 45 obese and 45 non-obese Iranian children aged 2-14 years was measured. Those with serum 25(OH)D status <30 ng/ml (73 cases) were treated with one pearl of vitamin D3 (50 000 International Units) once a week for 6 weeks. Serum vitamin D was measured once more 2 weeks after treatment.Results: The frequency of hypovitaminosis D was 43/45 (95.6%) in obese and 30/45 (66.7%) in non-obese children at baseline (p < 0.001). After treatment of 73 cases (43 obese, 30 non-obese), the above percentages were decreased to 24/43 (55.8%) and 1/30 (3.3%), respectively (p < 0.001).Conclusion: Our study demonstrated a high frequency of vitamin D deficiency among Iranian children, particularly the obese ones. Moreover, low therapeutic response in the obese group is witnessed. [ABSTRACT FROM AUTHOR]

ObjectivesThis study aimed to assess the effect of multivitamin use during the pill-free interval on the continuation rate and side effects of combined oral contraceptives (COCs) within the first few cycles of use. MethodsIn this trial, 332 women presenting to public health centres in an Iranian city each received a COC pack containing 21 pills and were randomised to one of three groups: two of the groups also received 42 multivitamin pills or 42 placebo pills to be taken once a day for 7 days before starting COCs and again during the 7-day pill-free interval for five cycles, while the third group received no multivitamin or placebo pills with their COCs. The groups were compared using Cox regression and χ2tests. ResultsThere were no losses to follow-up. Continuation rates at the sixth cycle were 88% for the multivitamin group, 75% for the placebo group and 67% for the no intervention group. Compared with the multivitamin group, the six-cycle discontinuation rate was significantly higher in the placebo group (hazard ratio [HR] 2.26, 95% confidence interval [CI] 1.15–4.45;p= 0.019) and no intervention group (HR 3.15, 95% CI 1.66–5.99;p< 0.001). Nausea, mood changes, weight gain and breast tenderness were significantly less common in the multivitamin group than in the other groups in all cycles, and spotting/irregular bleeding and dizziness were significantly less common in most of the second, third and sixth cycle follow-up. ConclusionsMultivitamin supplements could significantly reduce the side effects of COCs in the initial cycles and improve continuation rates. However, the study limitations do not allow for any definite conclusion for their use in clinical practice, especially in communities rich in nutrients. Chinese Abstract 摘要 目的：本研究旨在评估在不服避孕药的间歇期口服多种维生素对续用率的影响，及服用复方避孕药（COCS）最初几个周期的副作用。 方法：在这项试验中，在伊朗城市代表公众健康中心的332名女性均收到含有21粒药物的复方口服避孕药包，并被随机分到3组。其中2组的妇女还分别收到了42粒维生素或42粒安慰剂，这些药物需要在服用口服避孕药之前及不同周期的间歇期内每天服用1次，连续服用7天；第三组只有复方口服避孕药。不同组之间用COX回归及卡方检验进行比较。 结果：目前还没有丢失的随访。三个组在第六个周期的续用率分别为：口服维生素组88%，口服安慰剂组75%，无干预组67%。与口服多种维生素组比较，口服安慰剂组在第六周期的停药率明显高（HR2.26，95%CI1.15-4.45;p=0.019），无干预组的停药率也明显高于口服维生素组（HR 3.15, 95% CI 1.66 − 5.99; p = 0.001）。在所有周期中，恶心、情绪变化、体重增加及乳房触痛在维生素组明显少于其他2组，瘀点、不规则出血、眩晕在第二、三、六周期很少见。 结论：多种维生素的应用可以显著降低开始口服复方避孕药的最初几个周期内的副作用，同时可以提高续用率。然而，由于这篇文章的限制，并无明确结论支持他们广泛应用于临床，尤其是在有丰富营养物质的社区。 关键词：副作用，复方口服避孕药，续用率，维生素 [ABSTRACT FROM PUBLISHER]

