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Objective(s): One of the most significant influencing factors in patient safety is the existence of a patient safety culture in the hospital. Patient safety culture is one of the important topics and one of the important concerns of managers and policy makers of the health system. This systematic review was conducted with the aim of determining the status of patient safety culture in Iranian hospitals. Methods: In this systematic review study, electronic search in Farsi and English using keywords Patient Safety, Hospital, Patient safety culture, in databases Medline, Google Scholar, Elsevier Direct Science, Ovid, PubMed and patient safety culture, patient safety and The hospital was conducted in the database of Jihad University Scientific Database (SID), Iran Nursing Publications Bank (Nindex), Magiran and Iranmedex between 2010 and 2020. Articles were extracted in 2021. Results: A total of 182 articles were extracted and finally 23 articles were analyzed. In most hospitals, the overall scores of patient safety culture were reported as low and moderate. The highest score was related to the dimensions of the manager's expectations and actions in the direction of patient safety and the transfer of important patient information between different departments and shifts, team work within the department and organizational learning, and the lowest score was related to the dimensions of non-punitive response to events and the dimension of openness of communication channels. Conclusion: valuing patient safety can be effective in the development and progress of hospitals in the country in order to improve the culture of patient safety. Improving relationships and teamwork within hospital units and creating a non-punitive environment can be effective in improving patient safety in the hospital.

Objective (s): Hospital indicators are very important in indicating their performance. Indicators are used as a tool to compare the number of services, evaluate services, compare services with standards or compare them with previous years. The aim of this study was to determine performance indicators of hospitals in a number of teaching hospitals and comparing them with performance indicators of Ministry of Health and Medical Education, 2019 Methods: This was a cross-sectional study that descriptively examined the performance indicators of 12 hospitals affiliated to Ardabil University of Medical Sciences. The data were collected by referring to statistical unit of health deputy and analyzed using SPSS22 software. Results: The ratio of active beds to fixed in 9 hospitals (75%), bed performance ratio, admission ratio per bed and average length of stay in 10 hospitals (83.3%) and bed turnover interval in 7 hospitals (58.4%) were desirable. The bed occupancy ratio in 7 hospitals (58.4%) was poor compared to the standards. Conclusion: The performance indicators of the hospitals affiliated to Ardabil University of Medical Sciences were relatively good compared to the standards. However, there is a need for promotion and improvements. Therefore, it is necessary that managers take the necessary proceedings to increase hospitals’ performance indicators.

Human fumarylacetoacetate hydrolase (FAH) domain containing protein 1 (FAHD1) is a mitochondrial oxalocatate decarboxylase, the first of its kind identified in eukaryotes. The physiological role of FAHD1 in other eukaryotes is still poorly understood. In C. elegans loss of the FAHD1 ortholog FAHD-1 was reported to impair mitochondrial function, locomotion and egg-laying behavior, yet the underlying mechanisms remained unclear. Using tissue-specific rescue of fahd-1(-) worms, we find that these phenotypic abnormalities are at least in part due to fahd-1's function in neurons. Moreover, we show that egg-laying defects in fahd-1(-) worms can be fully rescued by external dopamine administration and that depletion of fahd-1 expression induces expression of several enzymes involved in serotonin biosynthesis. Together, our results support a role for fahd-1 in modulating serotonin levels and suggest this protein as a novel link between metabolism and neurotransmitter signaling in the nervous system. Finally, we propose a model to explain how a metabolic defect could ultimately lead to marked changes in neuronal signaling.

Introduction: Use of fluoride compounds is one of the most effective ways of preventing decay and among these varnishes have high acceptance among different fluoride products. Aim: Hence, the aim of this research was to evaluate the microhardness of tooth enamel after the usage of two different commercial products of fluoride varnish. Materials and Methods: This in vitro experimental study was performed on 51 extracted premolar teeth. The teeth were divided randomly into three 17-membered groups. The first group received Duraflor varnish, the second group received Ariadent Iranian varnish while the third group received no treatment. Micro hardness of tooth enamel was measured utilizing Vickers method before and after the use of fluoride varnish. ANOVA, Tukey, and Wilcoxon statistical tests were utilized for statistical analysis of data. Results: The comparison of mean change in micro hardness before and after the use of fluoride showed that increase in micro hardness in Duraflor varnish and Ariadent varnish group was significant when compared to control group (p0.05). Conclusion: According to the findings, the use of fluoride significantly increased the enamel micro hardness which did not show a significant difference between two groups of Duraflor varnish and Ariadent varnish.

While patients with obstructive sleep apnea (OSA) or multiple sclerosis (MS) are at high risk of developing postoperative complications, both of them have special anesthetic considerations in intraoperative and postoperative periods. A careful preoperative evaluation, use of the optimal anesthetic regimen and close postoperative care is essential for these patients. Rarity of coexistence of both obstructive sleep apnea and multiple sclerosis in a surgical patient necessitates careful anesthetic management. We here report anesthetic management of a female patient with OSA and MS who underwent anesthesia three times for surgery and review the literature.

Upper limb fractures are prevalent injuries. An essential element of fracture healing is to maintain the bones alignment. However there are lots of complications associated with traditional ways of treatment, such as compartment syndrome and stiffness due to immobility for long time. Also evaluation and observation of the limb under the casts for potential infections and skin issues are not possible. By this article an invention of puzzle shaped cast for upper limb is introduced. This novel cast is made up of different parts that they complete each other and join as pieces of a puzzle to shape a cast. By this mean physical examination during the healing process is possible and the complications could be less.