BACKGROUND: While yellow card reporting system has started in 1998 in Iran, the ADR reporting rate is very low. OBJECTIVE: In order to explore whether the Iranian Pharmacovigilance system could be modified, and to determine reasons for under-reporting, a study to investigate the role of pharmacists in ADR reporting was done in Shiraz. METHODS: A cross-sectional study was conducted between January and June 2013 in Shiraz, Iran. After describing the study and its goal for each participant, oral consent was taken. RESULTS: 100 out of 120 pharmacists (83.3%) agreed to participate in the interview. 79 out of 100 respondents were working in private pharmacies, 7% in governmental pharmacies, and 3% in pharmacies located in hospitals. Although level of knowledge regarding ADR was low among pharmacists, all of them admitted that paying attention to ADRs and timely reporting is very important. While 6 (6%) pharmacists thought that they had been taught too much about ADR in the university, 30% believed that it was enough, 41% claimed that it was not satisfactory and 23% admitted that it was little. CONCLUSIONS: Our pharmacists have little knowledge about the process, goal, and importance of ADR spontaneous reporting system. Otherwise, education and training courses will be important in maintaining, improving and enhancing ADR reports by pharmacists. [ABSTRACT FROM AUTHOR]

Drug-drug interactions (DDIs) are an important type of adverse drug events. Yet overall incidence and pattern of DDIs in Iran has not been well documented and little information is available about the strategies that have been used for their prevention. The purpose of this study was to systematically review the literature on the incidence and pattern of DDIs in Iran as well as the used strategies for their prevention. PubMed, Scopus, electronic Persian databases, and Google Scholar were searched to identify published studies on DDIs in Iran. Additionally, the reference lists of all retrieved articles were reviewed to identify additional relevant articles. Eligible studies were those that analyzed original data on the incidence of DDIs in inpatient or outpatient settings in Iran. Articles about one specific DDI and drug interactions with herbs, diseases, and nutrients were excluded. The quality of included studies was assessed using quality assessment criteria. Database searches yielded 1053 potentially eligible citations. After removing duplicates, screening titles and abstracts, and reading full texts, 34 articles were found to be relevant. The quality assessment of the included studies showed a relatively poor quality. In terms of study setting, 18 and 16 studies have been conducted in inpatient and outpatient settings, respectively. All studies focused on potential DDIs while no study assessed actual DDIs. The median incidence of potential DDIs in outpatient settings was 8.5% per prescription while it was 19.2% in inpatient settings. The most indicated factor influencing DDIs incidence was patient age. The most involved drug classes in DDIs were beta blockers, angiotensin-converting-enzyme inhibitors (ACEIs), diuretic agents, and non-steroidal anti-inflammatory drugs (NSAIDs). Thirty-one studies were observational and three were experimental in which the strategies to reduce DDIs were applied. Although almost all studies concluded that the incidence of potential DDIs in Iran in both inpatient and outpatient settings was relatively high, there is still no evidence of the incidence of actual DDIs. More extensive research is needed to identify and minimize factors associated with incidence of DDIs, and to evaluate the effects of preventive interventions especially those that utilize information technology. [ABSTRACT FROM AUTHOR]

Drug-resistance and adverse effects of current drugs are the most obstacles in the treatment of epilepsy. In a plan for finding new natural anticonvulsant agents, we studied the anticonvulsant effects of essential oil (ZMEO) and methanolic extract (ZMME) of Zhumeria majdae in pentylene tetrazol (PTZ) and maximal electro-shock (MES) models in mice. Mice received different doses of ZMEO and ZMME, 30 min before induction of chemical and electrical convulsions. Neurotoxicity (movement toxicity and sedation) was evaluated using rota-rod test. The mortality was determined after 24 h following injection of different doses of the ZMEO and ZMME. The obtained results show that ZMEO dose-dependently protected mice from tonic convulsions induced by PTZ and MES with effective doses (ED) of 0.26 (0.13-0.39) and 0.27 (0.17-0.37) ml/kg respectively. Toxic doses (TD) in rota-rod test for ZMEO was 0.55 (0.42-0.70) ml/kg. ZMME at dose of 2 g/kg decreased tonic convulsions as much as 40 %. For ZMEO, TD of 0.55 (0.45-0.69) ml/kg was obtained. ZMME significantly decreased the walking time in rota-rod test at dose of 2 g/kg. Lethal dose (LD) of ZMEO was determined as 2.35 (1.98-2.65) ml/kg. ZMME showed about 34 % death of the animals at dose 5 g/kg. The essential oil of Z. majdae could be a good candidate for further anticonvulsive studies. [ABSTRACT FROM AUTHOR]

Background: Adverse drug reactions (ADR) are ranked as some of the major causes of patient morbidity and mortality. Spontaneous reporting of ADRs has remained the cornerstone of pharmacovigilance and is important in maintaining patient safety. This study was conducted to assess the nurses' knowledge and attitude towards pharmacovigilance, reasons for not reporting ADRs, and their pharmacovigilance practice. Materials and Methods: A questionnaire was prepared to investigate knowledge, attitude and practice (KAP) of nurses regarding ADR reporting. In November 2009, the questionnaires were given to 500 nurses of a teaching hospital in Tehran. Findings: Knowledge and practice of participants were not satisfying; however, their attitude towards pharmacovigilance was at a high level. About 91% of the nurses had never reported an ADR. Most nurses liked to report the ADRs to the physicians (87.1%) and pharmacists in hospital's ADR center (1.8%) rather than the ADR National Center. The main cause of under-reporting of the suspected ADRs was unawareness about the existence of such a national center. Among nurses who had reported ADR for at least once, the majority preferred using phone (10 out of 50) or Yellow Cards (7 out of 50). Only 1 person out of 50 preferred using internet for submitting the reports Conclusions: Since the nurses in this study had little knowledge and poor practice regarding the pharmacovigilance and spontaneous reporting system, interventions such as holding pharmacovigilance workshops in the hospitals focusing on the aims of pharmacovigilance, completing the Yellow Card and clarifying the reporting criteria are strongly recommended. [ABSTRACT FROM AUTHOR]

Drug Utilization Evaluation (DUE) studies facilitate assessing the appropriateness and rational use of medications. The goal of the present study was to evaluate Amphotericin B usage in neutropenic patients. A prospective DUE study was performed in Hematology-Oncology and Stem Cell Transplantation wards at Taleghani hospital for one-year. National comprehensive cancer network, clinical practice guidelines in oncology, American Hospital Formulary Service and other relevant medical practice and up-to dated articles were used to evaluate whether Amphotericin B is properly used according to the guidelines. All data collected by a pharmacist in daily review using information of physician and nursing records as well as laboratory findings. During the one-year study, 35 patients receiving amphotericin B were evaluated. 29 patients (82.9%) received amphotericin B due to neutropenia and fever and 6 patients had confirmed fungal infections. All of the injectable solutions of amphotericin B were appropriately prepared for intravenous infusion. In addition, for all patients, ordering (indication) of the study drug was in accordance with the guidelines. Twenty-five (71.4%) patients received an appropriate dose according to the guidelines. Duration of treatment was properly selected in 21 (60%) patients. Twenty-two (62.8%) patients developed hypokalemia as the most frequent adverse drug event. Although, preparation and indication of amphotericin B was in compliance with the current guidelines, dosage and duration of treatment were considered to be incoherent with the designed protocol used in this study. We conclude more attention should be paid to dosage and duration of treatment with amphotericin B in order to optimize its administration. [ABSTRACT FROM AUTHOR]

Background: Patients' beliefs about the necessity of medicines and their concerns about adverse effects might influence the adherence and treatment outcomes. This study was carried out to investigate the impact of patient's beliefs on their adherence to prescribed medicines in three different chronic diseases and the role of demographic factors in this relationship. Methods: This cross-sectional descriptive study was done during 2008-2009. Data was gathered through interview with 213 patients referring to educational pharmacies of Isfahan University of Medical Sciences, Iran, and suffering from one of the chronic diseases including asthma, cancer and kidney transplantation. Three questionnaires, including demographic factors, beliefs about medicines (BMQ) and Morisky's medication adherence assessment, were used. Descriptive data and correlation analysis tests were made by using SPSS17. Findings: Age, but not gender, had a significant role in patients' adherence to medication. Education level was positively correlated with adherence to medicines in patients with asthma and whom with kidney transplantation but not in patients with cancer. The patients' belief about their medicines had a significant impact on their adherence to their prescription in all three subgroups of patients; however this relationship was stronger for patients with cancer and kidney transplantation than asthmatic patients. Conclusion: Patients' beliefs about their medicines could influence their adherence with medication, especially for more serious diseases. It is also concluded that younger and higher educated patients are more adherent. It seems that educational interventions, especially for older patients and in chronic disease states, are beneficial to improve their adherence with medication. [ABSTRACT FROM AUTHOR]

Background: Continuing medical education (CME) is compulsory for physicians in Iran. Recent studies in Iran show that modifications of CME elements are necessary to improve the effectiveness of the educational programmes. Other studies point to an inappropriate, even irrational drug prescribing. Based on a needs assessment study regarding CME for general physicians in the East Azerbaijan province in Iran, rational prescribing practice was recognized as a high priority issue. Considering different educational methods, outcome-based education has been proposed as a suitable approach for CME. The purpose of the study was to obtain experts' consensus about appropriate educational outcomes of rational prescribing for general physicians in CME and developing curricular contents for this education. Methods: The study consisted of two phases: The first phase was conducted using a two-round Delphi consensus process to identify the outcome-based educational indicators regarding rational prescribing for general physicians in primary care (GPs). In the second phase the agreed indicators were submitted to panels of experts for assessment and determination of content for a CME program in the field. Results: Twenty one learning outcomes were identified through a modified Delphi process. The indicators were used by the panels of experts and six educational topics were determined for the CME programme and the curricular content of each was defined. The topics were 1) Principles of prescription writing, 2) Adverse drug reactions, 3) Drug interactions, 4) Injections, 5) Antibiotic therapy, and 6) Anti-inflammatory agents therapy. One of the topics was not directly related to any outcome, raising a question about the need for a discussion on constructive alignment. Conclusions: Consensus on learning outcomes was achieved and an educational guideline was designed. Before suggesting widespread use in the country the educational package should be tested in the CME context. [ABSTRACT FROM AUTHOR]

1. Generically based pharmaceutical systems exist in a few countries of the world, such as Iran. Most developed countries have free market pharmaceutical systems. Drug-related problems (DRP) have been reported mostly in the Western world but few data are available for generic systems. In this study, we tried to measure the prevalence of drug-related problems leading to hospital admissions in Isfahan, Iran. 2. One thousand consecutive hospital admissions in three major teaching hospitals were studied for a period of 6 months for the presence of DRP as a cause of hospital admissions. Two subcategories of DRP were considered: (i) drug therapy failure; and (ii) adverse drug reactions. Preventability and outcome measures were also assessed. Medications responsible for DRP were classified according to the Anatomic Therapeutic Chemical (ATC) classification of the World Health Organization. 3. Of the 1000 admissions studied, 115 (11.5%) were owing to DRP, 81% as a result of drug therapy failure and 19% as adverse drug reactions. A total of 106 out of the 115 DRP cases (92%) were either preventable or probably preventable, most of which had to do with either prescriber or patient error. An overview of DRP showed that 58.3% resulted in complete recovery, 33.9% in relative recovery and 7.8% in death. Close to 1% of hospital admissions resulted in DRP-related deaths. 4. The overall prevalence of hospital admissions caused by DRP is similar to that in free market pharmaceutical systems. The high preventability rate of these problems should alert clinicians and policy makers to design strategies to curtail this. Also, reasons for differences in subtypes of DRP between the results of this study and those of the literature from free market systems needs to be investigated further. [ABSTRACT FROM AUTHOR]